Alendronic acid

[Mercat]

Hello

So I’ve had another telephone consultation from the latest GP saying my bloods are fine (not raised) 🙄 yes I know!! I’m tapering myself DDS and on 12.5mgs at present . I was initially diagnosed Dec 21 - and had got down to 9mg but Nov 22 had a flare and had to go back up to 15mgs - I’ve now been seen several times by different GPs all with different ideas - however the last GP just told me to carry on tapering myself - which I was happy about , but the go before him had refered me to Rhumatology and they’ve basically said doubtful I have PMR due to age, bloods etc but send the GP the guidelines to follow 🙄 by now it’s been a year on steroids - the bloods showed low Vid D and then I had to get diff bloods done to rule out RA - that’s all come back fine - but the latest GP now wants me to go on Alendronic acid , not really keen to go on this 😕 my question is do I really need to? I’m taking Vit D chewable tabs everyday. I am 50 and my DEXA scan last year was perfect?

[piglette]

If your Dexascan is perfect I would say that you do not need AA. I have been fighting with my GP for ages, I think I have finally won!!

[PMRpro Ambassador]

What were your t-scores do you know?

While I was sorting through a pile of medical stuff this afternoon I found my first dexascan result from here, done in 2013. My spinal t-score was -1,6, the left hip -0.7. I had one done last week: spinal t-score -2.2, left hip -1,1.

On the basis of my original dexascan done in the UK 15 years ago after 3 months of pred we had decided I didn't need AA, calcium and vit D would do for now. My dexascans have been not much different since then. I recently had a spinal x-ray which had evidence of compression in one vertebra that might possibly be a fracture. As a result my rheumy wanted me to have a bisphosphonate infusion to prevent any progression of the spinal problem. I have had it.

I was automatically handed AA nearly 16 years ago - it has saved me 15 years of taking it. I always said if there was evidence I needed it, I would take it, I wasn't happy to take it "just in case".

If your dexascan really is perfect, I would say no. But you do need good calcium and vit D (not the pathetic 800 IU the supplements provide, I have taken 4000 IU'day most of the last 15 years because otherwise my vit D level slowly falls to depleted levels). And you need dexascans every 3 years or so at least.

[Oh-my]

I would try and get another DEXA scan then you are informed. It would probably have to be private as the NHS have a minimum of 2 year gap

I did after a year on Pred above 10mg and I was disappointed at how much my scores had dropped. I have been having frequent DEXA scans as part of Bristol university longitudinal study and had grown complacent as I had well above average bone density. After a year of Pred I am now borderline osteoporosis. Many have no change at all. I am one of the unlucky ones but I am very glad I checked.

[Bridge31]

Your latest GP is just following the tick list for PMR. I simply refused to take it after my Dexa scan was fine for my age. I had my second scan 3 years later and it was still fine. If you had one 1 year ago I would say no thank you and have another scan in 2 years time especially as you are only 50 but make sure you are taking enough Vit. D

[Logic]

I was absolutely terrified to take this but I was in my 70s and scan showed some bone loss. I took calcium and vit. D tablets for two years and finally gave in when the next scan was worse.It is a pain in the neck but it's only once a week and you do get used to it. I was mainly worried about needing dental work in the future such as an extraction but talked it over with my dentist and she said lots of her patients took it.

I took it for four years and at my last checkup, after a scan showed improvement, she said I could take a holiday from it. But I had to promise to take calcium faithfully.

I take Citracal with D3 daily. My calcium and vit. D levels are fine at every blood work appointment. I have been off prednisone for over two years now and I think that is a more horrendous thing than anything else, yet we do what we have to do.

I have great teeth and except for a couple of fillings, I've needed no dental work. That was my biggest fear. My dentist was extremely careful at checkups to fix the littlest thing before it became a problem.

That being said, if you had an ok bone scan, why would you need this med? You can take vit. D and eat foods that contain it. I would have a talk with your primary care doc. This is a serious medication. And you are still very young.

Good luck.