Alendronic Acid

[SudsSuds]

When I saw a new rhuemy yesterday she mentioned Alendronic Acid. I had not heard of it. I take Calcium D3 because a DXA scan showed osteopenia in my lower back. Would Alendronic Acid be helpful with Calcium D3 or instead of it?

[piglette]

I personally would not take Alendronic Acid unless it was proved to me I had osteoporosis and needed it. My GP is very keen I should take it as l have been on long term steroids. I point out to him I have a good Dexascan. It does not seem to make any difference. It seems he has read somewhere that Alendronic Acid goes with long term steroids. I take vit D with calcium.

[DorsetLady PMRGCAuk volunteer]

AA is recommended in guidelines if you are over 65 and (as you are osteopenic) that is probably why they are pushing it. But it’s personal choice -I took it for 4 years with no issues, but my view is, why take it if it’s not really required.

It depends what your readings are -there’s a wide range which fail into osteopenia range -and osteopenia doesn’t always become osteoporosis.

Unless proved otherwise with a new DEXA I’d say stick with a VitD/Calcium supplement

[jessiem]

I was advised to take it “just in case” I refused as my DEXA scan was good. I take Calcium and Vit D and lots of dairy in my diet.

[PMRpro Ambassador]

You take it with calcium/vit D - it directs calcium into the bones and you need plenty of calcium available in the system to prevent blood calcium becoming too low which can be dangerous.

You have osteopenia in the spine - only the spine? And what was the t-score, do you know? Osteopenia is NOT an illness, not a pathological condition. It is the word that means your bone density is lower than the comparison - the average bone density in a 30 year old, After about 30 everyone's bone density falls slightly and slowly, whover they are. Mine was slightly down a couple of months after starting pred, I took 4 AA tablets before stopping until I got my results - with the agreement of a different GP. I have never taken another, just calcium and 4000 IU vit D (much more than the usual recommendation) and at my last dexascan my t-scores were still in the mid-range for osteopenia, nowhere near osteoporosis

[SnazzyD]

For me it would depend on what the numbers were and how osteopaenic I was. You wouldn’t expect perfect bones at this age and it doesn’t mean that you are on the fast road to osteoporosis. I started out with GCA on 60mg having already lost 10% of my mass due to surgically induced menopause at 41 and chronically low vitamin D. The FRAX risk assessment tool (available online) still put me in the range of no AA needed. 3 years later I had lost a further 3% and am still just under the threshold for treatment. I refused because I have particular reasons to worry about the risks of AA. I would advise finding about your actual risk rather than going on just the word osteopaenia. Doctors I saw kept saying it was their gold standard practice so I took that to mean they were worried about being seen to not be adhering to that. It wasn’t about individualise care. I will also say that keeping up with bone health is more than popping AdCal and doing a bit of exercise; you do need to work at it. It is worth reading the book Your Bones by Lara Pizzorno. You can dip into it because it has specific sections.

[PamJCam]

5 years ago I was given AA as I was borderline osteoporosis…I had been taking it as directed for about a year when out of the blue I had the most horrendous pain in my chest a few hours after taking it and later found out it had given me an hiatus hernia (literally burnt through my oesophagus according to the doctor) which I now have for life. I have been offered an intravenous version of it but I’m going the old fashioned way with calcium supplements. So many medications we take can have many side effects and they can be devastating 😢

[SudsSuds]

Ok in reply to everyone I will avoid unless there is a provable compelling need. I am not there yet and and I don't know my t-score. What does that measure? I already have a hiatus hernia so that's another negative.

[PMRpro Ambassador in reply to SudsSuds]

It is the figure that relates your bone density to that of a 30 year old in standard deviations if the 30 year old is the mean.

[SudsSuds in reply to PMRpro]

Whew - so the bigger the number the lower your bone density? What's is the range? If it's all on the web could you direct me to a reliable source?

[DorsetLady PMRGCAuk volunteer in reply to SudsSuds]

This contains links to ROS and WHO -

healthunlocked.com/pmrgcauk...

[SudsSuds in reply to DorsetLady]

Thank you