Bone Health
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ON PREDNISONE AND HAVE OSTEOPOROSIS

I have PMR and I am on Prednisone. My osteoporosis T score -2.6 in my back and -1.5 in my hips. I have a 10% chance of a hip fracture in the next 10 years and a a 23% chance of a compression fracture in my back in the next 10 years. I have been on Prednisone for 6 months. My doctor wants me to start Prolia now. I don't want to. I want to go on a strick diet of calcium rich foods, calcium supplements, vitamin D and nordic walking at least 2 miles each day. I already started this about 2 months ago. I get another bone density test in September 2018. I would be interested in all your opinions. Thank you very much.

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Please don't start Prolia with scores like that. You may never be able to come off it. It's implicated in rebound osteoporosis. Have a look at this:

healthunlocked.com/pmrgcauk...

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I agree strongly HeronNS and with Met00 that or risk of a fracture is not really that high! I would 100% try and stick to as natural an approach as possible !

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If I decide to take a drug for osteoporosis, what would you reccomend I take?

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You absolutely have to work that out with your doctor. I am not qualified at all to make such recommendations. What country are you in? There is almost certainly an Osteoporosis organization with a helpline of some sort where you can get your questions answered. Good luck. I'm sure you will make the choice which is right for you.

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I'm in a very similar position, but I have recently suffered a compression fracture of the spine. I'm under great pressure to start bisphosphonate infusions. I've read a number of articles about natural methods, and I've been taking the supplements, including K2, magnesium, D, calcium, prunes etc plus walking. Still the fracture occurred. I'm in a real quandary as to what to do. Sorry to be negative but I may have no real choice. I've spoken at length to my GP and she says bisphosphonates despite the recent research is the best they've got.

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What where you doing when you got the fracture and how long have you been on your supplements?

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I've no idea - I wasn't aware I'd fractured it until my rheumatologist sent me for an x-ray because of continuous pain around my chest / back. I suspect it was a rather energetic dog we were looking after who just pulled and pulled! Id been on calcium and vit d supplements all the time I've been on pred - 3 years. I've only been taking K2 for the last 6 months.

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Thanks for your reply. The K2 helps direct the calcium to the bones. I also take k2 and walk 2 miles a day.

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I have Vasculitis and have been on Prednisolone for 4 years. At the beginning of my treatment I was on 80mg daily with 1gram infusions over 1 week, at the same time. Gradually reducing to 5mg. I've had 4 fractures in my spine and now have bisphonate infusion along with Adcal D3. I have no problems with them.

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There may indeed be a case for a couple or three years of bisphosphonates in a situation like yours. It's denosumab which is turning out to be a real problem because you can't just stop taking it. There's too much risk of developing rebound osteoporosis, caused by withdrawal of the drug and unrelated to the original diagnosis. Prolia should NEVER be offered as the first line drug.

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Your T-scores aren't that bad, so I'm surprised your GP wants you to go straight onto Prolia! A T-score between -1.00 and -2.5 is not classified as osteoporosis, but osteopaenia, so your hip score is well within the osteopaenia range and your spine score is only just in the osteoporosis range. Another way of looking at the risk is that you have a 90% chance of no fracture in your back in the next 10 years and a 77% chance of no fracture in your spine! However, unfortunately one of the side effects of prednisone is that it can weaken your bones, so I think it's normal for GPs to advise some sort of osteoporosis medication. As you don't want to take any medication at this stage, maybe your GP would be happy to monitor your bone health, particularly as you're due another DEXA scan in September. If you do decide to accept medication there are a number of alternatives to Prolia which could be considered first. You might find it helpful to talk to the NOS nurses about your options: freephone 0808 800 0035

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Thank you so much. I am sure glad I joined this discussion blog.

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In case you haven't seen it yet, my journey: healthunlocked.com/pmrgcauk...

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