For vitamin K, make sure you check with your doctor and/or pharmacists: it has interactions with many medications. But yes, together with calcium supplements, those are the ones I've heard. Resistance training (e.g. weights or exercise bands) is also critical for preserving and building bone density.

Actually they don’t recommend more than 2000 of D3, more is not really necessary. What is necessary is calcium and calcium citrate is better absorbed by your body. I had a pharmacist tell me do not take calcium carbonate, Calcium citrate is much better for you. A pharmacist calls me every six months to discuss what drugs I’m taking.

My oncologist recommended 1200 mg of calcium and I’m also taking 2,000 units of vitamin D per day.

I have thought about whether I need supplementation, butI need to research vitamin K more. My understanding is there’s two different kinds, one of which comes from dark leafy vegetables. Mostly vegan (with periodic seafood), I get the dark leafy vegetables every day. I blend about a quart of veggies in water every morning including kale, spinach, (this is also where I add a cooked tomato in olive oil every morning), etc. But I am likely missing the other source of Vitamin K that most people get from animal consumption. So I’ll keep researching. Thanks for mentioning.

I believe there is a lot of variation in what happens to individuals taking vitamin D-3 supplements. Some take daily doses of 2000 IUs, others take 5000 IUs while some - in admittedly rare occurrences - take 10,000 IUs.

The only way to really know is to have a blood test to check on your vitamin D level. I believe LabCorp will perform this test for $50 to $75. The goal is to obtain a "healthy" level measured in units of nanograms per milliliter (ng/mL).

Example: I take 5000 IUs daily and my vitamin D level is 60 ng/mL. But I also have a friend at my health club who takes 2000 IUs daily. His vitamin D level is slightly higher at 65 ng/mL.

As mentioned in another post on hormone blocking therapy bone health, I have collected advice primarily from Nurses (PAs, RNs, APNs). Doctors have rarely focused discussions with me on non-medicine bone issues unless directly asked.

First: Vitamins:
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1. Calcium Citrate (not carbonate)
2. Magnesium Glycinate
3. Vitamin D3

The amounts of these vitamins varies; there are many opinions. I'd suggest starting with a good (mostly vegetable) diet, looking at the the recommend amounts from the bottle labels, asking your nurses or doctors for more detailed advice, and looking at this web site. Opinions vary; bodies vary, results vary.

Second: MOVE:
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Exercise your bones with weights, floor exercises, FAST walking (especially up and down hills). It helps to have a willing partner for walking because on rainy, hot, or cold days having a scheduled walk with a partner helps one to get moving. BUT, don't walk on snow and ice; falls for people like us are dangerous.

As always YMMV (your mileage may vary). But if ever there was a time to focus, do smart things, and move, it is NOW.

Many common medications can deplete bone mineral other than ADT. Proton pump inhibitors , for example, are offenders. I was diagnosed with osteoporosis on a bone density DEXA scan nearly 2 years ago and have been on a bisphosphonate since. I take Caltrate/D once daily and Vitamin D2 2000 IU daily (as well as occasional Tums, calcium carbonate). I just started ADT, receiving my first Lupron injection 3 weeks ago. I will be due for a follow up DEXA in December marking 2 years since my first DEXA.

A bone density is the best measure of bone health although imperfect. In the absence of a fracture history, a low bone density fails to fully assess the quality of bone matrix.

Everyone deserves an evaluation of their bone health and fracture risk, but I am not sure that everyone on ADT requires bisphosphonate intervention.

Bisphosphonates are not without side effects, but the most notorious association (osteoporosis of the mandible) is infrequent. After treatment of >5 years on bisphosphonates there are reports of atypical stress fractures of the femur, so most providers would recommend limiting the use of bisphosphonates to a 5-year interval and then considering alternative pharmacologic approaches if the bone density remains low.

Hi everybody. Thank you so much for your input and advise to my inquiry for bone health while on ADT.
Wishing you all the best.
Tom