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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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johnernest | @johnernest | Oct 4 10:58am
In reply to @kenk1962 "I believe there is a lot of variation in what happens to individuals taking vitamin D-3..." + (show)
Profile picture for kenk1962 @kenk1962

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.

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My urologist checks my calcium and D3 every 3 months as part of all the other tests he runs every 3 months since I have been on ADT. As a result he prescribed 5000 iu d3 and 600 mg of calcium. My d3 was slightly low at first, but is now in the normal range because of the supplements. I take citracal brand calcium which is calcium citrate. As far as vitamin K2, I don’t supplement, but try to eat foods rich in it such as Gouda cheese, etc. Also spend 4 days a week lifting weights to help protect my bones.

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Robert | @rlplaut | Oct 4 11:23am
In reply to @rbtsch1951 "Many common medications can deplete bone mineral other than ADT. Proton pump inhibitors , for example,..." + (show)
Profile picture for rbtsch1951 @rbtsch1951

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.

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@rbtsch1951 Hi rbtsch1951, Your note and image above is exactly what I have come up with over the past 4 1/2 years of my PC treatment. I'm trying hard to do the vitamin/exercise stuff to NOT get an osteoporosis diaganosis on my upcoming DEXA. Necrosis of the jaw (NotJ) is physically horrible, and specific breakage of the femur is just plain weird. My doctor says thst such side effects are very - very rare. But I am very - very fearful of such dramatic side effects.

I am probably considered an annoying patient to my doctors and nurses, but at age of 81, I think I'm sufficiently informed to have some considered input to my treatment.

I do understand that dentist involvement is important in avoiding the NotJ event.

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northoftheborder | @northoftheborder | Oct 4 11:36am
In reply to @johnernest "My urologist checks my calcium and D3 every 3 months as part of all the other..." + (show)
Profile picture for johnernest @johnernest

My urologist checks my calcium and D3 every 3 months as part of all the other tests he runs every 3 months since I have been on ADT. As a result he prescribed 5000 iu d3 and 600 mg of calcium. My d3 was slightly low at first, but is now in the normal range because of the supplements. I take citracal brand calcium which is calcium citrate. As far as vitamin K2, I don’t supplement, but try to eat foods rich in it such as Gouda cheese, etc. Also spend 4 days a week lifting weights to help protect my bones.

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@johnernest Any excuse to eat cheese sounds gouda to me!

(joke only works with the English pronunciation, but 🤷)

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kenk1962 | @kenk1962 | Oct 4 12:07pm
In reply to @johnernest "My urologist checks my calcium and D3 every 3 months as part of all the other..." + (show)
Profile picture for johnernest @johnernest

My urologist checks my calcium and D3 every 3 months as part of all the other tests he runs every 3 months since I have been on ADT. As a result he prescribed 5000 iu d3 and 600 mg of calcium. My d3 was slightly low at first, but is now in the normal range because of the supplements. I take citracal brand calcium which is calcium citrate. As far as vitamin K2, I don’t supplement, but try to eat foods rich in it such as Gouda cheese, etc. Also spend 4 days a week lifting weights to help protect my bones.

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@johnernest Looks like a great, if not optimal, plan.

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thomb22 | @thomb22 | Oct 5 7:52am
In reply to @thomb22 "Hi, looking for info on what type of vitamins can help with improving or stopping osteoporosis..." + (show)
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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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

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