Had my first dexascan last week. Nurse called tonight and said it showed slightly thinning bones. I was told to take 1500 mg calcium which I thought I was but now realize it was only 1000! I really thought I was on top of it all but my brain just does not due the job any more. Also I walk a couple times a week. Somewhat disappointed that I didn't get a better report but maybe it's good? Any suggestions of questions for gp next week. Don't see rheumatologist for 6 weeks. Thanks to all on this site who help keep me straightened out.🐰
Slightly thinning bones: Had my first dexascan last... - PMRGCAuk
I wouldn't just accept "slightly thinning bones" as a result! I'd want numbers - I got my full report in the post yesterday. I saw the results at the time though - and I suppose you COULD say my bones were "slightly thinning" with a t-score of -1.5, down from -1.3 over nearly 4 years. But that is still slap bang in the middle of normal and acceptable for my age.
Without being able to see a trend you can't really say anything much - but if all she suggested was a bit more calcium that's fine as long as you are also taking vit D. I take 1200 mg which is the normal suggestion here in Europe when on pred. Heron will know the other stuff that helps so I'll leave that to her.
Can you increase the walking? And resistance work with weights has been shown to improve bone density - done carefully that's fine even in PMR.
It isn't DON'T, it is BE CAREFUL. If you start with almost no weights and just maybe 4 or 5 reps and then build up SLOWLY, you should be fine. It is just that if you dive straight in, as most trainers would have you do, and do 10 reps and repeat with a significant weight then you will suffer sore muscles afterwards which can take days to recover. Everyone would be a bit sore to start with - but our muscles don't recover in the same way and it might put you off doing anything!
I take 800 IU vit D with the calcium supplements - which isn't really enough in the winter so i take a bit more. I live in Italy, spend a fair bit of time outdoors with no sunscreen but my blood vit D level isn't sky-high despite the supplements.
I used resistance weights for several years but I found little and often better than a big effort. And at times I was using the weights machines but without the weights! It did help and I wish I could find a gym round here but all we have are the expensive ones which is annoying as ALL I'd be able to would be the weights. I can't even use the pool as I am allergic to chlorine.
First off, please don't take too much calcium. It can lead to other nasty things, like kidney stones, or even increasing risk of stroke, etc. It's best to get about 600 mg through supplements and the other half in your diet. You need also to take not just D3, which should have been advised when you were told to take calcium, but also Vitamin K2 and magnesium. Most micronutrients will be available in a balanced diet, but sometimes we can't get enough K2 so that will probably need to be supplemented. You can get it from grass fed (never grain fed) animal products including dairy, as well as a small amount from fermented foods like sauerkraut and its kin.
The greatest risk factor for fracture is falling, so strength training (sensibly as PMRpro says) and improving your balance are key. Weight bearing exercise and optimal nutrition will keep your bones strong and healthy and encourage normal bone remodelling.
IMHO (and that of many others) if you eat a decent diet with a wide variety of foods then you don't need multi-vitamins. Especially if you get a lot of some vitamins in your diet - too much of some is worse for you than not enough. It's probably better to either adjust your diet or use specific ones you may be depleted in.
Even if you get 100% of the RDA for calcium in your food, it does help to have some extra because pred makes you lose more through the kidneys so the idea is that there is more present to be captured (if you see what I mean). You are replete in vit D I take it? Because if THAT is low, calcium isn't used properly, and diet will not help vit D - too few foods with a lot of it.
Read up on the other micronutrients. I respectfully disagree with PMRpro about the Vitamin K2 not being a necessary addition. Many of us live in places where our food supply is much corrupted - no access to grass fed animals for example - so our diet is deficient. I have to say I'm feeling better since I a) cut back on my calcium supplements and b) added Vitamin K2. Another thing is to avoid foods which can leach calcium out of the bones. I understand that a diet high in animal protein - and yes that includes dairy - is also high in phosphorus. And the usual advice, cut back on refined carbs and avoid sugar. I think Americans, for example, consume vast quantities of soda pop and whether artificially sweetened or not that's a bad choice.
Thanks for clarifying. It did seem from the way you described not needing extra vitamins that you were referring to everything except the necessary calcium +D. I used to take multivitamins until I learned better. Much better to get things through diet and targeting particular issues with individual supplements when required.
Not necessarily! I have two friend with PMR/GCA. One is in her mid-80s and has a bone density near to 1! The other was told in her mid-70s that her bone density was 98% of "normal". If they had had some thinning - the mind boggles what it was in their mid-20s which is when it is probably at its peak!
I think one of the things which muddies the water is we are all, no matter our size or ethnic origin, measured against the same standard. I'm beginning to think that because I have what are called small bones I'm naturally going to show up as someone with low bone mass. Of course. Different countries actually have different standards for what counts as osteoporosis because of this fact so a woman in India may show up as perfectly normal whereas in North America she could be diagnosed as having low bone mass. If I have time I'll try to find the reference for this.
Specifically looking at Indian population in relation to generalized Western population. Which I think begs the question that the Western population is extremely diverse.
The number that is taken as the line is said to be just a number pulled out of the air! Based on the bell-shaped curve of what bone densities are found in the general population. There is supposed to be no real research that says definitively "this is safe" or "this isn't" - I am willing to be convinced if someone shows it to me.
However, I think I said earlier: people with "low" bone density don't have fractures, people with "normal" bone density do. They might assume I have a problem as I have a history of fracture. But you have to look at why - it was a fall skiing, at speed though not at high speed. I still landed very hard!
Sorry about your bones. Eat lots of yogurt, cottage cheese, green leafy vegetables. Increase walking, weight bearing exercises., if you are strong enough, lift some weights.
I have osteoporosis and can't take calcium pills. Went through gamut of treatments. Had Prolio....10% improvement but Dr. Is going back to Reclast because I'm on Pred