PMR and Osteoporosis

[RheaV]

I've been diagnosed with PMR in the summer of 2017, though I suspect I had it a number of months before that. I started Prednisone at 15 mg, after a bit I went down to 10mg, and since then, I've been tapering very slowly and am currently on 3 mg with no PMR problems. But I had a bone density scan in January, and have been diagnosed with osteoporosis. I'd had osteopenia before that. I know that pred steals calcium from bones, but at the low doses that I am currently on, does that continue? I really don't want to take any drugs, and am doing a lot of weight bearing exercises right now.

[SnazzyD]

Hello, I’m sure someone here will ask about the actual T scores. Had you been taking any VitD and Calcium during this time?

[Hidden]

Hi RheaV

HeronNS is a bit of an expert on improving your Bone Density, she’s in Canada so they join us later in the day. I’m sure she’ll be happy to give you some pointers.

Regards

MrsN

[PMRpro Ambassador]

What are your actual t-scores? (Though why Snazzy didn't ask for numbers straight up ... )

[RheaV in reply to PMRpro]

My T-scores:

Lumbar spine -1.70

Total left hip -2.37

Left femoral hip -2.92

[PMRpro Ambassador in reply to RheaV]

Do you know what they were before and when was that? Those are pretty low hip values.

[SnazzyD in reply to PMRpro]

Because I feared I might get the answer! 😬

[HeronNS]

The main risk factor for fractures is falling, so anything you can do to protect yourself - maintaining and improving sense of balance, keeping strong (as you are with your exercise) and removing hazards in your home - will be helpful. I wrote an account of what I did and there may be some advice in there you can use:

healthunlocked.com/pmrgcauk...

Best wishes!

[RheaV in reply to HeronNS]

I forgot to say I have a compression fracture of the L2 vertebra.

I just moved this past summer, and I am so impressed with this municipality. For $70 for 3 months, or $150 per year, those 55+ can take any number of fitness classes. Most of them focus on strength, flexibility, balance. This past year I've been taking at least 4 a week.

My biggest concern is my pred. At 3.5 mg, is continuing bone loss a big concern?

[PMRpro Ambassador in reply to RheaV]

The greatest loss is at higher doses - there is some evidence that there is still some loss even at such a low dose but it is very small. Were you told to take calcium and vit D supplements? Was your vit D level ever measured? If it is low then the body can't absorb the calcium anyway. It isn't a simple picture.

[RheaV in reply to PMRpro]

I've been taking Vitamin D forever, I think, and I usually have my Vitamin D levels checked about once a year. Here in Ontario I have to ask to have them checked. There is a charge for having Vitamin D levels checked, but because I am at risk for osteoporosis, there is no charge. They have always been good. I've always taken a calcium supplement, but I'm not sure that they were the best ones to get. Now I am getting them from a Health Food store--and paying a lot more for them!

[HeronNS in reply to RheaV]

Are you taking Vitamin K2? I've heard that Vitamins D3, K2 and magnesium are all really important for bone health, and, additionally, most of us get enough, or nearly enough, calcium from our diet. So the focus should be on those other micronutrients rather than calcium, important as it is.

[SnazzyD in reply to PMRpro]

That’s one argument I put to my Rheumy when I refused AA when I was found to be osteopaenic. 2 months Pre GCA my Vit D was found to be in my boots and I suspect it had been that way for years. Therefore I wanted to try a nutritional approach first to add the missing link first.