morning all
I managed to crack a tooth on a tea cake last week 😳 and after an emergency visit to the dentist I’m being referred to a hospital for an extraction because of the Alendronic acid ☹️ I have been on pred ( 5mgs daily at present ) as well as Alendronic for 2 years I am also taking Lefludamide ( 10mgs daily ) for RA My question is should I stop the Alendronic until after the extraction ? They said it could be a 2 week or 2 month wait ?? Many thanks for reading x
You should ask the dentist - but I doubt it will make any difference though since the bisphosphonate remains in the body forever.
That must have been some teacake! I got a fractured root in the back molar some weeks ago - think it must have been pomegranate seeds in an icecream! The tooth came out in 2 bits as expected but without any problem and healed beautifully. I don't take AA though.
Morning 😊 Thanks , they wouldn’t advise but then I suppose it’s not within their brief 😔 I have arranged for a call from a clinical pharmacist on Friday via my surgery ( who knew you could do that 😜! ) so will see what they say but I think you’re right and stopping won’t make any difference ☹️ The tea cake was lovely and not even burnt but I suspect it was a rogue currant 😊 ! Thanks again for your reply and all the support you give x
Definitely a rogue currant if it did that much damage 🤔
as PMRpro says stopping won’t make much difference,but probably wise to check. Good luck
I now have a whole new respect ( fear 😩 ) of currants !! Will let you know what the pharmacist says on Friday but I suspect you’re right and I should carry on taking it x
Oh dear…….Current alert 🤣😂…
Currently my teeth are awful thanks to Pred.
Some currant!!! And definitely not seedless ... Or it was VERY burnt ...
I know 😳 who’d have thought a currant could have done so much damage 😜 Guess I was just “ lucky “ 😂 ! X
“Bisphosphonates remains in the body forever.” That’s really depressing to read!. I’m coming up to my third year of PMR/Pred, currently transitioning from 2.5 to 2mg. Having recently moved house I had an ‘interview’ with my new GP part of which talked about Pred and Risedronate. He reiterated what all medics say, ‘take weekly until I’m off Pred’. He’s ordered a DEXA scan but warned could be a long wait. My previous scan was normal Sept. 2020. PS I’m taking the nasty Risedronate once a fortnight now, using my own pseudo science.
I took 4 doses of AA before discussing it with a different GP who agreed with me we'd wait for the dexascan result. It was fine, slight osteopenia that didn't signal a need for bisphosphonates. After over 11 years on pred- still hardly any change. And still no bisphosphonate, just 4000 IU vit D and plenty of calcium in my diet.
If you are on pred for more than 3 to 5 years - you shouldn't be still taking it unless you have had a "drug holiday" to reduce the risk of microcracks forming in the bone.
knowing what I’ve learnt from this site I wish I hadn’t started. I read with interest also about PPIs and bone health. I’ve decided to have break and take Pred with food instead (2 / 2.5mg low dose, right).
Adding by edit, I’m at the low(?) dose but feel I shouldn’t rush to finish and be off Pred.
You poor thing. I would definitely not get any more tea cakes from where that one came from!
Not another toasted tea cake will ever pass my lips 😳 ! However ……a full English is definitely a must 👍 Might take me 3 weeks to eat it right now tho 🙄 ! X
Be careful of any potato cakes you might have with the full English!!
😂😂😂 will deffo bear that in mind - who’d have thought dangerous breakfasts were even a thing 😜 ! X
Something Wicked This Way Comes!!
There is much evidence now on the negative effects of drugs for bones and stomach acid. Dr. Peter Osborne and Dr. Ken Berry have excellent presentations on YouTube. Search on their name with the word "bone" to view several titles. Neither prednisone or currants should take all the blame!
😂😂 thank you ! Will definitely give them a watch 👍 I dread Thursdays as that’s when I take my Alendronic so I would be happy to stop ! X
Drs Osborne and Berry are brilliant about many health issues. They teach the importance of adequate amounts of calcium, magnesium, and vitamins D3 and K2 because they all work together to form bone. Relying on the cheap form calcium carbonate is not recommended because it is not easily absorbed into the bloodstream and not efficient for building bone...
Excellent information to have - thank you ! Will be reading up on their advice tonight - the murder mystery novels can have a night off 👍 x
Do these doctors offer their own, more expensive, form of calcium?
Dr Peter Osborne does have a supplement line which is naturally sourced and gluten free. I listen to quite a number of healthcare presenters and think he is the best in the USA for combining knowledge of physiology, drugs, nutrition and herbs. I don't know about availability to other countries, but studying the formulations of his products would be very informative. He does videos at least twice a week and his main focus is educating about the problems caused by eating grains, such as our major issue of chronic inflammation.
Yet calcium carbonate is what the NHS prescribe! But why wouldn't they as it's the cheapest. Calcium needs stomach acid to help it absorb properly. I've got my PPI daily dose down from 80 mgs to 10 mgs in the last year and hoping to get rid of it altogether in the next couple of months as I reduce the Pred further. Must look up Drs Osborne & Perry. Thanks for the info.
I’ve watched the you tube videos as recommended by AdoptMeow today and found them really enlightening !! Well worth a watch - such useful info given !!!
Yes, I've watched them too. I tried the 'bones more brittle with biphosphonates' argument with my rheumy, but she said ' you won't be saying that if you break your pelvis.' I still wasn't persuaded to have the infusion.
it was the bit that said the T scores in Dexa scans were compared to that of a 35 year old woman 😳 ???? X
Bone density at 30-35 is taken as the maximum you are likely to achieve - you are building bone density in teenage years and after 35 the bone density slowly falls again. The t-scores are measures of the deviation from that theoretical maximum and minus figures show how much lower it is. The z-scores compare you to others of your age group - but that isn't really particularly useful since comparing rubbish with rubbish is still rubbish ... So to speak ...
Brilliantly put and lovely and clear 🎉 Thank you ! X
I know! Mind you, I didn't expect 18 months on Pred would give me a T score of -3.9 in the spine. That was a shocker. Guess I'm unlucky as others seem to maintain good bone health even beyond that.
Dr Ken Berry and Dr Peter
watched Drs Osborne and Berry today - soooo interesting and enlightening !!! Thanks for the recommendation x
I've read that taking calcium with orange juice helps with the absorption. As we have no pharmacare in Canada I buy my own and have always taken calcium citrate, and more recently calcium hydroxyapatite as it's supposed to be more easily absorbed by people on pred.
I've taken both. Not at the same time though. Calcium hydroxyapatite constipated something awful. And so costly for the privilege.
Thankfully have never had that problem. Mine is in the form of a supplement which includes a lot of the other bone healthy supplements, and yes it is expensive. Guess I'm one of the guilty privileged who has a choice about what they do. Guilty but also grateful.
hi I'm glad I'm not the only one I take AA every Monday I dread it coming round in fact I'm in the Cotswold this week so decided not to take it
I usually take mine on a Thursday and didn’t this morning - made for a much nicer Thursday 😂 ! Enjoy the beautiful Cotswolds x
thank you take care
After two years on AA you are within a time when discontinuing the drug altogether could be an idea. I have no idea what your bones are like, of course, and why you were prescribed AA in the first place, but it is now thought that two or three years is about the limit before you enter the territory where the bones begin to become brittle. What AA does is prevent old bone cells from being removed which is a process which happens throughout our lives and is called remodelling. When new bone is laid on over old bone you appear to have improved the bone density. Unfortunately the old bone is not as strong, and as time passes and new bone is laid down over an aging matrix you run the risk of "atypical" fractures. So it is a balancing act, to take AA only as long as the benefit exceeds the detriment. This is true of all the osteoporosis drugs which slow or prevent remodelling.
That’s really valuable info to have ! My last Dexa scan said that there had been no further deterioration in my bones so I’m hoping that it might be a good time to stop taking it 👍 Will request a copy of my recent scans and see if I can make sense of them as a non - medic x
just ask on here if you give us numbers we’ll advise.
Fab - thanks ! Will be “bothering “ my surgery tomo for the previous 2 Dexas so I can compare and contrast 👍 x
Thank you for this simple, clear explanation! I started taking bisphosphonate in July 2022 since being diagnosed with osteoporosis in my spine. I have been on Prednisone since end of May 2021 and am currently at 7 mg.
It's always good to be aware of any potential downsides for medications we take, helps us avoid adverse side effects. My doctor mistakenly thought my DXA scan showed osteoporosis. In fact it was "osteopenia" aka low bone mass. So I avoided an argument about medication, although it was recommended on the basis of several risk factors, and successfully improved my DXA t-score from -2 to -1.6, at which point the recommendation for bone meds was dropped. A lot of people have worse results of course and I do count myself lucky.
I learnt from mistakes made from taking Methotrexate ! Unknown to me my blood tests weren’t being monitored and it was only because I started to ask questions and felt really ill and stopped taking them that I realised my ALT numbers had gone from 12 to over 300 😳 ! As you quite rightly say it’s good to be aware of potential downsides in medication and not necessarily follow blindly 😳 ! I question everything now and this website and your goodelves ‘ advice is invaluable !! X
LucilleG I've just read your profile story. I hope you are getting good care now? That rheumatologist sounds like an example of the worst kind. As long as you have no GCA symptoms, and you are able to keep obtaining the pred you need, I'd avoid that person like the plague. How does it work out being seen by different doctors at a drop in clinic all the time? Given your timeline you are certainly not "hooked on pred". Sounds like without interference from ignorant doctors you had been doing very well. Median time on pred is close to six years, some off sooner, many take longer! And people can develop PMR symptoms younger than 50, although it is more common in older people.
I’m on 5 mgs of Pred and plan to drop 1/2 mg in a months time 👍 Different doctors all the time is a nightmare and I’ve got a better relationship with the Consultants secretary than I do with him ( and get better help and advice ☹️ ) My next blood test is on Monday and I’ll be phoning on Thursday for my results as I’m now on Leflunamide and am keeping a close eye on my liver numbers ! I’ve got a “ follow up “ appt on the 19th December - not hopeful for other suggestions from him 🙄 x
Hi Georgians,have to say my dentist hates the stuff calls it a lot of shit,had to get teeth checked more often, it's to do with the roots not healing or the bone and can cause problems, good luck,I was on it for 4 years and just stopped it,if it was me I wouldn't take any more until after op and healing done .take care
hi ! That’s both good and bad to know 😜 ! I’ve stopped taking it as from today and collected my previous 2 dexa scans from the surgery this morning so I’m more informed as to my bone health 👍 There’ll no doubt be another post from me on here later with numbers and letters asking for a translation 😂 ! X
Hi I just had a tooth extraction after I got a very bad infection after a filling. I was on Boniva and on the advice of my rheumatologist was told to stop taking it for the next 3 months and after the extraction site was examined by him and I will need to have an MRI of my jaw bone to make sure all is good
Hi - thank you for sharing your experiences ! Hope all’s well after your extraction - I decided to stop taking Alendronic acid until after my extraction 👍 and even then I may take a longer “ holiday “ from it 👍 x
All went well so far. Make sure they give you antibiotics after for 7 days. I was put on 2 different ones flagyl and amoxicillin. They should help to prevent any problems. Will be a few more weeks before I have MRI. I don't think I will go back on Boniva again . I have had a lot of problems with those drugs and I have tried them all.
I’ll make sure I get some antibiotics 👍 The dentist said it could take between 2 weeks and 2 months for the extraction 😩 I’m having to only chew on one side and if I forget it’s really painful !
Alendronic Acid and...
Alendronic acid or not?
Update on Tooth Extraction 
