Spine Doctor and hip doctors opinion .. scared to start taking them

I just had my visit with my breast oncologist at Memorial Sloan Kettering Cancer Center, NY.
I am on anastrozole 1 mg./daily to prevent a reoccurrence of cancer. Bilateral mastectomy in May 2025. Stages 1 and IIa. Early. She recommended calcium 1200-1500 mg. per day and Vitamin D 2000 IU per day. I have heart disease also and she said - do not take K2. Potential blood clotting issues and re: the magnesium she said "if you want to take it go ahead" but did not endorse it. Only calcium and vitamin D3. In 2023 my bone density scan was normal - age 68. Now after 3 months on the breast cancer medication & at age 70, my bone density showed osteopenia in my left hip. Spine and right hip was normal. She referred me to an endocrinologist for evaluation. I don't know what, if any, the endocrinologist will suggest.
Yes, weight bearing exercises, walking, stair climbing, squats, diet, no alcohol, no smoking - all excellent to ward off osteoporosis. It is scary to take this cancer medication but I am between a rock and a hard place. Nothing is easy.

bevlevvancouverbc,
not to detract from your potent post, but I'd like to point out that most fractures in women with osteoporosis are in the spinal vertebra. These fractures heal, but in a abnormal configuration. Kyphoplasty tries to restore some of the height, but can't restore normal height. It doesn't matter that we are a little shorter. What matters is that it throws the entire vertebral column off normal curve. It forces the woman into the bent forward positions. Her lungs can't fully expand. All of her internal abdominal organs have less space. It places anterior pressure on all of her vertebral discs, increasing the risk of disc migration and herniation.
Then there is the pain. If there is enough crush in the vertebra, the compression fracture will be extremely painful initially. That pain can usually go away after six months or the vertebra can continue to compress and destabilize. There is less space for the nerves that exit through the joints at the sides of the vertebra. Sometimes not enough space. Those nerves provide excruciating pain when they are crushed with movement and sometimes constant pain even without movement.
So, the whole goal of life changes. It becomes a matter of alleviating the pain.
I'd far prefer to have a hip fracture than a spinal compression fracture. The hips being the next most common area of osteoporosis fractures. They don't actually heal either. Most of the time you can get a hip replacement, thought.

The only issue with K2 is that it can interfere with prescription blood thinners. If you're just taking baby aspirin, it's fine. I am on a statin, and I take K2, and my cardiologist has no issues with it.

Osteopenia is not something that requires medication. I'd certainly try exercise and nutrition to start with. Leave the meds for later, if necessary.

P.S. Get an exercise band and look into doing clamshells. Good for the hips.

I totally agree with you! I was diagnosed just this year and when I did my initial research, everything was so scary, I actually didn’t sleep very well for weeks!! All I kept thinking of was that I was going to die if I fell! I nearly gave up golf because I’m not supposed to twist or bend according to many articles I read!! Luckily, I mentioned it to my chiropractor who had me get tested for Vit D (I was deficient) and he also told me to continue playing golf because my body/and muscles are used to it!!
Of course now that I have educated myself, my outlook is better; I am healthy (no underlying symptoms), I don’t take any medications for anything, I play golf, I walk at least 45 minutes each day and I started to lift more weights based on the LiftMOOR trials (under PT supervision).
I sometimes think that if a celebrity or major influencer has this disease, it would be front and foremost as far as research is concerned. And also because it is an “old person” disease, we are told to just take medication. My PCP didn’t even talk to me about my diet!! Or exercise!! He just wanted to put me on Fosamax!! My endocrinologist, once we ruled out underlying factors, wants to give me ReClast even though my CTX numbers are in the 400s.
I am tired of big pharma and doctors who are focused only on prescribing meds. Thankfully, there are some great podcasts out there than are informative and give me hope.
Have a listen to one I just listened to by Dr Sheri Betz. She talks mostly about reading the DEXA, but towards the end she talks about vertebral fractures and how they are not a death sentence.
https://www.strongbonesstarthere.com/bone-coach-understand-your-bone-density-scan-dxa-results

Thank you for your response , still very scared not to take them and super scared to take them . I will listen to the postcad I do not know if I am being stubborn not to take medicine or if it really is just a statistics info . Very confused . Will visit a second endocrinologist to see a second opinion and yes i feel fine and do not want to start feeling bad at 67 so not smoke drink eat healthy just yes have stress and now more .. will keep you posted . Just beginning to educate myself on all this

Regardless of if you decide to take meds or not, the ultimate goal is to reduce fractures. A Krefeld part of this is reducing falls. Make sure you get a good physical exam focused on fall risk including weakness, poor balance, gait instability, sensory limitations, TUG test (timed get up and go) (≥12 seconds to rise, walk 10 feet, and return), reduced performance on rising from a chair multiple times test, cognitive testing, tests for postural hypotension (testing BP lying, sitting, standing). Also a vision test from an ophthalmologist or optician.

If any of the tests are abnormal, there are treatments for many of the causes of fall risk

Also Medicare pays for a home visit annually. I don’t know what type of practitioner, but I would hope the would look for environmental causes of falls — area rugs, poor lighting, stairs if you have trouble with them, there are more…

@shelldct1

thank you for link: have seen a lot of her videos,
but haven't seen this one.
Her suggestion - protect your spine.
I don't think I've got the hip hinge spot on ...yet.
the squat that Dr Claudia Tamas has shown
in one of her videos: will take awhile, even with the
guidance of a PT.

Reports I've found interesting:
https://www.npr.org/2009/12/21/121609815/how-a-bone-disease-grew-to-fit-the-prescription
and
https://pmlive.com/pharma_news/ucbamgens_evenity_finally_cleared_for_osteoporosis_in_europe_1319792/#:~:text=In%20Europe%2C%20an%20EMA%20advisory,of%202020%2C%20according%20to%20UCB.

I so agree with all that has been written here. I was diagnosed with osteoporosis in July and have been on a research journey and praying about what is best for my body. I was prescribed Evenity, which is a newer medication. My copay per month was going to be around $1000! So I am not doing that. I was prescribed another med but looking into that now. I am not convinced that medication is the way to go for me. Not saying never though. I too am concerned about long term effects of these meds aside from the side effects. I exercise and eat right and am increasing that now. It is frustrating that we have to do all of this research on our own. Keep posting ladies. I have been so encouraged by you all.

OMG; I just read both articles!! It is clearly BIG PHARMA and the BILLIONS they can make!!

I can’t believe that the DExA machines were invented in order for Merck to sell Fosamax! Because without those machines, how would one know they had low bone density unless they fractured and needed to go on FOSAMAX!!

And the fact that many women are put on these pills when they are borderline between Osteoporosis and Osteopenia just astoundings me, given that those numbers (-2.5, you are at Osteoporosis) were arbitrary!!

Thanks for sharing this.

@girlgma9

Another thing we don't mention enough is the toll
on our emotional well being.

Lately I have been wondering why do so many
people, mainly women it seems, get osteoporosis.
First glance, it appears to be global:
but have not done enough data search to see
if there are pockets of places that do not have
it to the extent of western societies -
exclude studies on societies that have
diets of natto, or people who squat
in agricultural work or sitting squats instead
of chairs like we do.
Has lifestyle changed so much, the answer
is of course yes.
Many things have changed in our lifestyle.
But, I am at this place,
what if it was a nutrient, whether vitamin
or mineral, or .. that our diet does not supply anymore,
or does not supply enough.
If it is genetics, as one endocrinologist said to me -
then please show me the studies -
because mother and sister had it only tells me
that you had common lifestyles.

Scurvy and rickets.
Sailors got scurvy which was helped with lemon/
lime..that is why they were referred to as Limeys.

Nothing is that simple of course. Osteoporosis might not be that simple -
... our body functions are dependent on many
hormones/ digestive system, and so on, that as laypeople
we certainly don't fully understand.
Menopause, lack of hormones has a role.
Aging has a role,
As we age, perhaps our system gets less efficient
at absorbing what is needed for health and bones.

the osteoporosis enigma is like the 3 blind men with
an elephant:
one says the elephant looks like a huge trunk:
the other says the elephant is huge ears:
and the the third says something else

the parable on the web is
One man touches the elephant's side, thinking it's a wall;
another feels the trunk and calls it a snake;
a third finds the leg and compares it to a tree
The parable illustrates that individual, subjective experiences can be
true in isolation but fail to capture the entire objective reality.