Hi,
My blood turnover results (P1NP and CTX) are good, PTH within range as are my thyroid function results. 24 hour urine calcium is below the minimum range. I am not on any osteoporosis medication. I have osteoporosis in my lumbar spine (DEXA -3.5).
As my bone turnover and thyroid function results are all favourable what else could be the cause of my osteoporosis? Thank you
Do you not have osteoporosis in your hips and well? It's a systemic disease, meaning that bone loss is normally experienced at a similar rate throughout the body. When I was first diagnosed, I was told my t-scores were -3.2 (spine) and -2.3 (hip). At my next scan my spine was -3.6 and my hip -2.5. 16 months later I then had a REMS scan, which showed both scores to be identical at -2.6! REMS is more reliable than DEXA (unfortunately only available privately and in limited locations), and it seems very clear to me that an error was made in scanning my spine. If you have any curvature of the spine it can make it far more difficult to line you up properly on the scanning bed. So if you only have osteopenia in your hips, then it's likely that one or both measurements are wrong.
Having said all that, there are multiple reasons for bone loss, including lack of exercise, inadequate diet (including, but not exclusively, insufficient calcium, magnesium and protein intake), low Vitamin D (responsible for absorbing calcium), other absorbency issues (eg coeliac disease), certain medications (eg PPIs and steroids), a family history, early menopause...... Have you had your parathyroid levels measured at the same time as calcium and Vitamin D? Does your 24hour calcium test simply show that your body isn't getting rid of much calcium, or is the level low because it isn't taking in enough to be able to excrete much? Or is it being retained in your blood because you have raised parathyroid levels? These are all things that should be checked out. For most of us, there's unlikely to be one single cause, but rather a combination of two of more factors. In my own case, I suspect low Vitamin D levels, early menopause, too much sugar in my diet, reduced absorbency due to IBS, and a sedentary lifestyle!
Thank you. Lot’s to think about. All my blood results are within range. How do I determine the cause of low urinary calcium? My vitamin D levels are very good. Oh, and my hips are osteopenia. 😊
Apparently low urinary calcium can be a sign of problems with the parathyroid hormone. Other than that, I don't know what can cause it. Have you had a blood calcium test done, at the same time as parathyroid blood test?
If your hips are osteopenia and your spine -3.5, that's a huge difference and I would want to know why! Many doctors say it's just the way it is, but some experts are adamant that this means one or both measurements are wrong. In my case, the spine score was wrong.
My endocrinologist didn't test for secondary causes of osteoporosis or any of the bone markers before prescribing osteo-meds. Unforutanely, I'd already taken alendronate for 1.5 years and had a zoledronic acid infusion in November 2019, before learning my dr should have run these tests before prescribing osteo-meds.
When I saw my endocrinologist on August 31, I mentioned to him that I wanted to start monitoring my bone turnover markers. He wrote a prescription/referral for the following bone turnover markers:
- CTx, C-terminal telopeptide if type 1 collagen
- NTx, N-telopeptide cross-link
- osteocalcin
- P1NP, pro-collagen type - 1 N - terminal propeptide
I recently listened to a webinar about bone turnover markers. The person who hosted the webinar provided a pdf about bone turnover markers*. During the webinar they said that in order for bone turnover marker tests to be accurate you need to do them while fasting and avoid certain supplements etc. I really want my test results to be as accurate as possible so I want to do them correctly. If anyone is familiar with what exactly you are supposed to do or NOT do before having these blood tests, could you please let me know. My doctor gave me the prescription with NO instructions.
I have already scheduled an appointment to have the tests done next week and I am just trying to make sure I do them correctly.
Thank you.
*IF anyone is interested in looking at the bone turnover marker pdf mentioned above, there are 2 links in my bio you can cut and paste into your browser, one of the 2 links is to the bone turnover marker pdf.
There are a number of causes of osteoporosis which all should be checked when decisions are being made about medication, etc. This site discusses secondary causes of osteoporosis.
osteoporosis.ca/about-the-d...
Another thing which can skew the results is the presence of osteoarthritis. This can (much to my own concern) cause bones to seem a bit more dense than they really are.
There are so many factors. Perhaps, as it appears the usual tests have been done in your case, it comes down to lifestyle and possibly also nutrition. The body needs Vitamin K2 (not K1) to send the calcium to the bones, Vitamin D cannot do this. Magnesium is another important mineral for proper calcium absorption. Some people say that a higher intake of boron is also helpful (hence the populalrity of prunes, although there are a number of other good sources).
Also, appropriate exercise is needed. The constant slight stress on bones which something as simple as walking can make can be enough to stave off the bone thinning which eventually leads to osteoporosis. It's important to do some kind of weightbearing exercise, walking is simple, walking with a weighted vest is even better. Swimming is not so good in the sense water actually bears your weight for you, but the strengthening effect of water exercise has an indirect effect on improving bone density as the muscles themselves provide some of the needed stress.
If you hve no compression fractures, do look into the possibility of using a weighted walking vest. The best kind has very small weights so the amount you carry can be increased in very small amounts for your safety. It isn't the amount of weight you carry, but the steady increase which continually challenges the bones.
Thank you! No compression fractures. Taking supplements, calcium preparation containing micro nutrients, vit. K2 and vit. D.
Have just bought a weighted vest, walk almost every day, practice tai chi and am a vegetarian.
Not sure being a vegetarian is necessarily an advantage, (neutral?), but the rest looks very positive. I was able to turn things around for myself in a year in spite of taking prednisone. You might like to ask your doctor to keep tabs on that low calcium though. Btw I am sort of vegetarian, definitely not vegan. As I now seem unable to eat beans in any form my main source of protein is nuts and animal products (eggs, dairy). Basically all I've really given up is meat, including poultry.
Hello. I have Osteoporosis and have Hashimoto's disease. I had OP long before my thyroid issues were diagnosed. Are you menopausal? I decided not to go the route of medications, read all I could regarding a natural way to treat the condition. To be clear I have always had low sugar, very nutritious non-junk or processed food diet and have done regular weight-bearing exercise all my life. My blood boils when I'm told OP is due to smoking, too much alcohol, poor diet, lack of exercise etc. None of these factors has ever applied to my particular situation. I followed a stricter than usual protocol of diet, exercise and precise vitamin and mineral supplementation for a period of five years and my Dexa scan remained unchanged. My very good Endocrinologist supported me in my quest but has since stated that he has never seen a woman reverse OP post-menopause through natural means. It seems that there is just something in the body system or metabolism that ceases or shuts off this bone-building process around the time of menopause. My bone turnover is normal and my calcium and vitamin D blood serum levels have always been near the top of their ranges.
Thank you Baobabs. Like you I have always lived a fairly healthy lifestyle. I am 61 so have been through the menopause. I have rheumatoid arthritis and am on Abatacept for it. Other than that, I am on no other medication so I think what you say may be correct. No known history of osteoporosis is my family. Thank you for taking the time to respond. Take care.
You are welcome, however, this whole situation is like trying to find the missing link. My feeling is that the causes of OP are much more complex than anyone seems to think. I can understand why folk try to find one or some reasons in the plight to resolve the mystery. If it were as simple as say diet, exercise and clean living then we wouldn't have queries like yours or probably unhelpful replies like mine. There are patterns and trends though. The western world seems to have significantly more cases than other parts of the world. I have tiny bones and I can't believe Dexa scans allow for this. surely the density of a very large boned person can't compare with my chicken bones? Does the machine adjust for such variables? I have also researched bone quality. I have never broken a bone in my life despite still running and weight training. From my reading about OP treatments, apparently, bone growth, as a result, can be brittle and prone to breakages. Up to the age of 45, my Dexa scans were fine. Those I had at 60 showed a severe bone loss. I know people who have built bone and come out of OP. As well as changes in diet and exercise, they have taken some kind of drug therapy. I would be very interested to hear from anyone who has reversed OP even to Oesteopenia, using natural means.
Baobabs, we are both on the same page! I am Asian and small boned too. I have read a study where Chinese women who are also tiny have low bone density but tend not to have fractures etc. I agree that we do not fit into the scenario of ‘one size fits all’. Likewise with my RA medication, I was given a standard dose the same as would be given to say someone twice my size and suffered horrendous migraines. Thankfully my consultant was understanding and agreed that maybe the standard dose was too high for me so I now take the med once a fortnight as opposed to weekly!
Ahh, that's good news. An astute medic! Really, I have and still am trying everything to halt and reverse OP but would invite anyone, anyone to offer up a natural regime that offers some success at bone building.
Hyperparathyroidism is a big cause of osteoporosis. It causes calcium to be constantly released from the bones into the blood stream and is due to an over active parathyroid gland and is resolved with a small operation and can lead to the reversal of osteoporosis. Get your GP to test your calcium. If its out of range then you need to get your parathyroid hormone level check.
Thank you! My blood calcium and PTH results are both within range so could hyperthyroidism still be an issue? What other tests would I need?
Do you know the results of your calcium and parathyroid hormone and the ranges they are marked against. My 1st pth level was at the end of normal so i was dismissed the next one was way out.........ive just had a parathyroidectomy and because i have no other health issues my surgeon has advised me that my bone density should return to normal within 2 years
That’s good news for you. My Ca was 2.41 mmol/L (range 2.2 - 2.65) and PTH 3.1 pool/L (range 1.6 - 6.9)
Are you on any medication which can affect calcium or parathyroid hormone. Have you had vitamin d checked ?
Not on any medication that would affect calcium or parathyroid and vitamin D levels are always good, well above the minimum required.
Have your physicians suggested any causes early menopause for example HRT meds? Have you every been treated for cancer as some chemo drugs can result in osteoporosis.....other than that I have no advice😔
Thank you. No to all the points you raise
This doc discusses his belief that OP can be prevented/reversed through natural means. A lot of what he says has been discussed here but he goes a bit more in depth. Hope this is helpful... youtube.com/watch?v=2Qv01Wf...
Thank you. I’ll listen to it later
Thank you for posting this. So nice to hear a physician describe how osteopenia and osteoporosis can be prevented or reversed through non-medicine means. Unlike a mere patient like me describing their experience he has the knowhow to list the various common medications which can contribute to bone thinning. I also like that he knows about Vitamin K2 - how many doctors do?
buddytobuddy why not make a new post telling community members about this video? It is exactly the sort of succinct, clear information we need!
Thank you, HeronNS and happy you found it helpful. I will create a new post now.
Just listened to it. Very interesting, thank you buddy to buddy
You're very welcome, Mistydawn . I find myself referring back to this video when I need to be reminded to stay the path in regards to more natural means of addressing my OP. Best wishes to you!
Best wishes to you too Buddytobuddy and thanks again for sharing
Someone once said to me that if your father had it you are almost bound to get it. My father was very bent, though I never heard osteoporosis mentioned. He died in l966, so I don't know how early it was diagnosed. Don't know if it's true or not, but I blame my genes.
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