Dexa scan shows osteopenia, don't yet know reading. GP will call tomorrow to discuss (my request).
I'm thinking this should be straightforward, that GP will keep me on Allendronic Acid, Calcium, Vitamin D and Prednisolone: I am slow tapering between 9mg and 8mg and this seems to be going well. I'm feeling positive (except for the fatigue, lethargy, and dizziness): pacing myself on the DIY.
Is there anything I should be discussing with GP, please?
I wouldn’t be too dismayed by “ Osteopenia” it means borderline and there is scope for improvement. In addition to the protective measures that you already have in place, regular weight bearing exercise would be helpful. Heron’s advice on improving bone health was very good in a post quite some time ago. Perhaps she still has it.
Thanks. My reaction was to think that, being on steroids for 9 months it is almost inevitable that the scan would show osteopenia and that a future scan will show back to normal. Not worried, more curious. (I've never broken a bone in my life.)
I was told that I had the bones of a 30 year old after 4 years of Pred. So there is an element of luck in all this. I hope your results are good.
Did you have a DEXA scan before? Do you know this to be a deterioration since Pred or a continuation of what was before?
I was found to have pre-existing osteopenia but they agreed for me to have just vitD (that I was deficient in also) and calcium because I was not happy to take bone meds for a number of reasons. According to the FRAX tool I was just below the line for needing meds.
Just in case you’re interested :
sheffield.ac.uk/FRAX/tool.a...
I am yet to find out if my decision was the right one.
To add to Snazzy's comment - I also rejected AA on the basis of the baseline dexascan and in my case it was the correct decision. I have only a very small deterioration in my t-scores after over 11 years on pred, much of it at above 10mg/day, and the most recent result was about 2 months ago. I took calcium and vit D religiously until last year when I had to stop the calcium because of side effects. I also walked for half an hour every day if the weather was good (most days here where I live) although that also fell by the wayside over the last 18 months or so.
What are the problems with AA, please? I don't seem to have any side effects. I find it irksome to take but am now used to it.
A very basic one is that some dentists won't touch you with a bargepole! One nasty adverse effect is avascular necrosis (AVN) of the jaw bone in particular and you should have any invasive dental work that is anticipated completed BEFORE starting AA but some dentists take it further. The AVN can also affect other bones and there is a risk of spontaneous femoral fractures - we have had a few people on the forum in the past. It has also been established that after a few years the bone being produced can have microcracks and is more porous and MORE likely to fracture - hardly the aim of the exercise. Once a bisphosphonate is in the body it is there for the rest of your life so it isn't a case of deciding you will stop and in a year or so it is back to baseline. All things considered I believe it should only be used when required - not "just in case" because it can be a mixed blessing.
PMRpro. Thank you, that answers my main worry. I had a tooth break off at the gum at the start of the first lockdown, having been on AA for a couple of months (it was nothing to do with AA). Dentist still closed. I will have to put my self in his hands. Good job I'm not proud about my looks! Fortunately I've got no pain. I mentioned the situation to GP but he thought it wouldn't be a problem. Another niggle I've got!
That was the first. (Never had a break in 81 years, although mother had osteoporosis and sister has it.) Recently I had a fall in the high street - not watching the new kerbs - the only damage was to my nose!
GP said the osteopenia is in hips, spine is ok. He says it is old age not the Pred which I'm thinking is correct. I will get the scores when he sends a copy of the report. Meanwhile no change in medication.
Osteopenia is NOT a disease. It is in most cases a reflection of normal bone thinning as we age, and can be slowed by nutrition and appropriate exercise. As others have pointed out if you have had a previous DXA scan, especially on the same machine for accurate comparison, and it shows a decline, then you need to step up your game when it comes to looking after your bones. You should not accept any prescription of osteoporosis drugs unless you have sustained a genuine fragility fracture.
This is my (now rather old but still relevant) post: healthunlocked.com/pmrgcauk...
Thanks for that. I seem to be doing most of the right things, which is good to know.
See my question to PMRpro
If you really want to go to town, read this book about all things bone health. I learnt that regarding exercise, all is not equal.
Your Bones by Lara Pizzorno.
Thank you.
I find this review interesting! 'Your Bones will be an important handbook for anyone wanting to prevent osteoporosis in later life.' At 81....
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