Advice needed My DXA scan taken in May 2019 shows Osteopenia T-scores - 0.7 to -1.3lumber spine, -1.6/7 hips, should I take Zelandronic acid
Advice needed My DXA scan taken in May 2019 shows... - PMRGCAuk
Advice needed My DXA scan taken in May 2019 shows Osteopenia T-scores - 0.7 to -1.3lumber spine, -1.6/7 hips, should I take Zelandronic acid
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Stellamavis
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Well I absolutely wouldn't - and don't in fact. Your t-scores are even marginally better than mine were when I first started pred 12 years ago and they have gone down very slightly for the last dexascan last autumn. I expected our local osteoporosis guru to insist I took something - all she said was that she was amazed, had never seen such good results from someone on pred and just to keep doing what I was doing! I took 4 AA tablets right at the start, discussed it with a different GP, we agreed to wait for the dexascan - and I have never needed anything at all except calcium and vit D. I stopped the calcium supplements because of bladder problems and just eat lots of cheese but I DO take a lot more vit D than is usual in the supplements though.
t-scores that are better than -1.6 are usually taken as not requiring any treatment - just good calcium/vit D. And yours are.
I’ve been unsure whether to take this medication as Ive only had the advice of the rheumatologist. I was first diagnosed with PMR in 2015 by a Gp, I’d had the symptoms for about 2/3 years before then in my hips/groin area, I’d seen a few GPs over those years and always told its age or sciatica and prescribed co codamol, I knew it wasn’t sciatica as that pain is different in a different area and down lower back and legs, and even saw chiropractors but nobody ever mentioned PMR, I was at the end of my tether so looked up my symptoms on line when the pains then started in my shoulders and my biceps were so painful I couldn’t function properly and forever crying from the pain, so when I saw yet another Gp I asked could it be PMR and yes it was after taking blood tests so prescribed 10 mgs of Pred and hurray life went back to what I remember it like before the pain, I didn’t see rheumatologist till I’d been upping and lowering dose on Pred for near 4 yrs that’s when he suggested ZA , I wasn’t too keen and unbeknown to me at the time was suffering pain from Gall stones which was excruciating (also have a hiatus hernia and mild oesophageal inflammation), I didn’t want more pain from this new drug Rhuemy wanted me to take so his nurse suggested I put it on hold till gall stones dealt with, strangely not had pain from gall stones after I had a scan so discharged from Rv list after being pain free for 18 months! although I did change my diet to plant based and it helped. So just recently had a phone call from the rheumatology nurse offering me an appointment to have Zelandronic acid and again I said I would put on hold for now, I have been reading info on here which makes me feel I don’t want to take it but until my letter came from the hospital with the T scores I thought I’d get some advice from those in the know, I will say no if asked again by Rhuemy when I get my next appointment with him. Last saw him in May when my Pred was upped to 40 mgs as symptoms of GCA appeared between both Covid jabs, and I was thinking that my PMR was burning itself out obviously not..
So those are readings AFTER years of pred and no bisphosphonates either?
Was prescribed omperazole 20mgs twice daily but only took once a day then doc changed to lansoprozole 30 mgs twice daily but again only took once a day as I just thought I had bad heartburn, but it was gall stone pain so Gp added ranitidine at bedtime as and when needed. No longer take that now but still only take lansoprozole once and usually before my Pred which I take in early hours ( now on 16mgs ) from 40mgs end of April this year as dropping down 10% of previous doses.., so far so good apart from occasionaly feeling off balance if I try to move too quickly walking or excerting myself unexpectedly
No - those are PPIs, stomach protection, and they can contribute to loss of bone density too. Bisphosphonates are usually alendronic acid of the zolendronic acid you are being offered - by infusion so OK for people with gastric problems.
I’m not keen to take any of those at the moment. Have just looked at my hospital letter which says Intravenous Zoledronate to be booked when result of vitamin D available (Normal) What I’ve read about these Bisphosphonates seems like they don’t do much for the bones in the long run so I’m going to refuse if offered again
Then your results are impressive - and would reinforce my decision not to take any now.
I intend to
When. I saw the rheumatologist at Osteoporosis Clinic at the Bristol Hospital due to my DEXA scan results showing v. bad osteoporosis & a stress fracture in the spine (been on steroids for 5 years for GCA), I was very reluctant to be given a Zoledronic acid infusion which was what he was suggesting because of side effects etc. He spent ages explaining that if the risk of hip & spine fracture was high that was when he put patients on the infusion but, they now only do it for 3 years, as they have found any longer & it can make the bones note brittle. So after 3 years of, possibly foolishly refusing it, I have been persuaded.
personally I would not take Alendronic Acid with those scores but it is really up to you and your doctor.
I don’t want to take any more meds as I’ve recently had my Pred upped from my lowest dose of 5mgs to 40 in May (now being treated for GCA symptoms) although now down to 16 mgs
My 2 cents here - I absolutely would not take it with scores like that. Mine were much worse than yours and my Rheumatologist suggested I take fosamax, but as she so cleverly put it - "it is what we are encouraged to recommend from the Academy of Rheumatologists" if you are on long term prednisone, she then went on to say, the decision is totally mine and strongly suggested that i consider taking Bone Strength, do weight bearing, watch my caffeine (not good with this one). So, I have done that but also do the yoga poses that have been shown to build bone: sciatica.org and walk with a weighted vest. My last DEXA scores have improved slightly. I have also read a lot about the difference between bone density as measured by DEXA and bone quality and strength. Not to say they will stay that way, but for me right now it is what I plan to continue. I am still on prednisone, but a small dose (5 mg). My Mother had horrible osteoporosis so don't know if I can beat the genetics, but am going to try.
I love hearing these success stories!
Those scores are not unusual for older people. It's normal to have some lessening of bone density as we age and I have to say if your t-scores are still as good as they are after the medications you've been taking there's no need to add an osteoporosis drug. If you are concerned that you may experience more bone thinning as the years go by, there are ways to slow that down. Have a look at my story for some ways to maintain (and even improve) bone density without using any of the OP drugs. Also SandyBoots suggestions.
