Hi All
I was all set to start on MTX tomorrow but have have now been told to wait until my GP has spoken to my Rheumy as my DEXA scan shows I have thinning bones of the spine! GP was concerned as I am only 54 as he put it.
Any experience out there please?
Thank you. Hope you all have a good day x
Hiya Usha. I had my first DEXA scan at 49 which put me right in the crossover from green to amber (done abroad & a different scoring system) so considered osteopenic. I'd been diagnosed two years previously & I was on 15mg MTX & other RD meds at the time with the occasional course of steroids. My next one was 2 years later, taken as part of my initial testing requested by my UK Rheumy to consider if all the meds my previous Consultant recommended I continued were necessary. The results from all the normal Initial diagnosis testing all were deemed necessary but the DEXA results showed slight deterioration, -1.6 at the lumbar spine & -1.5 at the femoral neck. As these results were borderline my Rheumy made the decision to start me on ADCal-D3 & a bisphosphonate (Alendronate) but I didn't tolerate that very well so now take (Risedronate) but starting to have side effects from that. My GP is happy for me to change to an infusion though my Rheumy is concerned that as I haven't tolerated the previous bisphosphates that I may have increased a hightened intolerance to an infusion. My next step is to talk through with my GP just where we go next to preserve my bone density & try to slow progression.
Maybe your GP wanted to be sure that your Rheumy is happy for you to start MTX, it's his call as the prescriber & will prefer to put it past him before prescribing it, covering his back so to speak, but I wouldn't have thought it was any detrement to start on it. It's never been a cause of concern in my case, rather the amount of steroid treatment I've had historically & continue to have. Controlled studies have been done to determine if the risk of developing fractures are increased by taking MTX & it's been found to be unlikely that there is any increased risk of osteoporotic fractures & why I think he'll likely give the ok. You don't give your results but I would think your GP has probably only referred older people for DEXA scans as part of OA treatment & why he said "only 54".
Hope this helps.
Hi NMH, thank you for your comprehensive feedback as always!
It was the Rheumy who requested the dexa scan and didn't have the results when I saw him on Wednesday. It was only yesterday when I went to pick up my prescription that my GP said the dexa shows thinning of the spine but did not elaborate only saying not to take MXT until he had spoken with Rheumy. So, I do not know the actual results and the fact that GP would not give them to me is also a little concerning. I have requested the results from my Rheumy.
Wow, you really seem of have been put through the mill health wise. So sorry for you!
Thanks again x
I'm reasonably sure you've no need to be concerned. Obviously it depends on the results & your GP didn't give you those so you'll just need to wait until he's spoken to your Rheumy, he's the one to make the decision though as I've said I think steroids are the usual concern. I've been on MTX coming up to 7 years & it's never been mentioned or questioned, that's with 4 different Rheumies so until you have sight of the report (if you asked to be copied in on yours) it won't be clear. Does he know much about how Rheumatology, is it listed as one of his interests?
I had been diagnosed osteopenic. But was on methotrexate for five years until I was stopped for cough side effect . I wouldn't be worried. I am sure the GP and rheumy will sort this out.
The more hatful drug with osteopenia is steroids. Steroids will thin the bones down if taken long term
I was on MTX for several years when a cancer diagnosis and the need for chemotherapy meant I had to stop. After cancer treatment I was sent for DEXA and was told I was osteopenic. However, I now have Vasculitis, and back on MTX 25ml injections. As well as steroids. Prednisolone is worse for causing bone thinning, as is Anastrazole (anti cancer drug) but all I take at the moment is Adcal D3. If you have concerns, visit: nos.org.uk/
All the best. xx
Thank you poemsgalore1 for the link and your thoughts xx
Au revoir for a little while
Just a little update on a diagnosis.
Feeling a little deflated
Feeling a fraud and a little homeless!
