What is my fracture risk?

[Zadock]

I was diagnosed with osteoporosis last November and prescribed Alendronic Acid. I was slow to begin taking it, wanting to understand the risks and benefits etc. But I wasn't told what my risk of fracture is? The report I was sent shows T scores and Z scores but not the risk of fracture.Has anyone else here had the same situation? Do I simply need to ask, or can I work it out for myself?

It would be good to know, as if it's pretty low I may well stop taking the medication! I haven't had any fractures or problems so far......

[Stayloose]

If you search ' fracture risk assessment tool'you could perhaps work it out yourself. Otherwise ask GP for a copy of the full report..

[Zadock in reply to Stayloose]

Thank you Stayloose. I’ll do that.

[1ChLoE]

Hi There is Fracture Risk Assessment Tool ( FRAX) university of Sheffield. It a tool to help you find you fracture risk. You answer a list of questions and it tell you your score.

[Zadock in reply to 1ChLoE]

Oooo thank you 1ChLoE! I'll take a look.

[MWZ3]

How many fractures have you had? Your bones may be strong. If you’ve had zero fractures then you likely have zero risk. If you stay on the drugs though for any length of time that changes. People have reported fractures when they come off.

[MWZ3]

I just did that and although I have osteoporosis my risk of fracture is low probably because no broken bones to date and I’ve never smoked.

[Zadock in reply to MWZ3]

What do you mean by low? Mine comes out at 18.7% which is more than I had hoped! Assuming I'm reading it correctly. And that's with no previous fractures or smoking. I don't want to take the medication but equally don't want to become stooped or break bones in the future.

[MWZ3 in reply to Zadock]

Depends how old you are. I’m 78 in December so that alone says I’ve got this far without breaking bones and osteoporosis was diagnosed at 70. Not just borderline either! My number was 3.3%.

[Zadock in reply to MWZ3]

Well done! That's good to hear. I am 63 and my spine T score was -2.5 (hip was -1.7). Doing the FRAX calculation the results box was red and showed 'BMI 18.7% - the ten year probability of fracture' and then below that 'Without BMD - major osteoporotic 7.9'and 'hip fracture - 1.7'. Not sure what those bits mean? Thanks for your advice MWZ3.

[Stayloose in reply to Zadock]

I think that means that 7.9 people in your situation, out of a hundred, would get a vertebral fracture in the next 10 yrs, 1.7 people a hip fracture. low chance 😊

[Zadock in reply to Stayloose]

Thanks Stayloose. That sounds good. I assumed though that the risk was the 18.7% figure. Is it not?

[Stayloose in reply to Zadock]

Best check it with your GP.

[Stayloose in reply to Stayloose]

Hmm. Is it your BMI thats 18.7 ? That would be your weight. Are you on the lean side?

[Zadock in reply to Stayloose]

Oh yes it could be! Hopefully I’m an idiot and mis-read the results. Thank you 😀

[MWZ3 in reply to Zadock]

That’s not even osteoporosis really. I’d like those numbers. Maybe go the natural route as people who are borderline like that seem to be able to pull it back easier I’ve noticed from comments over time. The 1.7 one is the condition of all your bones from what I’ve read.

If you go by the lowest score you’re not too bad at all.

[Zadock in reply to MWZ3]

Thanks MWZ3. It’s so helpful to have feedback like this.

[FearFracture in reply to Zadock]

I was diagnosed at 50 and my lumbar spine was -3.9 and hips were around -3.1ish. I’m small, 4’11” and currently I weigh around 107lbs but prior to my original DEXA scan, my weight was a good deal lower—pointing this out because weight effects bone density. I have no fragility fractures, have never smoked, and rarely drink. If my numbers were as good as yours I wouldn’t have taken meds.

If you are interested in attempting to improve your bone density w/o meds go to BetterBones.com and on that website search Cindi’s story. I think she was around your age and she was able to reverse her bone loss naturally. Also look up OsteoStrong.me. If there were an Osteostrong w/i 2 hours of my home I would signed up to use their program.

[Zadock in reply to FearFracture]

Thank you so much for this! I’ll take a look at your suggestions. From all the advice here I’m tempted to stop the medication. I’ve only been taking it just over a month. And yes, I’m working hard now on diet, supplements and exercise. Never thought that health would take up so much of my time!

[walk21]

I wonder why you were tested and offered medication if you have not had fractures. That might be important

[Zadock in reply to walk21]

I think because I asked for it, and my mum had osteoporosis, but not until her 70s. And perhaps because I have auto-immune thyroid disease.

[MWZ3 in reply to Zadock]

Maybe treat that as it explains the osteoporosis.

[Zadock in reply to MWZ3]

I suppose the start of it may pre-date my hypothyroisism diagnosis,but it was picked up quickly (about six years ago) and has been treated since then. So I don't think that is the cause of the osteoporosis which perhaps has more to do with too much time sitting at a desk in my thirties, forties and fifties! Plus family history. I am now doing weight bearing exercise, pilates, lots of hill walking etc. Better late than never I hope.

[MWZ3 in reply to Zadock]

Sounds like you’re younger than I am. Are you taking vitamin K2? I’m guessing you’ve been doing things like checking your vitamin D levels and calcium and having the fruits and vegetables and oats and all the goodies to support your bones

[Zadock in reply to MWZ3]

Yes I do take K2 but only started about a year ago. I’m trying to do the right things now re diet, exercise, supplements etc. Better late than never!

[Cappuccinobaby]

Have you had hyperparathyroidism ruled out as a cause for your osteoporosis?

[Zadock]

I have Hashimotos (hypothyroidism) which may be relevant but not necessarily the cause of this. But thanks for the suggestion. It's just difficult to weigh up the pros and cons of medication and make an informed decision!

[FearFracture]

For smaller ppl, I’ve read that the FRAX so is not as accurate. The example I heard is that if your t-scores are say -3.5 range and you are a 5’1” 110 lbs woman your bones may be stronger than a DEXA and FRAX score imply and that it is probably a good idea to get a TBS (trabecular bone score) to give you a better idea of your bone strength. My endocrinologist failed to do any type of baseline measures before putting me on meds. I only learned later how sloppy he was/is about treating my low bone density. The TBS is not a separate scan, meaning it can be done/calculated when you DEXA is done you just need to make sure the imaging center you use has the capabilities to do the TBS (it’s basically software that can be loaded onto existing DEXA machines). Also look at my bio, there are 2 links, 1 is for tests to rule our secondary causes for osteoporosis, the other link is for bone turnover markers. It’s best to have bone turnover marker tests done before you start meds and then once you start taking bisphosphonates a few months in, you have the bone turnover marker test again to see if the drugs are working. That way you don’t waste 2 yrs between DEXAs taking a drug that might not be working for you.

[Zadock in reply to FearFracture]

That’s so interesting. Thank you. I’m 5 ft 4 and 110 lbs so smallish and light. I’ll definitely check your suggestions. My endo requested the tests three months after starting medication and I had a DEXA scan before that but maybe that’s different? It does surprise me that he and my GP had no hesitation in saying I needed medication.

[FearFracture in reply to Zadock]

Sounds like they looked at your petite frame and age and your lumbar t-score and that’s it. Dr. Lana Simpson lanisimpson.com/ talks a lot about DEXA scans (often about how they are misread or performed incorrectly). One thing she mentioned is if your wrist is smaller than 6” you are smaller boned and your DEXAs can be “off”. I guessing you might fall into that category.

Another thing I’ve read is that it’s easier for women to increase lumbar bone density than hip density. Since you back is your lowest number back extension exercises, especially weight, might help improve your spine.

Also, some women have had luck improving BMD by doing HRT (hormone replacement therapy). I think that bisphosphonates and HRT both lower the P1NP.

[Zadock in reply to FearFracture]

Thanks for all your comments. Really helpful. I’m grateful.

[nottowell]

I took Aldronic Acid for a long time but the side effects were awful, so i now have prolia injections twice a year, there are side effects to all of them but at least i don't feel them i havehad 6 fractures

[Zadock in reply to nottowell]

Oh dear - how difficult for you. What side effects did you have on alendronic acid?

[nottowell]

Sickness for a few days then time to take another one wont go back on them again fine on prolia