steroids and osteoporosis

Hi there did Know of the risks With my previous bout of PMR I had one at about your age and was fine My Dr said anyone on 7.5 of streroids should have one and I am due one shortly Have been taking the weekly bone drug this time as my Dr thinks it is better to start with it as prevention is better than cure as you say your other conditions may be contributing towards it Best wishes

Hi there again Nannypat - I was sorry to hear about your osteoporosis diagnosis at only 53........were you prescribed the bone protection tablets when you commenced on the steroids? If not, then they will hopefully improve your bones if you have been given them now. I have an elderly aunt who has had very good improvement since taking them, although I must admit that she does also swim and attend the gym a few times a week.

I had a Dexa scan when I first commenced on the steroids which showed osteopeania of the spine which I believe is the stage before osteoporosis. Now two and a half years later I am about to have another scan so I'm crossing my fingers! I eat a live yoghurt every day in the hope that it will give me some protection.

As you say, it is hard when you keep getting hit with one thing after another but I hope you feel back to your usual cheerful self soon. Best wishes and good luck.

MrsO

Hi Mrs G and Mrs O, thanks for your kind words of encouragement.. I really appreciate them. I've been taking calcium and vitamin D tabs for a while now (obviously not working!!) I'm hoping to see a consultant soon and hopefully we can sort me out!

I've also started walking when I feel up to it(I borrow my daughters dog..it helps that hes not very big so he doesn't go too fast) and

I also borrow my grandson Adam to bring me swimming!! :lol: (Hes not very fast either!!) Trouble is, getting into the pool is easy..you just jump in..but getting out is a different kettle of fish!!! Adam is only 9 and hes not very good at shoving me up the steps!!

I must say that its nice to hear from people who understand exactly what we are going through, and hopefully we will all get better sooner rather than later. I hope you both get good results with your scans when you have them.

ps absolutely hate yoghurt in any way,shape or form..any suggestions?

Nannypat - As you're already having calcium and Vit.D tablets and still have osteoporisis, then maybe you'll be prescribed a stronger medication for your bones when you see the consultant.

Yoghurt is so good for so many things but I get the message that you don't like yoghurt!!! :lol:

One other food type that I have several times a week for my bones is oily fish (sardines, mackerel, salmon, trout) because they contain Vit.D which helps the body to absorb calcium in your diet, plus getting out in the sunshine, of course (when and if we are ever going to get any!)

Bless Adam and bless the dog - they sound as if they're doing a great job for you!

Good luck when you see the consultant.

MrsO

Hi all,

I had an x-ray scan across my spine some months after starting on pred and calcium/vit-D tablets and it showed a few percent drop in bone density. I was immediately prescribed alenat/aledronat which is taken once a week. Whereas pred slows down the rebuilding of bone material the alenat slows down the breakdown of bone to compensate. Now a year on, I recently had a second bone density test, this time on the heel, and the result showed higher than average density for my age. So it seems to work. (Still stuck at 5mg pred per day though).

All the best; davblo - Sweden

Davblo

Sorry to tell you, but a Dexa scan (hip) shews the best results.

NHS hospital only go by the Dexa (hip) scan.

Heel scans can be done at chemists and some supermarkets which you pay for on the spot. They are not as good as the hip scan if the heel shows wear, they tell you to go to your GP with the result and when you go - the GP refers you for the Dexa at the hospital.

mrs K

Hi Mrs K,

Re: \"They (heel scans) are not as good as the hip scan\"

Thanks, they didn't tell me that.

The first one I had was in a big computer tomography x-ray a scanner; but i guess that was expensive to use.

They have a heel scanner that travels around between the hospitals, so I had to wait until it came here.

I'll ask about the Dexa scan next time I see them.

All the best; davblo

Hi my Doctor started me on a weekly Alendronic tablet as well as daily Calcium tablets as soon as I started on 20mg of prendisolone last October When I had PMR before in 2002 I didnt have the Alendronic tablet but she said that now they had moved on to prevention with bone loss not catch up and I am due a Dexa scan in the next 2 weeks I thought if you were on over 7.5 of steroid you were supposed to have the scans on a regular basis ???? this could be my surgerys policy though

To answer both Davblo and Mrs G

Dexa scan - google the NHS site and you will see the current state of play.

A Dexa takes about 20 minutes and costs the NHS about £20 - a hip operation runs currently at nearly £13,000. That's why the Govt are pushing scans and changed the policy.

Therefore the reccomendation is that any woman over 60 or past the menpause (which can occur earlier) has a Dexa every year.

Pred takers (and they are not just pmr and gca people and not just women) on a dose of 7.5mg or higher or a long term user (lower dose) - first Dexa after six months - thereafter yearly.

Push for it - save the NHS money.

mrs K

Oops - although I previewed - I missed the spelling mistake

its not 'menpause' - its menopause.

But I did smile.

mrs K

MrsK

You'll have poor old Davblo in Sweden blushing!!! :lol:

MrsO

I dont thinkl the guidlines are being followed !! The only people I know who have had Dexa scans are people on steroids or older people who have broken bones Its a shame they dont do more as I seem to know more and more people who are haveing replacement hips

I'm only 50, but I'm menopausal (my periods stopped 2 years ago) and I've been on Prednisolone for PMR since May 2008, yet I've never even heard of a Dexa Scan. I am on HRT and luckily still have a pretty active life including a lot of walking and swimming.

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Hi all;

Mrs K: \"...not 'menpause' - its menopause\"

Freudian slip?

Re: bone density measurement; there seem to be different policies in effect in different places.

Isn't it the same for PMR (and other) diagnosis in general? I've seen so many different stories on this site alone. Then there were the differences in blood tests and how often they are carried out. Not to mention the adjustment and regulation of prednisolone dose.

I've searched a bit and there seem to be several different types of bone test. One site listed about 8, and at least 2 were on the heel. I'm seeing the district nurse on Monday (because my blood pressure's been high for about 5 monhs) so I'll try to find out which test I had and what else is available.

I'm learning more and more that if you don't ask you don't get...

All the best; davblo - Sweden

Davblo

Not being a medical person and having to learn more than I ever wanted to know due to GCA and Prednisolone. I have listened to both my GP(who is excellent - both of them) and my Rheumatologist (who again is first class (re I not the lucky on), who both insisted on a Dexa scan (luckily I was at 97%) and also Professor Bhaskar Dasggupta an internationally recognised expert on both pmr and gca - I can only tell you what I know happened to me.

I also checked the NHS website, the RCP website and the Osteoporosis National Charity site as well. The latter pushed for scans. The DHS latched on when they realised the cost of hip replacements had shot up (aging population) and particularly in women who were past the menopause and because of this - loss of bone density - so preventative measures were needed to keep the cost down - hence Dexa Scans. But whereas heel scans are available 'over the counter' they are not as good as 'hip'scans - but have a useful part to play.

Long term usage of prednisolone leads to loss of bone density - therefore the reccommendation is - after six months of long term usage - a Dexan scan - thereafter - yearly. As prednisolone is used not only for pmr and gca - the use of the Dexa scan is for all long term users.

I stand to be corrected - but this is my undertanding of the position in the UK at this point in time.

I know its not followed by every medic - its called patient power - ask politely but fimrly and you should get one, if not - ask why and refer them to the NHS policy. Once you are aware - you are on better ground and cannot be treat like a 'two year old going on 100'. Yes, ageism is rife in the NHS as well as other areas in the UK.

Well, that's me on my Overdraft soapbox (yes, I am over my three score years and ten).

mrs K

Mind I still have a laugh, a giggle and am not a Victor (ia) Meldrew yet.