Treating osteopenia and osteoporosis

I only started having real health problems when I was 72.  Not bad, eh?  Then PMR struck, causing many difficulties and side effects.  Later, OA set in and Osteopenia.   Hope the future is good to you.

Hello Alison ---

Just diagnosed with osteoporosis -- wanted to stay in bed with covers drawn over my head .

..I too took calcium, magnesium, exercised all my adult life, according to Dr...this is because of menopause hormone loss...an excellent book I have found is The healthy bones nutrition plan and cookbook....by Laura Kelly and helen Bryman ---completely natural plan (Amazon) ---explains what we have to do to get calcium to absorb.   I was told by endocrinologiest to take Forteo --was horrified by it's side effects, and

considering Prolia --which I am scared of as well....so far, I am walking with weights, drinking nettle tea, eating greens, and trying to learn 2 or 3 more things a week and not be overwhelmed.....I am age 58  --encouraged my sisters to get bone density test.  

Good luck to you!

It's a horrible diagnosis.  One feels shattered, not to say crushed.   I was incorrectly told I had OP, turned out is was low bone mass, aka osteopenia, but during the two months before I got clarification I did a lot of research and also got help from a friend who had moved from osteoporosis to osteopenia and continues to improve (confirmed by DXA scans).  In one year my main reading of -2 has improved to -1.6.  I am still on low dose prednisone (down to 2.5 mg) but all the stuff I've been doing, including taking vitamin K2, using waeighted walking vest, walking 10,000 steps, practising tai chi and Nordic walking - guess it's really working!  (Btw I am now 69)  All the best!  

Should clarify - I have never taken any of the osteoporosis drugs and never will.

Hello there Anhaga. Just been reading through this thread and been researching since I got my horrible diagnosis last week of osteoporosis. Two minus 3.5 scores (total hip was much better score though osteopenia).

I am not keen at all to take the bisphosphonate drugs and looking into natural ways to improve things. I am shocked with my diagnosis to be honest, as I felt I was low risk but at 64 and 15 years post menopause, I guess not. Also I only got a bone density scan due to the endocrinologist believing I had been overdosing on thyroid meds. Maybe this was a contributory factor, and have now reduced them in case.

I cannot see anyone on here suggesting using a rebounder. Like the walking, there seems to be conflicting views on whether they help. Much easier for me than walking daily, and can be used on a wet day. It's like a mini trampoline, and it's suggested that NASA used them to help with bone density after space trips. Good for balance if nothing else, and I am now adding it in to daily exercise routine.

I am adding in some good supplements as well as my diet which is pretty good (I have some food intolerances which limit me a bit). As my calcium intake was not great, I now have Teff seed porridge which has a good calcium amount.  I gather that strontium is worth a try (apart from D3 which I have taken for years, and K2 which I recently added in). Someone recommended a supplement called Bone-Up made by Thornes which has a good mix of useful things so I thought I might try that too but some of the ingredients are the same. .

Hi

Just a note of caution - I asked my osteo physio about using a trampoline and was told not a good idea as I have T-2.8 in my spine, and apparently the jumping isn't controlled in the same way as if you are on the ground. So maybe worth checking with your specialist if this is okay for you. I'd like to find out more about what astronauts do to recover bone density after a space flight, so if you have any links, please share

Thank you ANW. Are you in the UK? Unfortunately I don't have a specialist to ask this, but I have just noticed on a UK booklet about osteoporosis about the caution given re jumping generally and that they don't really know for sure of the safety of rebounders if you have a score over -2.5 ie just no research done on it. Certainly people who sell rebounders indicate that they are safe for osteoporosis.

That said, in the same booklet they suggest that not all people in that category should necessarily avoid higher impact exercise depending on level of fitness and if any other problems. As I don't have any symptoms of pain at all in my back and really do want to try and increase my bone density if possible, I will continue I think but bounce more gently and cautiously. So far I have never had any pain in the back from it. I do get achey legs but have only just started really and am not used to the exercise on it. The other thing about the rebounder is that you don't need to go up very high at all, just an inch or 2 at most, and so it does feel very controlled while you are doing it.

The way the notifications come in, I get the most recent first....  However I think anything we can safely do which stresses our bones can only be a good thing.  I am on prednisone for polymyalgia rheumatica, and I'm sure this contributed to my bone thinning although it was probably not the only factor.  I have been taking a supplement designed for bone health which uses calcium hydroxyapatite which is supposed to be best for people on prednisone.  The other recommmended type of calcium is citrate.  One thing I did learn was that when we get a fair amount of extra calcium we can upset the calcium/magnesium balance.  But I think the easiest way to set that right is to have an occasional soak in a bath with Epsom salts!  I really prefer to get my nourishment from food but I guess as we age it's not always easy to do that, hence the need for some reasonable supplements.  

Over the past year, through gradually reducing pred dose (from 15,  now at 2.5) and watching diet, supplements and exercise, I've improved my femoral neck t-score from -2 to -1.6.  Last year "they" were recommending bone meds, this year they are not!  So improvement can happen the natural way.

I should perhaps add that I have an old diagnosis of (non-symptomatic) sarcoidosis, and this apparently has contributed to my bone thinning as well as low iron and, unfortunately, a high Vitamin D level.  So it's all a bit complicated. Still, keeps me busy in my old age!

Happy New Year!

Thank you Anhaga. I do appreciate your interesting posts, and it's so encouraging to know that someone is improving. Funnily enough, I was just thinking today about the Epsom Salt soaks! I don't do them yet, but intend to, but will need to just do a foot soak as we have no bath. At the moment I take quite a good magnesium supplement, but if I take too much I go to the loo too often! Also I have a good transdermal spray which I use on my legs in the morning (it has DMSO in it which helps it through the skin).

Interestingly I have never taken extra calcium before as I knew that you had to be careful with supplements as it could end up in the wrong places, I am guessing that now I am on Vit K2 Mk7 that it should be safer

I have a friend who has both Polymyalgia rheumatica and coeliac and I know she has osteoporosis, but I have never discussed with her what she has done for it, though I know she does a lot of walking.

I am a bit puzzled by the 'unfortunately a high Vit D level' - I thought that could be a good thing? Is it very high then? Most people's levels are not high enough in the UK (I am guessing that you are in Canada or US?).

Happy new year to you also! And thank you!

Yes I'm in the UK. After fracturing my wrist I got referred for a DEXA scan, then to a falls assessment clinic, where I was given advice on exercises and asked if I wanted to go to a "healthy bones" talk, or bone boost exercise sessions, and I just said yes to everything. One of the physios said don't use a rebounder. At first she said jumping was fine, but then phoned me to say her supervisor cautioned against this, due to my spinal t-score, but said I could do running on the spot instead. I barely lift my feet off the ground. Most of the exercise I do now is at the gym, using a mix of treadmill and static weight machines. Remember that weight bearing doesn't have to be high impact, so you could do a few gentle exercises with ankle weights, which I'm guessing is similar to being on a higher gravity planet! When I went to the bone boost classes (until I tripped and fractured my ankle!) the first thing we did was put on ankle weights, and then everything was done with those on.

I know that my score was 125 when it was tested a couple of years ago, and that was when I was just taking 2000 iu. I am now taking k2 Mk7 and also currently just take Vit d in the winter.

Well I bought the rebounder only 3 months ago, so obviously I want to use it, and did so after careful research (before I had been diagnosed with osteoporosis though). It was fortunate I didn't buy it earlier in the year though, otherwise I would have blamed my detached retina on it! 

It seems to me that there are lots of posts online about how safe they are for older people due to the lower impact on the joints etc. I personally think that unless you already have a back injury or pain, then the biggest danger would be to fall off. You can use a stability bar for safety, and I was going to do this, but my balance turned out to be better than I thought, and I have it in a small garden room, right next to a wall that I can steady myself on if needed.

I have just been reading a report that came out mentioned elsewhere on this forum, called The Emperor's New Clothes and it highlights how they believe that the real danger of fractures in older age is not principally from osteoporosis but from falls that come from balance issues re elderly frailty and loss of muscle mass (hope I have represented the report correctly as I read it quickly). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4497616/

I feel it would be a bit sad if I suddenly limit myself too much, when a week ago I was doing all kinds of things without worrying about them. I have no symptoms of pain in my back, and feel that rebounding is something I would enjoy. It's actually fun. I don't think I could ever bear to go to a gym and do anything as I hate the places, I will of course try to walk more than I have been doing though.

Sarcoid granulomas activate Vitamin D.  Normally the body only activates what you need, which is why the sun doesn't poison us!  I was told that the number should not be above 150, that 200 was when they would get really worried.  As I had not being taking untoward amounts of D, and the test was done at the end of winter, I can only assume it must be sarcoidosis, which I was diagnosed with when I was in my early thirties, but never had any known symptoms beyond a swollen lymph gland which was removed and biopsied.

Exactly.  The biggest risk of fracture, for everyone, no matter their bone density, is falling!  That's why activities like tai chi are so good for us.  Enjoy your rebounder!  

Thanks for the link - interesting. It's certainly balance that's my problem. I got diagnosed with OP after a "fragility fracture" - slipped on ice and broke my wrist. Given that I've always been very good at tripping over my own feet - or anything else! - I certainly need to improve my general stability. I've been recommended tai chi and to lose weight. I wasn't suggesting not to use a rebounder, but just to check as I'd been advised against it. However, we're all different, and just because it's probably not a good idea for me, that doesn't mean it won't be excellent for you I know what you mean about not worrying about anything before the diagnosis, and then being extra cautious as a result. I think health professionals need to err on the side of caution, but I don't want to go through life worrying about breaking bones all the time. Although, having said that, with three fractures and a near miss in less than 18 months, I really need to do something ... like actually go to a tai chi class, and actually lose weight! Well, it's the new year, so perhaps that's a good time to start taking action instead of just thinking about it! Good luck with the rebounding - sounds fun

Thank you ANW. It's difficult this whole subject as I can see from further reading that if you have already had a fracture then you are at more risk and also that bone density isn't the whole story re quality of the bone (hard to get my head round the whole subject really, but it's not an open and shut thing).

I am glad that I live in West Cornwall now, as we rarely get frost or ice, so that's one risk less I think! On the down side we live on top of a steep hill, so if we do get ice I will be staying in. It's only happened a couple of times in 13 years of being here though.

Interestingly too, I have some hypermobility in my knees and ankles, but oddly my balance seems to have improved this summer after some years of being very off. I don't quite know why but am hoping that the rebounder will keep this up for me.

Anyway, good luck with what you are doing, as 3 fractures is a lot to deal with.

Ah right I understand now. I hadn't come across that before. I assume you cannot do a lot about it, other than the Vit K which would help from now on, and making sure you don't necessarily take more Vit D than necessary?

Thank you! I have thought of Tai Chi in the past, but getting to a class is tricky for me, and I prefer to do things on my own too. I love the look of it though. It looks very graceful. I do dancing (free expression) which I enjoy too (it's a dance/theatre group with improvisation).

I hadn't thought about hypermobility, but a physio told me a few years ago that my feet are too flexible. Gave me some exercises to strengthen them, but ... hmmm. I should go back to them. I believe the thing about tai chi is that it strengthens your core which helps your balance, so less risk of falling. I'm sure you could find exercises for that on the internet. One thing I've got into the habit of is standing on a bus with my hand around the rail but not gripping it, and letting my core balance me. I think you're right about a rebounder helping you with balance. It sounds fun! As to snow and ice, I've got some yaktrax. You can walk with confidence with them on your shoes - even on ice. The problem here in London is that roads and pavements are mostly gritted, and it's awkward getting them on and off for the small bits of icy pavement. But I should imagine a hill in Cornwall would be ideal for them.

There are some excellent videos on line.   To start, look for best full four hours tai chi tutorial for beginners.  Then you can watch videos of expert practitioners demonstrating, I find most useful the ones they call posterior view so you don't have to keep remembering which arm or leg to move.  

I too have a rebounder that I use to "jog" on.  I have not had a doctor tell me that I shouldn't use it but I have to admit that I never asked either.  I also have read about NASA using them as well.  I firmly believe that it helps strengthen my core and help with balance because I have to hold myself up and steady more than if I was just on the floor.  Plus it's less jarring on my joints.  Now, having said that my husband has neck and back issues from a hard physical work life and can't "jog" on it because it gives him a headache and backache and he thinks that it jars his spine so hmmm...  I don't have any balance issues so I'm thinking that if a person does that the rebounder may not be a good option.  I also do not have any issues with fractures so far so hope that continues.  I also hula hoop with a weighted hoop at least 15 minutes on most days because I have read that it helps with spine and hips but have not seen much discussion on here or other groups about that.  After a suggestion from a pharmacist that works with natural supplements along with prescription meds I have a calcium supplement with vitamin d3, vitamin k2 and magnesium.  I also have made a concerted effort to clean all the junk out of my diet and to get off my couch and move more.  My thoughts on that are that no doctor or medicine is going to help me if I don't help myself first.

Your last sentence needs to be written up on my wall (or computer!). I know I need to do lots more, but laziness takes over. Thank you for giving me another prod in the right direction! Could you tell me about the calcium/vitamin supplement? I've looked for vit K2, but my local H&B only has the MK-7 variety, which is not recommended. I've looked online, and found something there - but very expensive. It's worth the money if that's the only way, but if yours is the MK-4 version of vit K2, then it sounds much better. Can you give the make? Is it generally available from chemists?

Cheers

Why is Vitamin K2 MK-7 not recommended?  In fact this is the form obtained from natto, the Japanese fermented soy which is the source for our supplements.  It's what I've been taking for over a year.  The bones supplement I take also has a small amount of K2 in it, a mix of MK-4 and MK-7.  MK-4 is, I believe, what people get from grass fed animals, meat, dairy, eggs, but which is virtually absent from animals when they are grain fed, and which is why so many of us, expecially North Americans, are deficient in Vitamin K2.  Our own bodies do produce a very small amount, and a little may also be present in fermented foods.

Hi Anhaga

I've been reading around vitamin K2 since you said about the difference between K1 and K2, and it seems that research has suggested MK-4 is the one that builds bone. I can't remember why MK-7 wasn't recommended. Apparently in MK-4 supplements the vitamin is synthesised, but some other research done showed that for the natural source, it didn't matter whether animals were grass fed or not. I can dig around to see if I can find the information again if you like. Apparently in Japan they routinely prescribe a daily supplement of 45mg MK-4 to both prevent and treat osteoporosis, although there was some benefit in taking just 15mg per day. This is far higher than generally found in supplements here, and the jury is still out with the European authorities.

I would like to see where you found that, as everything I've read indicates that MK-7 is more bioavailable.  There may be some reason to prefer MK-4 produced directly by our grass fed animals, rather than MK-7 produced through bacterial fermentation.  But fermented foods are so good for us I'd have no qualms on that account.  

If you find the link please be sure to private message it so I actually get it!

Thanks!

To the best of my knowledge it is the MK-7 which is made from natto so you should have no issues with MK-4.  Like everything else we have to pay attention to our own situation.  People on warfarin or certain other bloodthinners need to be careful with K2 although i understand it's not quite as serious an interaction as with K1. I think we all get some K2 MK-4 naturally in our diet.  If you're able to find genuinely grassfed animal products - free range eggs, organic ghee, some kinds of cheese, that kind of thing - plus some other foods like sauerkraut and its relatives, you will probably be able to up your K2 intake even without supplements.

Thanks Anhaga!  I did some ready on natto this afternoon and maybe there isn't as much of a need to avoid as regular un-fermented soy.  I really hate to shop for a different supplement on-line as I have to be so careful with drug interactions.  I have made a real effort to remove all other forms of soy from my diet though.  Sigh...so much to think about and consider.

Hi

Reading your post is exactly how I feel, overwhelmed. I was diagnosed a couple of days ago 4 6 lumbar. Don't want to take meds . Not sure what exercises I can do. Been eating greens and dairy although I m not even sure if dairy is right.

Need to get up for work but just want to curl up and stay in bed

Yesterday i read an item about weighted walking vests.  The claim was one can use them even if one has had a spinal fracture.  If one has back pain, check with doctor first.  You can get vests which allow you to add very small weights and gradually build up.  So the suggestion in this article, which I cannot link to here, was to start with perhaps one pound.  Over time you can add weights and build up, over several years perhaps, to as much as 10% of one's body weight.  The weight should be worn at least three times a week, an hour or two each time, but the more the better, especially as one gets used to it.  I have a vest which has weights that are so small it takes seven to equal one pound, so I can add mere ounces at a time.  I was able to start with 5 lib, and have worked up to just over 7.5.  If you google weighted vest texas the company I ordered from is near the top of the list, its name begins with an h.  It was expensive, but will last me for the rest of my life and is very comfortable to wear.

I think, generally speaking, from the reading I've done, fermented foods tend to avoid some of the problems one might have with unfermented forms because much of the digestion has already been done by microbes.  

At the bone boost classes I attended they got us to wear ankle weights during the exercises to increase stress on the bones. I didn't ask them about weighted vests, but when I went for an assessment, the nurse suggested I use a backpack weighted with food cans. I'm guessing a weighted vest would be more comfortable.

No doubt!  I had been carrying a backpack around with five pounds of weights inside, and the weighted vest is infinitely more comfortable.  I had lost about 15 lb before starting this journey of ill health, and my aim was to work up to carrying the equivalent around in my vest.  But now I've lost even more weight so to make up the difference it would actually be 20% my body weight, which seems a bit much (20 lb).  

This is an interesting one. I'm more than four stone overweight, so I'm thinking I'm carrying that extra weight around with me - doesn't that mean that I'm already doing weights all the time? But I have a feeling the answer is no. One A&E doctor said that if I lost weight it would reduce pressure on my joints. I'd be interested to know more about the difference between carrying extra weight because you're overweight, and carrying extra weights.

There may be another reason why your bone density is lower because it is mostly thinner people who get osteoporosis, or at least are claimed to.  I kind of wonder if their bones are "thinner" because they don't need to be as dense if the person is a lightweight.  But just a thought.

No, that doesn't work for me as I'm overweight, not thin. I'm guessing, though that being relatively sedentary in my teens and twenties is the main cause. I was never into sport and did mostly sedentary work from 17 onwards until my forties.

I actually think I was very lucky in that at the age ot 48 I got a job in the public library, and for seven years one of my occupations was shelving books (I also did readers' advisory or refernce work) and that involved a lot of pushing, pulling and lifting of weights, as well as stretching high and crouching low.  So throughout those early years of menopause when bones are a risk of losing density I was constantly stressing them.  Which is why I was so horrified all these years later to find that my bones were now diagnosed with low mass!  But a lot of time had passed, plus I'd had a broken leg which immobilized me for a few weeks the previous winter, and also suffered from undiagnosed polymyalgia for over a year so there were bunch of factors working against me.  Plus I had lost a lot of weight, without even noticing - you'll laugh,but I thought manufacturers were making clothes bigger, it didn't occur to me that I was getting smaller!

LOL! You're quite right - I did laugh! The thing is, we don't know what our bone density is until something happens and we have a scan. You don't know how the density has changed over the decades. It could have been low to start with, or maybe there was a different issue that we don't yet know about. You don't know what your T-score would have been if you hadn't done all that library work. My guess is that in another two or three decades osteoporosis will be a major issue due to the kind of lifestyles that young people have today. Maybe in the future it will be standard to test people at 15, 30, 40 etc so as to advise people before the cracks begin to show, so to speak.

Where I live I have recently found it's recommended that both men and women be routinely scanned at age 65 for a baseline reading.  I was over 65 when I broke my leg.  Now I don't think it was a fragility fracture, it was rather a trauma I suffered to experience the break, but no one suggested I have a scan at that time.  It was about eighteen months later, three months into prednisone treament for PMR, that I asked for the DXA scan.  Even my doctor just wanted me to start AA with no scan, because of the steroids.  It was the mistaken diagnosis of osteoporosis (my doctor misreading the summary report which is all she got, no t-scores provided) which put me into major research mode, because I decided at the beginning I would rather crumble into dust than take OP meds.  A friend of mine was my inspiration, she put me on to K2, and also was a role model because she had definitely been diagnosed with osteoporosis and yet through entirely natural, drugfree means had moved her bones into osteopenia territory and was continuing to improve - confirmed by her followup DXA scans.  So I knew it could be done.  

That's encouraging, although I do have a rather vivid imagination when people say things, so as I read your post I "saw" you disintigrating into a little pile of dust - cone shaped - all ready to be scattered without the need for a cremation! (Hope your sense of humour is not too dissimilar to mine - no offence intended here.)