Osteopenia

The treatment for adrenal insufficiency is 5 mg of hydrocortisone which can cause bone loss. My initial scan was to determine a baseline which discovered that I had osteopenia. I am on the lowest dose twice a day.

I was diagnosed with adrenal insufficiency (cortisol very very low). My adrenal glands had shutdown - the very low cortisol. The pituitary gland was sending the signal to the adrenal gland to produce more cortisol - very high prolactin levels.
 
@thudson1965 Yikes! Glad you figured things out. So corticosteroids can cause bone loss? I’ve been having those shots in my knees quarterly since 2010. I’ve had them in my feet for several years, a couple of times per year. And I’ve had them in my shoulder once. All the injections are to reduce osteoarthritis pain. Do you think they could cause bone loss? What about Aleve? Since Osteoporosis is in my family, so that’s probably my primary contributing factor.
 
You might want to read up on Alleve taken regularly and liver damage.
It used to be prescribed as a continuous daily dose but now it is seen as a dangerous idea
 
snow said:
Are osteo Rx medsthe “biologics”?

@thudson1965 is correct in saying that steroids can cause bone loss. Fortunately/unfortunately for me I am allergic to systemic steroids, so I can't take them. Long term use of any steroids can cause bone loss. That's also bad news for men whose prostate cancer progressed to bone cancer since I hear that is part of the therapy.

@snow I suggest that you start with the "National Osteoporosis Foundation". Here is their link:


Then sign up for their forum on "Inspire".

I just discovered that they have changed a lot about their forum, so try to feel your way around until you get used to it. (I haven't been active for quite a while.)

I had several kidney stone surgeries BEFORE I started supplementing for OP. My urologist prescribed "potassium citrate" pills (prescription only). I haven't had any stones since then. WARNING: They are expensive! But they do prevent kidney stones.

There are so many OP meds. They work differently. Some speed up bone absorption and others speed up bone production. You need both. It is VERY complicated. That is why the NOF.ORG and forum are such important places to start.

Vitamin-K2 (MK-4 and MK-7) are important to direct the calcium to the bones and not your arteries or kidneys. Now digestive problems for me.

Once you sign on the forum search for Kathleen1314 and The BoneLady and DEXAGuru. They were very helpful to me.

Here is another good starting link:


God bless!
 
Maymay941 said:
You might want to read up on Alleve taken regularly and liver damage.
It used to be prescribed as a continuous daily dose but now it is seen as a dangerous idea

I think it is Tylenol that causes liver damage.

My doctors have told me, at my age to stay away from all NSAIDS, like aspirin and Aleve, because they can cause brain bleeds. I am already taking an anticoagulant (Xarelto). So I am at greater risk.
 
@Maymay941 I can’t get out of bed without Aleve. I’ve taken large doses since 2009. I’ll deal with liver or intestinal damage if/when it happens. All liver tests to date are normal. I’d rather live with decreased pain than zero pain relief without Aleve. Even with Aleve, I can still barely walk right now.

@MezaJarJarBinks Thank you so much for all of your advice!
 
Sounds good sounds like a plan.
I must say medical statistics don't seem to apply across the board and for sure you gotta do what you gotta do.
I hope the information Mezza Jarjar Binks provided leads to some very useful rabbit holes on how to manage the condition
 
@snow So sorry to hear about your health issues - at 46 you're way too young to be dealing with this stuff!

Have you ever tried osteopathy? It won't fix stuff but it may offer some relief.
 
@Sci_Fi_Fan No, I haven’t seen an Osteopath, yet. They are doctors who prefer to follow an organic way of doing things, and use a whole-body approach. They’re not actually bone doctors. But I’d try one sometime.
 
Our health is a major balancing act of finding what works for an individual and asking others what worked for them. I have a few other health conditions beside the prostate cancer and incontinence.

I AM NOT A MEDICAL PERSON - just speaking from my experience.

Each doctor wants to stay in their lane and many do not look at the 10 pages of forms they have us fill out.

I do not take calcium any more because in the mornings I my urine has several hundred tiny white dots which I assume is calcium.

I do drink milk, eat cheese, and try to get about 1,000 mg per day. I drink several days a week a premier protein 11 ounce shake that has 650 mg of calcium.

Questions
1) My instinct is to say wait until you get a baseline. Hoping you can get the appointment and test in the next few weeks. I have not had my vitamin K levels checked. (Note while search for a test I discovered their is a drug called K2 which is not Vitamin K2 - so be specific when looking for a test.)

There is Any Lab Test Now which I have used for other test that do not require a doctor's prescription. The Micronutrient test is $499 for 31 vitamins, minerals, etc.
Any Lab test in UTAH



The Micronutrient test - You will have to call for a sample test result to make sure it contains vitamin K2



2) I do not do soy - I have a mild allergy to soy.

3) I suggest miralax in morning coffee and/or colace stool softener (Docusate Sodium) 100 mg. Using the daily stool softener may be easier on your GI system and much cheaper using the store brand. I purchase from local grocery store pharmacy are 400 softgels for $7. These were recommended in the pre-surgery paperwork from my urologist.

4) Repeat answer from above
I do not take calcium any more because in the mornings I my urine has several hundred tiny white dots which I assume is calcium.

I do drink milk, eat cheese, and try to get about 1,000 mg per day. I drink several days a week a premier protein 11 ounce shake that has 650 mg of calcium.

5) I took Zoledronic Acid Infusion (Reclast) infusion (30 minutes) in 2019 and 2020. My osteopenia improved enough on my 2022 DEXA scan that my next scan is not until 2025. I skipped the 2021 scan because of COVID.

6) I had my first DEXA scan in 2018 at age 53 which showed I had osteopenia.


I too have osteopenia. My endocrinologist treats the condition using
Zoledronic Acid Infusion (Reclast) - a yearly 30 minute infusion. I had the infusion in 2019 and 2020. My DEXA scores improved so much, that my next scan is in 2025 (last scan in 2022).

I am glad to read that others are taking vitamin-k2 (MK-4 and MK-7). I use the following one.

 
@snow

WOW! What a story you have. I am so sorry for all your pain and suffering. It makes me feel guilty for complaining about my many issues. :(

Anyway, to answer some of your questions:

"1. Do you think I should wait to begin taking K2 M—4 and K2 M—7..."
It sounds like you have already decided to wait until you meet with an endocrinologist. That sounds like a good idea to me. The hard part is finding an endo that will do all that testing. There are certain "bone makers" that should be tested for as well. Here is a link to one of the posts on the "Team Inspire" group from Ladybug-88:

I have been taking "Innovixlabs K2 Mk-4 and Mk-7"; one with each of the 2 meals I eat per day. Here's the link on Amazon:

(As a man, it is hard to find an endo that is willing to bother with my osteoporosis since, "There has not been many studies on how men should be treated." Therefore, I have not been tested.)

"2. Have you ever tried Natto?"
No, I have not.

"3. What do you do or take to counteract constipation from calcium?"
I take generic PEG-3350 (MiraLAX) and mix it with my coffee or a glass of water. I take it once about every 3 days. However, my constipation started years ago when I started taking medications for all my other conditions. Be careful to drink lots of water with any of these stool softeners because that is what they use to work.

FYI: I used to take psyllium fiber as a supplement, but I didn't drink enough water and ended up in the hospital for bowel blockage.

"4. Do you take Calcium Carbonate or Calcium Citrate?"
I take the citrate version for better absorption. I researched this on ConsumerLabs. At that time, they highly rated the Costco Kirland brand. It has 500 mg. of calcium, D3 800 IU, and a bunch of other things. I take one tablet with the 2 meals I eat per day.

FYI: I also take "NusaPure Strontium Citrate 680 mg.", once per day, but hours away from the calcium. It is the same thing as calcium but has a heavier atomic weight, so it makes for a denser DEXA scan. Here is another "Team Inspire" link posted by a knowledgeable member, "Kathleen1314":

"5. What prescription medications have you taken for Osteopenia..."

None. After doing months of research and asking my dentist and every doctor and nurse that I see, I decided that it was far too much of a risk for me. I have had extensive dental work done, and I am now wearing fully implanted upper and lower dentures. Since every one of the prescription meds for osteoporosis can cause devastating necrosis of the jaw and other nasty side effects, and I have not had any spontaneous fracturing, and my DEXA and FRAX numbers are not bad for a 76-year-old man, I decided not to take anything that is available today.

"6. How old were you when you were diagnosed? Did you have a lot of bone fractures or were you just having the routine DEXA scan that comes with age?"

I'm 76 now. I think I was about 60 when I had my first routine DEXA and was told that I had osteopenia. I had no symptoms, and the only fractures I had were from falling. No treatment was offered at that time, and there was no concern. It was in 2020 that my DEXA score in my "left femoral neck" was -2.5. The doctor wanted me to start "Prolia" immediately. I told him I would investigate and get back to him. A few months later I sent a reply via MyChart portal and told him I could not take that chance.

FYI: My loss of bone mass was mostly caused by all the various meds I have had to take over many years. Since losing my thyroid to cancer in 2011 I have been taking artificial thyroid, which tends to lose bone mass. Also, the "proton pump inhibiters" I used to take for gastric reflux can be damaging to bone.

Kidney stones:
I have a long history of kidney stones that started long before I started taking calcium. It wasn't until a few years ago when I went to a new urologist group that I was prescribed "Potassium Citrate 10 MEQ ER", taken 3 times a day. This stuff is super expensive, but I have not had any more stones since I started taking it, so it's worth it for me.

May God bless you in your journey, and may you find the answers that are right for you! 🙂
 
@MezaJarJarBinks Thank you for sharing your detailed information. I really appreciate it. I have opened the webpages you referred me to, and I’ll read them later tonight. Hopefully they’ll help me become more involved on Inspire.

Interesting that you’ve probably suffered bone loss from all the other medications you take. That may have affected me as well over the years; who knows. I’ve been on so many meds for so long; way more than both of my parents combined. Because of all of the Aleve I take for back pain and overall chronic pain, I have been taking Prilosec/Omeprazole for about five years. As I understand it, of the PPIs, Prilosec is one of the least bad in terms of side effects. I hope so. Interesting that the physician who initially prescribed Prilosec to me, as well as the rest of my physicians, including the one who diagnosed me with Osteopenia, never mentioned that Prilosec may cause bone loss.

I try to remember all of the potential side effects for all of the meds I take, and I reduce the meds I take by about half a couple of years ago. But then I added a couple. I’m thinking now maybe I should possibly create a spreadsheet of all the medications I take and all of their potential side effects, so I’m not always having to look them up over and over again and can instead just refer to my spreadsheet. Then again, having to look them up over and over again means that I’m getting the latest information. But if I have my spreadsheet, when I experience a side effect, such as constipation, I could go look at my spreadsheet to see which medications cause constipation, and I would have realized that it’s been calcium for me all along. Or, if I experienced heart palpitations, I could look up which medication is known for causing heart palpitations as a side effect.

I do think I’ll wait to start the K2-M4 and K2-M7 until I can hopefully convince an Endo to run the bone marker tests you mentioned; thanks for the tip. I’m sorry it sounds like your Endo doesn’t treat you with respect you deserve.

Thank you for your advice about Strontium Citrate. That’s another of the things I had read that could be helpful, but wondered about.

Thank you for your advice about constipation medication and water because since I’m typically trying to avoid consuming liquid because of incontinence, when I have taken those conspiration meds, I now realize I have not been drinking enough water with them, which could explain why some of them don’t always work for me. You may have saved me a trip to the hospital with your advice about psyllium! I like Miralax if I have the time for it to work but if I’m feeling way too backed up, I may go for a strong Dulcolax suppository.

It’s nice to hear that somebody else has rotten teeth and would avoid the osteoporosis medications for that reason. My oral surgeon told me it would be more beneficial for my overall health to take the Rx bone meds than to worry about my jaw, but I’m not so sure. I mean, his assessment would behoove his practice: if I had that jaw problem because I took the bone RX medications, it’s his office I would be referred to for treatment! I think I’ll try to do what you did, which is to ask every doctor and nurse for their advice about those hardcore prescriptions.

As for Potassium Citrate, it’s good to know something is out there that can help reduce the likelihood of having kidney stones. I’m keeping these emails in my medical file for future use as well :)

I’m positive you’ve had more, and much tougher, medical trials than have I. Too bad you probably won’t be alive when I’m 76 because then we could really make an accurate assessment of whose life was harder, lol! Ultimately, let’s just say we’ve both suffered way too much! We’ve both had multiple, complex, chronic conditions for a long time - diagnoses and expenses that many people never experience one of in their entire lifetimes.

The important thing is that we’re not alone in our suffering, for we know one another thanks to the NAFC and Inspire. I mean, I feel completely alone medically with my friends and family; none of them can relate to even one of my conditions - yet. I think they may be able to with time and aging. For instance, I was first diagnosed with cancer when I was 39, and nobody from my high school reunion had it yet by then. But now several have even died from cancer.

One of the problems between my ex-husband and I was he thought medical conditions were all in the head and “mind over matter.“ Well, now he’s dying of rectal cancer that has spread all over his body, and he hasn’t been able to control it even with chemo and radiation, let alone his mind. We’re still good friends and confidants so I’m dreading the loss of him, but when he was initially diagnosed, part of me thought, “Now it’s finally your turn, you insensitive bastard!” He was so mean to me about my own medical conditions. Now he *knows* they’re real, and they’re in charge! It’s been somewhat of a relief to finally know somebody my own age who has had cancer.

Anyway, thanks to this forum, I *know* I’m not alone with medical suffering, and that keeps me safe through my more lonely, suicidal moments.

I’m filled with courage when I read what others have suffered through. I don’t belong to any other medical forums for my other conditions, though I’m sure they would also help me - I would never have enough time for that amount of a male in reading! It’s just that I feel like I receive enough love, support, and understanding here that I don’t need to belong to other forums, though I will become active on Inspire because bones are a major big deal during our existence.

Thank you again for your support :)
 
@thudson1965

Yikes, about the white dots in your urine!!! Good to know to look out for those maybe. Women don’t often look at our pee because we just flush the toilet before we even stand up. But in the past, for my Urologists, I have definitely measured my urine, so that’s a way to visually check one’s pee periodically for white dots.

I’m glad you found a way to get enough calcium through things you eat and drink. Medical professionals always say doing so is the best way to get one’s nutrients.

Thank you for the link to that non-prescribed lab test site. The micronutrient test sounds AWESOME! Depending on what insurance I have in any given year, that website may be the less expensive way to get certain labs performed. I’m keeping your post in my medical file for the rest of my life, also! I had no clue one could get labs without medical personnel or the court system ordering them!

Sorry to learn of your allergy to soy; that would be tough!

Good to know you also like Miralax. It never occurred to me to put it in anything but water. I’m pretty good at not tasting things that I don’t want to taste when I consume them, so I usually just choke my MiraLAX-laced water down. Maybe next time I’ll mix them with Coke or coffee :) I’m going to need a lot of stool softeners to combat the heavy-duty pain medication side effects after my knee replacements. I have tried a place and Senneka in the past but had preferably quicker, though gentle, results with Miralax.

Thanks for the links to the versions of the things you take/use. I definitely need to do more research on Reclast before I see my Endo because I’d like to have an answer prepared if that’s recommended to me. I guess if something like Reclast could improve every decaying, painful joint and bone in my body, maybe I would be foolish to worry about just my jaw. I would really like to not have jaw surgery and have face scars, however. Such a strange side effect I need to read more about!

Thank you again for your assistance :)
 
@Sci_Fi_Fan I just realized that when you ansked if I’d tried osteopathy, you were referring to what we in America call chiropractics. In both places, there are medical Doctors of Osteopathy, but they don’t work necessarily especially with bones. Their main philosophy is to work holistically on a patient’s entire body, which does sound nice, and is contrary to a standard medical doctor, who tends to have one specialty and disregard the entire body as one system. Some of them provide massages. I’ve never been able to afford a massage, but I guess I would try one if a doctor was doing it.
 
@snow

FYI: I just received this link to a .gov article about "Gender Disparities in Osteoporosis".


Also, "Milk of Magnesia" works quickly for me.
 
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