Undecided

[Viking1822]

I had a bone density scan in the summer and was told I have osteoporosis. I am 80, I thought I was quite fit but now I'm frightened of falling.

My Dr has suggested taking Alendronic Acid tablets. I looked for a support group and came across your website. I've been reading all your stories and feel quite frightened of the treatment.

I've always had to be careful of what I eat, no spicy foods etc. and had IBS for years. I also have a phobia about taking tablets and have to halve them sometimes.

I was told I have to start off with the tablets. GP not very sympathetic and makes me feel I'm being awkward. I have to think about it.

Wish I hadn't chosen such a silly title. 😊

[Met00]

I suspect most people in their 80s would be shown to have osteoporosis if they had a DEXA scan, because we all lose bone density as we age. Can I ask why you had the scan - have you had a fragility fracture? Whether or not to recommend medication should be based on your FRAX fracture risk score, combined with your age, not on your t-scores alone. Do you know your FRAX score (eg 10% risk of fracture in the next 10 years)? At age 80 you would need around a 20% fracture risk in order for medication to be considered beneficial - see the chart here: nogg.org.uk/full-guideline/....

[Viking1822 in reply to Met00]

I'd had back ache, I was referred in April and had a bone density scan in August. I haven't had a fracture. An MRI scan in the past showed my spine is curved. Looking on Patient Access the fracture risk assessment report mentions 10 yr fracture risk major osteoporotic is 15% and 10 yr risk of hip fracture 6.4%. T-score of AP Spine -2.0 and Right femur in Neck -2.8 Recommended scanning in 3-5 yrs. I take Evacal D3 . Hope this answers your question. I don't understand a lot of the information. Thank you very much for replying .

[Met00 in reply to Viking1822]

In that case I would take that chart to your doctor and ask why he recommends medication when it isn't indicated in NOGG guidelines, because your 15% fracture risk is below the 20% threshold! I'm not saying not to take the meds, because that has to be your decision, but I would certainly want to discuss it further with your GP. A lot of GPs don't know a great deal about osteoporosis and it may be that, with an osteoporosis diagnosis, he simply believes that indicates the need for medication. Or it may be that your DEXA report recommends it, but again I would question why. At your age, those sound remarkably good t-scores (they compare your bone density to an average 30 year old, giving an estimate of how much density you may have lost since peak bone density at that age). Your scores are similar to mine, but you're 12 years older than me!

Has your doctor sent you for an x-ray or scan to find out why you're getting backache? Osteoporosis isn't painful unless you've fractured, so if there are no fractures in your spine, there are a number of other causes, including disc and muscular problems and arthritis.

[Viking1822 in reply to Met00]

I have a young lady Dr, the backache was higher than usual but didn't last long. I assumed the scan was just a check because of my age. I was surprised to read recently that osteoporosis doesn't give you backache but it's just something we get if we overdo things. In 2000 and 2020 I had sciatic for months, an MRI scan showed it was a disc pressing on a nerve, it eventually stopped hurting as long as I don't pick anything heavy up. Thank you very much for that, I feel much more optimistic.

[Met00 in reply to Viking1822]

If you haven't had an x-ray or scan to check for the cause of your upper backache, then there's always a small possibility of a fracture. If that were the case, it would increase your fracture risk score. As it was short-lived, it's unlikely to have been a fracture, but it's your decision whether to pursue that further.

[Viking1822]

Perhaps I put it badly, I'm guessing the bone scan was only because of the backache which had stopped by the time I received an appointment for a scan.