Osteoporosis and joint replacement?

Hi Kathleen!    I'm taking all the things you are taking except K2.  

I wish I could just relax in a warm pool.  I am a British ex-pat living in Germany, it's -2 to -3 at the moment here!😡.  I can go to the local Spa, but the faffing about getting there, showering, half an hour in the pool, showering, washing hair and getting home again I find more and more exhausting.  What can I expect at 76?

My husband is 80, and as fit as a fiddle.  Some are just very very lucky.

All the best fr C. 💐

The importance of K2 (not K1) is that

it is the vitamin which makes sure calcium is actually absorbed into the bones and not deposited on the walls of your blood vessels or other inappropriate organs.  It is in its own way as important as D3!

Dot, I still wonder if I am doing the right thing not taking the drugs so to hear you agree is emcouraging. I was concerned about swallowing fosamax and even more concerns about the injections.

Sorry about your accident!

Are you a GP or nurse?

Is there any advice you can offer about natural help or other?

 

Hi Kathleen, I was in charge of intensive care, now retired, my daughter is a GP. During my working life I had to know everything possible about drugs including interactions and "half life" so I never take anything before fully understanding every aspect of the drug. The drugs available for OP have a "half life" upto 10.9 years so any side effects could potentially be long lasting.

I take the same as you, eat a healthy diet with lots of oily fish, eggs, green veg and limited red meat. I also do weight bearing exercises, swimming etc. Sadly I am no longer allowed to ride as my pelvis is unstable, this has been the worst part of all this as I have ridden all my life and competed to a high level.

My accident was 17/12/14 and although it has been a long road to recovery, I can now do most things but limp when tired.

There is a new drug in the pipeline, could be available in the next few years so I will wait and look at the trial data as its published.

My t-score is very similar to yours and Constance.

Best wishes,

Dot x

I am interested in remaining drug free too. I took tamoxifen 20 years ago for breast cancer. I am now 62 and was diagnosed with osteoporosis when I broke my wrist a couple of years ago. I tried alendronic acid and then raloxifene. I didn't like the side effects. I stopped the raloxifene but my recent spine dexa scan has worsened to -2.8. I take calcium, magnesium and boron and also Vit D3 and vitK2. I have a healthy diet and drink a smoothie made with coconut milk each day. Not sure what else I can do. However I recently broke a rib when I was gently twisting and am now being referred to the osteoporosis clinic, possibly for injections. The side effects are very worrying and there are so many conflicting views. I honestly don't know what to do for the best. I wish there was an easy answer! Chris

Chrissie, I don't blame you for feeling confused. You certainly seem to be doing a lot of things right.  I have read, however, that the nutritional supplements have proven as effective as bisphosphonates in combatting osteoporosis, so I wonder if you may have a problem with absorbing calcium, etc?  Do you walk a lot?  It's supposed to be the best exercise for people like us with low bone density.  A quick internet search shows a number of articles saying that tamoxifen might cause a loss of bone density so perhaps that increased your risk somewhat.  I'm taking prednison which apparently actively interferes with calcium absorption, so I have to be careful not to take a calcium supplement within several hours of the pred dose.  I hope you are able to find a solution that works for you.  No one else can make the decision for you but I personally am avoiding the OP medications.

 

That is very interesting about the new drug and let us hope it is safe. 

The half life is the scary part. Also scary is swallowing and endangering the oesophageas as well as having teeth extracted. I do know the blood test to check that is safe. That information I got from an oral surgeon and I related it to my GP and she shared the knowledge.

Another thing that I fear is that some bones may be made more brittle.

So, for the moment I am going the natural route and will know how I am going with that in about 12 months.

Women over a certain age require four servings of calcium per day which is hard to get from diet alone. This information I got from a dietician.

Also, I have been told by someone that I should not take the calcium at the same time as the magnesium which I do now but unsure if that is correct.

I don't know about the boron. What does that do?

I did not think -2.8 was too bad. My sister has that result and is going the drugs route. She takes fosamax.

Yes, it is very confusing, and we make the best decisions for us, and just hope that is the best decision.

 

Anhaga, it would be great if supplements truly were as effective as the highly dangerous, questionably beneficial bisphosphonates in addressing osteporosis. However, from everything I've read -- and I've read quite a lot over the last few years -- this is wishful thinking. If it were actually the case, probably we'd have no need for this forum and our worries would be allayed. I know that some of the alternative practitioners make such claims for their supplement products or even for supplements in general, but there is little if any evidence to substantiate them.

Hi Allison, I have missed seeing you in this forum. How have you been?

I always like to read what you write.

 

Thank you for your responses. I think boron works with magnesium in helping with the absorption of calcium but I'm no expert. The supplement I take includes both magnesium and boron with the calcium. I tried Adcal from the doctor but I seemed to get constipated so this is a supplement from the health shop. It seems one problem gets resolved but causes another! I think -2.8 is ok but what I take in calcium supplements doesn't appear to be enough as I get older. I have a collie so she drags me out walking every day so I get a reasonable amount of exercise. Because of the breast cancer I was referred to the breast consultant just in case it was secondaries in the bones but as this isn't the case I am now being referred to the osteoporosis clinic. It may be that upping the calcium will be enough but I will let you know once I have been. This is a really good forum. Bone degeneration is really quite scary and yet there seem to be very few options for treatment. It's good to talk!

kathleen, thanks for your nice words; you are kind to note my absence. I've been around, so to speak -- just hadn't seen discussions that I thought I had much to add to until recently. Lately I've been focused mostly on increased pain due to arthritis in my hip and trying to decide if I should schedule hip replacement this year. (BTW, constance.de, I've asked several surgeons about this type of surgery in someone who has osteoporosis, and all have said that one has no bearing on the other.) How are you?

Oh what a shame.  However, everyone I know who has had a hip replacement has been thrilled almost immediately because the pain is all gone!

Hi Allison.  I'm getting on OK, thank you.  I don't actually NEED surgery, thank goodness, I am just interested in what happens with Osteoporosis.   I imagined with thinning bones it must be difficult if you did need surgery.

I have several other problems as well - PMR, Polyarthritis, Gout - so just wondering how things might affect me in the future.

My husband helps a lot.  The other day I hurt all over and said "even my face hurts."   His comment?  "It's a pity it didn't hurt when you were younger, it would have stopped you nattering".  Nice!😡.  Another one, when I was having a particularly painful day I said "I think I'll go out and shoot myself".  His answer?  "You'll have to go out and buy it yourself, I'm not paying for it"!  I do love this man!😄😄

I agree with you to some extent.  However the claim about the relative effectiveness of diet and exercise does not come from sites pushing specific supplements, but from studies.  I think the real tragedy is that people are not made aware at an early enough age what we must do to protect our bones.  I, for example, remember feeling quite cross at the age of 35 when I heard for the first time that I had now reached an age where my bones would be losing their mass.  I did what I could at that time, by starting calcium supplements, and I was really lucky at the age of 48 to start a job in a public library where for about seven years many of my hours were taken up with shelving books, so I've often though that, and walking, helped me through that menopausal drop in bone mass.  But it wasn't until late last year at the age of 68 that I began to understand exactly how little I knew and how much more I could have done over my lifetime to safeguard my bones. And I have always been one to try to live healthfully and considered myself well-informed.  Considering our skeleton is literally the frame on which everything else hangs I think it's bordering on negligence for health authorities not to give bone health at least as much attention as other major medical issues such as cancer and cardiac health.

Nothing like a good sense of humour to carry one through life's little tirals!

I believe boron is one of the elements that helps with calcium absorption.  It is readily available in the diet - I just make sure I eat a few prunes every day as I like them and they make a healthy snack.

My sister in law started Fosamax but had to discontinue because of side effects.  As she lives practically as far away from me as possible on the North American continent I have not had an opportunity to ask her what those side effects were.  I have friends who moved themselves according to their DXA scans successfully from osteoporosis to osteopenia levels through diet, including supplements, and exercise alone.  One continues her diet and exercise regimen and continues to improve, while the other has slacked off and become osteoporotic again.  So whatever we do, it is a lifetime committment!

Ok thanks Anhaga. I looked it up and it said fruit, in particular, was a good source. Avocados are too! 

Oh good, I like avocadoes too!

I could not agree more! I believed I would always have good bones and never have a back problem! I thought because I liked dairy my bones were protected. 

I was ignorant of what could happen to me at this age.

If I could go back I would learn more and protect my bones as much as possible.

As far as the diet is concerned as it is all I can have then hopefully I am helping somewhat!

The drugs are too scary so I will try to help with the diet and supplements.

Here's hoping!

I always look for your comments, Allison. You give the other side credence. It is good to look at things from both sides. 

I am not great but I can enjoy my home and my husband's company and the pool affords me some exercise.

We just celebrated our golden wedding anniversary which was lovely with all immediate family coming for a week of celebrations. Friends also came for a party.

I am sorry about your hip. That will be an ordeal for you.

Hope to see you on here again soon.

 

Hi Chrissie

I am very worried/scaredabout side effects of the drugs too, my spinal T score is -3.5 I am 54 years old. My doctor is quite adamant that I should take raloxetine. (I couldn't take the Alendronic Acid or similar) What problems did you have with that drug?

I am not taking vitamin K2 but feel I should. My doctor won't prescibe it, where can I get it from and how much do I need to take?

Thank you

Tania

Vitamin K2 should not need a prescription.  I buy mine from an organic foods store, so any alternative store like that, a health food store, etc.  The staff should be knowledgeable and help you choose a supplement that is right for you.  I understand that we can also get it from our food, especially if you have access to grass fed anumals and their products (eggs, dairy, meat) - not grain fed, which is where all our K2 problems lie as the animals can't convert K1 to K2 in the absence of a grass diet (or completely free range in the case of poultry).  It's also possible that we can get K2 from fermented foods like certain cheeses, sauerkraut and related fermented vegetables, even yoguhurt, and especially the Japanese fermetnted soy called natto which I understand is an acquired taste - and is the source of the supplements we can buy.  Some bone supplements now include K2, but I'm not sure if the amount would be quite enough for our therapeutic needs.

What is your doctor's reason for not prescribing Vitamin K2?

 

Hi Tania. I found with raloxifene that I was waking up with leg cramps every single night and they stopped as soon as I stopped taking it. I also felt not quite myself, a bit depressed I suppose. But this could have been the interrupted nights.  However you might not get those side effects. I get my Vit K2 in a supplement which includes Vit D3 but I am by no means an expert. I just asked for some advice in the health shop. I find it difficult to get my head around how much the bones degenerate as we age and whether we have to up doses of whatever if we go down the food and supplements route. My husband makes me live yogurt regularly, but there's only so much I can eat! Do we need to consume more in the way of calcium and supplements as we age to maintain the status quo?  It is very hard to put yourself onto these not very nice drugs when you feel perfectly well. 

Thanks Chrissie for your help. I will get some k2, I really dont want to get more depressed than I already am, oh well back to thinking. Did it state on the instructions that depression was a side affect?

Hi Kippy.  Got moderated.    Side effects include mental depression although of course not everyone gets all the side effects. Let's see if I can direct you to the website without being captured again.    It is just called drugs.  After the dot there are three letter starting with c continuing with o and ending with m.  When you get there, just type in your medication name.

I don't recall that it was mentioned but of course it might not have the same effect on you. I wondered whether it was because I had taken tamoxifen for 5 years as I think it's related in some way. I tolerated tamoxifen quite well until the last year so who knows whether that had some lasting effect. Good luck with whatever decision you make..

As if things weren't already confusing enough, a recent (late 2015) meta-analysis by New Zealand researchers found that taking calcium either in dietary or supplemental form did NOT decrease risk of fracture and that increased doses might even be harmful. (I tried to copy text from the article but that didn't work; try Googling it.) This isn't the first study to examine that issue. In Japan, for instance, rates of calcium consumption are low, but so are rates of osteoporosis. I'm not suggesting that we don't need calcium at all; just raising the possibility that one of the central tenets of osteoporosis prevention shouldn't be immune from being questioned. My nutritionist told me that it was best to get as much calcium from food vs. supplements as possible and she said that eating foods sometimes fortified with calcium, e.g., orange juice and certain cereals, was the same as taking the supplements themselves. My endocrinologist, a senior doctor at a major teaching hospital, had enthusiastically recommended calcium-fortified foods! But when I pressed him about the nutritionist's comments, he did not appear to know either if or how calcium-fortified foods differed from actual calcium supplements!

Older women need four serves of calcium each day apparently. Men only require three as do younger women.

If I think I have been under the four for a few days I take one only calcium top up.

Another interesting recent finding is that teenagers can bank calcium onto their bones which will stand them in good stead later on.

In Australia there is no excuse for not meeting daily requirements of any important food group but many do unfortunately!

I have read everyone's posts with great interest and although I am still waiting for an appointment at the osteoporosis clinic I am veering towards staying off the injections for a bit longer and persevering with calcium, D3 and K2 together with walking. I read somewhere you should not take more than 500 mg of calcium at any one time and not more than 1500 mg per day.   There is supposed to be no link between calcification and high intakes of calcium but when I had breast cancer a third of my breast had calcification - this was 20 years ago when I was 42 - so I prefer to take calcium in different formats throughout the day. I don't think it's a good idea to take large doses of any supplements anyway but that is just my personal opinion. At the moment I am -2.8, with no loss of height and 2 fractures (wrist and rib).  Bone loss is silent. That's the scary thing. But the medication is scary too!