Help with choosing a medication

Hi Sheilamac I would love to hear what your diet is. I have been on pred for 14months and also had DEXA scan at 3months showing I had Osteoporosis in my back. It was not down to steroids it was already there. They gave me Alendrotnic Acid to take but I have not done so yet. I was going to wait till my next scan 3yrs from first one to see if there was any change. I am only 50 so hoped I had some time to decide. If I can do something by trying a different diet I would be interested. Elizabeth

Hi Elizabeth, basically it's a high calcium height Vit D diet. So lots of dairy, lots of dark green leafy veg, like kale, broccoli and spinach, lots of oily fish like salmon and sardines. Plus calcium and Vit D supplements. I also take VitK2 which I understand guides the calcium to the bones and not into the blood vessels which can be dangerous.

I also got Nordic Poles and walk as much as I can. I try to do 2-5 miles a day.  Hopefully that will increase as my adrenal function picks up. 

The bone clinic told me to carry on with what I'm doing as it's obviously working. I hope this helps you. Check out high calcium foods online

Hi Sheila I am already taking vitamin D and Calcium. I started Vitamin K2 months ago and have a fairly healthy diet but could add a few more dark green leafy veg. I go to the gym 3 times a week where I lift weights as well as cardio. I was at the doctors the other day and she really wants me to take the Alendrotnic Acid for 5 years! Sound like she had not heard about it only being 2 now! I am very tempted to wait for my next DEXA scan in 2 years time. Tough when doctors are saying you should do something else. Thanks for information  

Elizabeth, google combination of micronutrients osteoporosis and you will find an article describing research done a few years ago which showed that nutrition, including some supplements, and appropriate exercise are effective in improving bone density.  I didn't follow the exact protocol of the experiment described but nevertheless improved my bone density in a year from -2 to -1.6.  Because I was on pred and had had a fracture a couple of years earlier my doctor was very keen for me to start AA (especially, I noted, after she attended an osteoporosis workshop).  The drugs are no longer being recommended.  I admit I came from only "low bone mass" not osteoporosis territory but I see no reason why most people couldn't have a similar improvement.  It's something you have to do for the rest of your life, but looking after the bones also contributes to general improved health.  At your age I completely understand why you would not want to start drugs.  However it might also be worth investigating why you have this concerning result at a relatively young age.  Could be very simple - sickness, lack of activity, something about your diet....

Good Luck!

Thanks Anhaga, I will take a look. There does not seem to be any reason for my result is poor. I have never been sick apart from PMR, I am very active, been a runner in my 30's (2 marathons) and gym a lot,  and my diet has been good for years now. I am not due to see the OP nurse for another 2 years so investigation is unlikely. I asked for another DEXA scan to compare to last year but was told that the change in results would be insignificant to not worth doing. I have to wait for 3yrs apart. I will do more reading. 

I did read somewhere in the last few weeks that in fact targetted diet and exercise can improve bone density as much as medications - and they have no side effects!

PS - and a lot of developing osteoporosis is in your genes...

My diet was what would have been described as 'very good' for a lot of years but this diet is very different. I drink or use often as much as a litre of fc milk a day, plus yoghurt which I make, cheeses, I try to keep away from carbs because of my steroid weight gain. I always liked salmon and tinned oily fish like sardines and pilchards so they have become my staples. My salads usually contain kale and spinach as well as the usual lettuces.

Re dexa scan, I was told 3 years as well but my doc ordered it a bit sooner because she was convinced it would show a deterioration and of course there was a massive improvement... The Bone Clinic wanted to wait another 3 years for the next one but I persuaded them to make it 2. They are as keen as I am to see what is happening. So it seems that the results can be expected to change in under 3 years. 

It's hard going against medical advice and I think they fear being sued. I actually told them that i would not blame them if I got a fracture. So now, as I do still have a degree of Osteoporosis I am trying to be particularly careful not to fall especially in these icy conditions we have at the moment! I decided I'd rather take that risk than take AA and as one of the side effects is a spontaneous fracture of the femur, no contest for me! I realise that statistically it is pretty unlikely but I could be one of these statistics. 

Hope my experience helps.

Webmd has an article, What Causes Osteoporosis? and Why?  which mentions a number of things one would never expect!  

Oh and the article Eileen is referring to may be the one you can find by googling combination of micronutrients osteoporosis.

I know 2 people on another forum who have both had spontaneous femoral fractures - which aren't healing - and another who has had shin splinits which her consultant says is due to the AA. That is out of less than 1000 members of the forums - which strikes me as not particularly rare...

Normally a dexascan should be done every 2 years, exceptionally less. 

And reducing al the other risks probably is far more significant than medication in reducing hip fractures which were already reducing in incidence anyway. Above all, maintaining muscle tone and balance are important - tai chi is said to be ideal. And good hydration and normal BP (not overmedicating and allowing it to go too low) plus good vit D levels are helpful. That is all for generally - in the house you need good lighting and removal of trip hazards. None of those have side effects!

Thanks Sheila, you have made me feel better about the decision I was making. I am young enough to change my diet more and push for a scan later this year.  Hopefully I will see a positive change. I really don't believe that there is enough evidence that AA will help!