Alendronic Acid

[jaycee444]

Had a fall at the weekend resulting in a broken wrist. It is an uncomplicated fracture but I have a feeling that the Rhumatologist will try to put me on Alendronic Acid and this is something I really dont want. My first reaction would be to ask for a Dexa Scan to see if its really neccessary and if it is - is there another Bisphosphonate that is easier to take and doesnt cause some of the side affects that I want to avoid? I already suffer from Ulcerative Colitis and I think Alendronic acid would certainly not help that! I have a friend who couldnt take Alendronic Acid but was then prescribed Zoledronate which was fine for her.

I am taking 1000mg Calcium Citrate daily and 1000ug Vitamin D3 along with Vitamin K2. My diet is rich in calcium too.

I am currently on 10mg Prednisolone and reducing very slowly (by half a mg about every three weeks) (My GP is letting me pace myself although Rhumie would like it down quicker.)

PS.... have just read that Zoledronate irritates the gut as well..... Do all Bisphosphonates do this?

[piglette]

Have a Dexascan first. I assume you have not had one. Anyone can break a bone, they don’t have to have osteoporosis!

Side effects of bisphosphonates may include bone, joint or muscle pain. Side effects of the oral tablets may include nausea, difficulty swallowing, heartburn, irritation of the esophagus (tube connecting the throat to the stomach) and gastric ulcer. One may work for you another may not.

[ncfaaeos in reply to piglette]

The side effect I got from this drug was very strong pain in my lower legs, which meant I had to stop taking it.

[SnazzyD]

Perhaps I’m wrong but I didn’t think a traumatic fracture indicated bone meds. I’d ask for a DEXA first.

[jaycee444 in reply to SnazzyD]

Yes I will definitely ask for a Dexa scan first.

[MrsNails]

Sorry to hear about your arm but as Piglette says anyone can break a bone, it doesn’t mean it’s Osteoporosis, get the results of the Dexa Scan first.

There are other options for improving your bone density, please have a look at HeronNS Posts.

healthunlocked.com/pmrgcauk...

Also I’ve had Zolendronic Acid Six Monthly by IV Drip (for a different reason) but as far as l am aware it bypasses the digestive tract so if necessary you could discuss your options with the Consultant.

Kind Regards

MrsN

Hope the Dexa comes back OK & your arm heals quickly 🌸

[Ruadh]

Hi Jaycee444 - You could treat osteoporosis with an alternative, and efficacious, therapy. Get hold of the book, 'Your Bones' by Lara Pizzorno, available from Amazon.

I reversed my osteo by following her suggestions; and that was some time ago now. Still reversed. Bones are now excellent.

Hope this helps - and, by the way - there is much information on this site re an alternative approach. Will need to dig for it. But we had so many discussions - which also picked out the side effects of the bisphosphanates.

[jaycee444]

Thanks for all your replies . Lots to think about .

[diana1998 in reply to jaycee444]

My niece aged 58 fell up a kerb and broke her wrist. Hospital gave her a dexa scan even though she's not thin and is very fit and it showed osteoporosis. They just said take calcium and get lots of sun. She has a holiday flat in Spain so has always sunbathed an awful lot. She would never have known if she hadn't had the fall. I was amazed.

[PMRpro Ambassador]

Does this help?

ncbi.nlm.nih.gov/pmc/articl...

[jaycee444 in reply to PMRpro]

Thanks so much PMRpro. This looks like invaluable reading .

[PMRpro Ambassador in reply to jaycee444]

And they should do a dexascan if there is any evidence the wrist fracture wasn't due to reasonable force - i.e. not a fragility fracture. People with normal bone density break bones too.

[Seraphina56 in reply to PMRpro]

I’ve been thinking about this same issue lately because I was automatically prescribed Alendronic Acid two and a half years ago when I started in Pred plus Adcal 750mg x4 daily. I stopped the AA recently after reading about the side effect.

I’ve been on 10 mg Pred for a year and been on it all together for two and a half years. My GPs have never suggested having a Dexascan. Just checked the NHS website where I found this. It says a Dexa scan may be recommended if you have been taking medicines called oral glucocorticoids for 3 months or more. So I think I’ll be getting in touch with them.

I’ve reduced to 9mg over the last month and I’m overwhelmed with tiredness.

[SheffieldJane]

My reaction would be the same as yours. I would wait until the Dexa scans were available. I think that this drug group is pretty similar in respect of potential side effects.

[HeronNS]

Like Snazzy, it was a definite impact so shouldn't count as a "fragility" fracture. Also, when I went to an osteoporosis info workshop at my local hospital they specifically said that fractures of smaller bones didn't really count in evaluating osteoporosis likelihood as they are so much more more vulnerable if impacted anyway. They considered "fragility" fractures of larger bones of far more importance.

[HeronNS]

Do you take your calcium in one dose or spread out through the day? The body can only absorb about 400 mg at a time. Other minerals are important for bone health, notably magnesium and boron. If you supplement magnesium don't take it at the same time as your calcium supplement as the body prefers calcium and will not absorb the magnesium as well. Calcium is actually notorious for interfering with absorbing other things, like iron, or pred!

[jaycee444 in reply to HeronNS]

Take my calcium split half dose at lunchtime with Vit D and K2 and the other half with my evening meal. I don’t take Magnesium

[DogAgilityObsessed in reply to HeronNS]

I’m running out of hours in the day for all the meds while leaving sufficient intervals. I only learnt about splitting the calcium this evening but didn’t know about taking magnesium at a different time. Can I take magnesium at the same time as the pred?

[HeronNS in reply to DogAgilityObsessed]

I remember when I was taking pred, calcium, and iron. You can actually take iron and pred together, but I needed to take iron more than once a day. I thought I'd need a spreadsheet. It began to feel like a part time job just keeping the various supplements + pred organized!

[DogAgilityObsessed in reply to HeronNS]

I haven’t even started tapering

[HeronNS in reply to DogAgilityObsessed]

I wrote down every single dose of pred I took. I think some people use an app on their phone. Only way to keep track once you're tapering!

[kalimche in reply to HeronNS]

Re Magnesium: having recently read on this site about the benefits of magnesium I decided to add it into the mix and am awaiting for my order to arrive... can you pls tell me when I should take it? I take pred in the morning (at the same time as my BP med and statin), and the Adcal at lunch and supper. Can I take the magnesium in the morning with everything else? Also what dose do you recommend?

[PMRpro Ambassador in reply to kalimche]

Enough to NOT get the downside of diarrhoea! Everyone is different - I shall have that inscribed on my headstone! It also depends a bit on the supplement, there are different magnesium salts and I can take some with no problem, others it is a very different matter.

[kalimche in reply to PMRpro]

Oh dear .... thanks for the headsup! This is what i have on order.

naturesbest.co.uk/minerals/...

Actually I see it says "1 tablet daily with a meal" - but from what Heron has said, it should not be taken at same time as the calcium? Looks like I will have to find time for a further meal....!!

[PMRpro Ambassador in reply to kalimche]

You aren't taking calcium with breakfast?

[kalimche in reply to PMRpro]

No, but I don't have breakfast. Just some yoghourt with the Pred, followed by a mug of coffee. And one shortbread biscuit - I stress the "one" because I am aiming at low carb and sugar, and hope that the one might slip in under the radar! Do you think that would count as a meal?!

[PMRpro Ambassador in reply to kalimche]

I would have thought so for magnesium - I don't bother, I need it for something else and just take it without anything to eat.

[HeronNS in reply to kalimche]

I don't take much at all, as magnesium is to plants what iron is to animals and there is plenty in a balanced diet rich in greens! I only take a little extra to balance the extra calcium I take, and even one of my calcium tablets is a balanced one with magnesium. The issue with not absorbing calcium enough occurs when we are taking extra calcium and the balance gets upset. Provided it's a balanced intake (nearly impossible with the kind of calcium supplements many of us take) then I think there isn't actually a problem. I have also used Epsom salts baths as a way to get magnesium as it's absorbed through the skin.

I haven't found any info which indicates it's contraindicted with pred so as you aren't taking pred with calcium you could take your magnesium at that meal. What I do is omit the calcium supplement a couple of suppers a week and take magnesium instead. My magnesium supplement is 150 mg magnesium citrate capsules and I have never had any digestive effects. As I see your tablet is a mix of different types of magnesium you are covering more bases, just follow manufacturer's recommendation for dose. If you can get hold of a book called The Magnesium Miracle by Carolyn Dean, in its 3rd edition now I think, you will learn more than you ever wanted to know, and probably be able to correct statements I may have made from imperfect memory of my reading.

[kalimche in reply to HeronNS]

oh dear - everything just gets so complicated! Many thanks for your reply.

[HeronNS in reply to kalimche]

I know. That's why you should relax! Observe the things you must, like not taking pred with calcium, make sure you take your supplements with a little food. I've found my bedtime dose of calcium is fine with just a large tablespoon of yoghurt or a small glass of kefir so I expect, if you decide to take your magnesium at bedtime, all you'll need is a little snack.

Some of us have found calcium supplement or magnesium supplement taken this way is a super sleep aid!

[kalimche in reply to HeronNS]

Thanks again. I don't have problem sleeping - in fact I normally fall asleep in front of the TV and have to take myself off to bed in the wee hours.... but once there, I drop off agains instantly!

[HeronNS in reply to kalimche]

Well, just trying to give you a possible time to take the magnesium.

[kalimche in reply to HeronNS]

Yes appreciated - could be an alternative, esp if I find any indication that should nto be taken at the same time as the Pred or other meds. Thanks again!

[jaycee444]

Thanks HeronNS that’s very enlightening.

[Thelmarina]

You’ve had a lot of tips and I don’t want to muddy the waters but you can overdo the calcium. My doc and the lovely Baskhar Dagupta, who gave us a recent Zoom seminar, feel that in the main we get enough from our diet if we eat dairy and so on. A Dexa scan would help, and if a bio sulphate is recommended you could try ibandronic acid which you take once a month rather than weekly. I do hope you get good advice, feel comfortable with your meds and feel back on course 🌺

[Whatallydidnext]

I’m exactly the same. I broke my pinky and they suggest same. I’m in 8mg Pred but after reading side effects I’m reluctant to take it. He’s suggested Methotrexate too but I’m staying away from that just now too. Horrific side effects.