Osteopenia Supplements that work?

Posted by jime51 @jime51, Sep 23 10:16am

I had my first-ever bone density scan today, now at nine months on Orgovyx and after 44 weekday radiation treatments February-April. The evaluation indicates Osteopenia, and I'm wondering what you take that works. I will be talking with physicians, but you're in the middle of this!
HISTORY: osteoporosis screening, 74-year-old male, prior hip or vertebral fracture, initial encounter

TECHNIQUE: A dual energy x-ray assessment of bone mineral density over the left forearm and right proximal femur was obtained with the following results, utilizing Hologic instrumentation. The images used for this analysis appear to have been properly
positioned and acquired.

COMPARISON: No prior similar studies are available for comparison.

FINDINGS: (Measured Region, BMD in gm/cm2, Young T-score)

Left radius 33%: 0.762, -1.1

Femoral Neck: 0.668, -1.9
Proximal Femur (total): 0.728, -2.0

Impression:
IMPRESSION:

Osteopenia/Low bone mineral density. No FRAX analysis secondary to prior hip or lumbar fracture.

This can serve as a baseline.

Note: The International Society for Clinical Densitometry (ISCD) classifies bone densities as follows:

Normal: at or above -1.0 standard deviation below mean young adult (SD)
Low Bone Mass Density (Osteopenia): between -1.0 and -2.5 SD
Osteoporosis: at or below -2.5 SD
Established Osteoporosis: at or below -2.5 SD with fragility fractures
Thanks for any help you may be able to give!

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Profile picture for mjp0512 @mjp0512

Question for the group. I've only been on ADT since 6/2025, but it appears this may be a long-term treatment. Which doctor do I push for bone density testing and follow-up? PCP, urology, radiation oncology, urologic oncology, cardiac oncology or do I need to find another doctor to add to the list?

And...thanks to the jime51 for bringing this up.

ETA: Never mind...just got an email that DXA scan has been ordered for the week after IGRT ends.

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@mjp0512 I have three specialists: urologist, radiation oncologist, and surgical oncologist/hormone specialist. The third is the one responsible for follow-up after radiation. He is the one who ordered the bone density test, and I've sent him a request regarding supplement suggestions since my next appointment with him is in November.

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Profile picture for jeff Marchi @jeffmarc

@mjp0512
You should contact the doctor that put you on ADT.

You should get a Dexa scan immediately So you have a picture of what your bone health is prior to taking much ADT.

A bone doctor that specializes in prostate cancer said that everybody should be on a bone strengthener if they are on ADT. I took Fosamax for six years, A pill you take Once A week. I am now on Zometa infusion every three months. You can also take Xgeva infusion as well.. It’s important you get this started soon.

You should also be on calcium, preferably calcium citrate, which is easier on the body. 500 mg twice a day is the recommended dose by oncologist that know what they are doing. Another thing you need is vitamin D. All of these should’ve been recommended by your doctor.

Considering all the doctors you have, you should really have a Genito Urinary Oncologist, overseeing all the other doctors and treatments. Those oncologist specialize in prostate cancer, unlike medical oncologist, who work with all different kinds of cancer and can’t specialize in prostate cancer.

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Thanks, Jeff. See post above yours. Urinary Oncology is the dude that ordered the scan. Sorry, I was too slow editing my post.

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Profile picture for jime51 @jime51

@mjp0512 I have three specialists: urologist, radiation oncologist, and surgical oncologist/hormone specialist. The third is the one responsible for follow-up after radiation. He is the one who ordered the bone density test, and I've sent him a request regarding supplement suggestions since my next appointment with him is in November.

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Thanks, jime51. I was too slow in editing my post above. All set.

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Many medications are associated with bone mineral loss as well as ADT. I was diagnosed with osteoporosis on a DEXA performed 18 months ago for just this reason and have been on monthly ibandronate ever since. I also have a history of Vitamin D deficiency and take 2000 IU Vitamin D3 as well as 600mg Caltrate/D daily. I received my first Lupron injection 2 weeks ago (having newly arrived on the PCa treatment scene after 4 years on AS). Currently scheduled by my PCP to have a repeat DEXA 12/2025 (marking 2 years on bisphosphonate therapy).

The risks of osteoporosis of the jaw with bisphosphonates as well as denosumab are well established, but in practice quite rare.

I do believe these approaches are the current standard of care for osteoporosis in the absence of documented bone metastases.

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Hi, looking for info on what type of vitamins can help with improving or stopping osteoporosis from taking the medication we take for our prostate CA. Friend recommended increasing D3 to 5000, and taking Vit K. Would appreciate your feedback. Thanks....

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Profile picture for thomb22 @thomb22

Hi, looking for info on what type of vitamins can help with improving or stopping osteoporosis from taking the medication we take for our prostate CA. Friend recommended increasing D3 to 5000, and taking Vit K. Would appreciate your feedback. Thanks....

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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.

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Profile picture for thomb22 @thomb22

Hi, looking for info on what type of vitamins can help with improving or stopping osteoporosis from taking the medication we take for our prostate CA. Friend recommended increasing D3 to 5000, and taking Vit K. Would appreciate your feedback. Thanks....

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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.

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Profile picture for thomb22 @thomb22

Hi, looking for info on what type of vitamins can help with improving or stopping osteoporosis from taking the medication we take for our prostate CA. Friend recommended increasing D3 to 5000, and taking Vit K. Would appreciate your feedback. Thanks....

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

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Profile picture for florida11 @florida11

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

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@florida11 That's almost the same as me: 1,000 mg of calcium and 2,000 IU of vitamin D daily (it's even on my hospital e-chart). And a 20-minute session 3 days/week on the basement weight bench with moderate weights: my goal isn't to bulk up, but just to keep my bones and muscles strong and flexible.

I mean to ask whether vitamin K would be safe with my meds, but forgot during the last oncology appointment.

p.s. I also do 30 minutes of physio exercises every morning, but that's more because of my spinal injury than the ADT.

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Profile picture for thomb22 @thomb22

Hi, looking for info on what type of vitamins can help with improving or stopping osteoporosis from taking the medication we take for our prostate CA. Friend recommended increasing D3 to 5000, and taking Vit K. Would appreciate your feedback. Thanks....

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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.

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