← Return to Anyone progress from osteoporosis to osteopenia?

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@triciaot

The one main contributor to increasing bone density, besides Reclast, is probably that I’m taking tamoxifen which is known to be bone protective in postmenopausal women. Evidently the reason is the positive estrogenic response it provides through the body, while blocking estrogen receptors in the breast. I am 2 years post breast cancer surgery.

I tried lifestyle changes before starting alendronate. I increased exercise, weight bearing exercise, and eating enough food high in calcium. Calcium supplements irritate my stomach. None of this stopped the bone loss progression.

I believe estrogen has a highest positive impact on bone health. But I cannot use it because of breast cancer, and family history.

The MD Anderson rheumatologist says the increase in bone density was due to the Reclast. He would like me to continue on it as it also reduces the incidence of bone metastasis. He is happy with my calcium numbers and said just keep doing what I’m doing (eating high calcium foods) if I don’t want to take supplements.

I also see a local endocrinologist who actually orders the Reclast, she has not said much about what is driving the bone density increase (Reclast, tamoxifen, or combo). But it’s a question I’m going to discuss with her because if I only will receive 3 infusions it seems to me pushing the last one out a bit will extend protection.

I have been following the Mediterranean diet, and started adhering to it much more closely since the cancer diagnosis.

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Replies to "The one main contributor to increasing bone density, besides Reclast, is probably that I’m taking tamoxifen..."

Hi @triciaot I read from a few articles that the main reason behind the bone mineral density increase by bisphosphonates is due to the decreased bone resorption rate by direct inhibition of osteoclasts. As a result, "While bisphosphonates consistently increase bone mineral density, the change in bone volume, as measured from bone biopsies, is not significant in most studies [160]. The increases bone density is predominantly due to further mineralization of the bone matrix, as more water molecules are replaced by mineral [161]". This excerpt describes short term effects of bisphosphonates.

Tamoxifen ( a SERM) and estrogen are both mild to moderate antiresorptives, although estrogen has many other roles in maintaining bone health. The antiresorptive effects of either estrogen or tamoxifen might be overshadowed by a strong bisphosphonate such as reclast during concomitant use. It will be interesting to hear from your team of doctors regarding the benefits combining a bisphosphonate with tamoxifen. Please keep us updated if you could.