Bone health a d Methotrexate

[4201]

Has anyone had any change in their bone density after being on Methotrexate for an extended time like 2 plus years? I had a spontaneous fracture of my knee and tibia. The orthopedic surgeon said it is osteoporosis causing this.

[Amy_Lee]

I did the BMD scan after 2 years of mtx. My left hip was diagnosed for osteopenia but no treatment was given. Started the calcium tablet 7 months before the scan though.

[4201 in reply to Amy_Lee]

Thanks for your response.

[helixhelix]

11 years on MTX and no change to bone density (when last checked a couple of years ago).

Women with RA have a slightly higher risk of osteoporosis, also if you are older, smoke and drink, have taken lots of steroids, don’t have a good diet, and have family members with it. Sadly it cal also happen with no risk factors, and a spontaneous fracture must have been scary. But I don’ think you can blame 1 year or so of MTX.

[AgedCrone]

I was on Mtx for 7 years & had no bone density problems.Even though I fell last year & fractured vertebrae ...a Dexa scan showed I had no osteoporosis even though I’m 70+.As you have been told you do have osteoporosis...maybe you should ask your doctors if you need to start taking some preventative treatment?

[allanah]

Had bone scans and still have strong bones thankfully x

[Hidden]

I have osteopenia, but have never been given a specific treatment..... I took calcium and Vitamin D for a couple of years, as they help with this. Now I take SevenSeas Women 50+ which has all-sorts inside, 2 tablets a day except for MX day, when I don’t take one of them as it has folic acid in. I’d recommend them if you are the right age

[Hidden in reply to Hidden]

Sorry... to answer your Q... I have been on Mx for about 10 years x

[nomoreheels in reply to Hidden]

Hiya CripLady. Only just seen this so a bit late coming back to the post, missed your reply somehow. Anyway, I’ve recently been doing some research on a supplement so it's fresh in my mind. I don't know if you realise but the quantity of folic acid in the supplement you’re taking is very small (200µg). This equates to 0.2mg, very much lower than the 5mg we generally take so I would have thought the effect it would have on MTX would be minimal.

[dippyd09]

I have been on MTX for 22 years. I was diagnosed with osteoporosis last year but I don’t think it was due to the. MTX, personally I think it was my diet. I didn’t eat enough food with calcium as I thought the calcium supplement would suffice so really it is my own fault. I now eat a healthier diet and try to do weight bearing exercises twice a day, nothing adventurous but just trying to improve my bone density.

[nomoreheels]

Not due to MTX (nearly 12 years) but to corticosteroids, intermittently for 3 or 4 years, 6 years continuously. I have tried 2 bisphosphonates & had to stop both but I do take Adcal-D3 twice daily. I'm sure you must have similar in the US? I also have DEXA scans biennially as I have osteopenia/borderline osteoporosis. My fracture risk has reduced with each scan which I can only put down to Adcal & reintroducing more dairy in my diet.

Have you had DEXA scans to work out your FRAX score or was it not known you have osteoporosis prior to the fracture? Ouch by the way. Post menopausal women do have greater incidence of osteoporosis due to reduction in oestrogen, important in retention of bone density. I don't know if you're of that sort of age?

[4201 in reply to nomoreheels]

I have yearly bone density scans and have a -2.5 score in spine and hips. I have stayed the same. Just turned 70 so officially really old! I now have a second fracture of the tibia in the other leg. My rheumatologist recommends PROLIA injectible starting immediately. Thanks for the response. I can't blame the Methotrexate. I need to get this bone problem under control. Very depressing.

[nomoreheels in reply to 4201]

Give over, 70 is the new 40 don't you know! Well, as you'll know your score is in the osteoporosis range & is why the Prolia has been recommended. I hope it makes all the difference for you. My GP wanted me to try an alternate injectable bisphosphonate, Reclast, but my Rheumy advised against it as she considered the side effects I had from alendronic & risedronate acid would be either the same or possibly increased. We decided on an increase in Adcal & including more dairy would be worth trying & it has helped. I wasn't in the same category as you though.

Again I do hope the Prolia helps & you have no further fractures. Worrying times for you I’m sure so take good care.