Dexa scan done

Hi Eileen yes the results are,  T- score  -1.6. and Z-score -0.6

I have been taking vitamin d and yoghurt since I learned prednisone can reduce the calcium intake

I'd say that was a level that meant the first place to start was calcium/vit D supplements, vit K2 (a la Anhaga) and the right sort of exercise: weight bearing, possibly with a weighted vest. As Anhaga shows - that can be very effective.

Hi Eileen yes I have been on Vitamin D and calcium. I do need to find a supplement of K2.

thank you for your advice.

Do you know if CRP levels going up are a normal progression of PMR?

mine have gone up and that is what my G.P said. Also said there is no need for concern.

Thanks

Once you are on pred your CRP levels should go DOWN, not up. If they start to go up then that may be a sign the pred dose you are on is not enough to manage the inflammation - it certainly isn't a normal progression of PMR that is supposed to be being treated using pred. It would be if you weren't on pred. 

I suppose it depends on your point of view - if my CRP were rising I would be concerned. It can be raised for other reasons, such as a cold or chest infection in particular, but if all you have is PMR and are on pred, no, it SHOULDN'T be rising and if it is, it IS a cause for concern. It needs to be checked in a week or so to see if it is still rising - and if it is, then you need a higher dose. If you get a return of symptoms in the meantime - you probably need a higher dose.

There is another lady on the forums whose doctor said "your CRP has improved" - when it was rising. The lady concerned is very aware and questioned what the doctor meant since it had actually gone up a lot relatively speaking. "Oh, it's only gone up a bit..." No, it hadn't. 

Unfortunately we need to have our wits about us - since some doctors appear not to!

Awesome Eileen! Thank you! I will go back and have another check.

It is hard to know if symptoms return as I have never been pain free. The pain has not increased.

Was there a good reason for the break? What did the fracture clinic say? A dexascan should be done in the first few months of steroid treatment to have a baseline, especially in young patients. It is in the BSR guidelines from 2010.

I don't think it's too late to insist on the scan..  Others in your position have discovered after a scan that they never needed to be on the AA in the first place and discontinued taking it.  

Yes Rachel, you should absolutely insist. I am so glad that I did change Doctors and asked my new G.P, and I only did that because Eileen said to do that.

I wouldn't have known otherwise and not had the test and not been aware to take vit d and calcium [yoghurt]

Please do insist!

Well this is interesting anhaga, because my score is not that bad, after reading yours, thanks for including your score, my T-score is -1.6 and Z-score is -0.6. I don't know what a z score is

I have been taking Vit d and eating lots of youghurt

Z-score is one which compares you with age-matched group.  i don't think it's particularly useful, I wasn't even given it.  I suspect but will never know that if I'd been given a DXA scan before or just after starting pred my score would have shown as closer to what it is now.  I did have a number of serious but hidden side effects so quite possibly bone thinning was one of them, but I'll never know for sure.  All I know is that after I started a more rigorous protocol to care for my bones the score improved even though for half of the intervening year between scans I was still at a pred dose above 5 mg.  

Thanks Anhaga, that is helpful. I don't need to take too much notice of the z score.

It is a shame you weren't given a DXA before. I am thinking the same thing, this is my first one and it may have already been a little low too.

 

Yoghurt has been shown to be a really good way to get your calcium.  Apparently it's in a form that the body can absorb particularly effectively. Consider adding a Vitamin K2 supplement, unless your diet includes products from grass fed (never grain fed) animals.

Thanks Anhaga, yes I am eating lots of yoghurt. I did google vitamin K2 last night, and it seems to be in chicken and egg yolk, unfortunately the chickens will be fed grains.

I will look for a supplement, thanks for this advice.

Hope you are doing O.k