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A cautionary tale for those on ADT: Lupron and Osteoporosis
I offer this as a cautionary tale for those on ADT; specifically Lupron.
I have/had osteoporosis of only the thoracic spine after taking Lupron.
Here’s a time line of experiences.
RALP 01/2022. Positive margins; then Lupron 22.5, quarterly shot from 3/2022 till last shot 01/2024.
PSA negligible since then.
Also had DEXA scans; all showed I was 70% to the good: 12/2022, 10/2024, 2/15/25
(Note: some hospitals Protocol calls for scans to only front view of 1 arm and 1 leg - that missed my spinal problem)
Starting mid-09/2025 I had chronic back pain that I attributed to too much walking and a sprained foot for a 10-day period. So probably muscle pain and I got PT my back starting ~ 10/01/25.
Early November pain got severe. Went to an orthopedic specialist. X-ray then was read (incorrectly FWIW) as no spine problem, I ‘should’ get PT; which I was already doing.
Later, pain got really, like blacking out severe.
12/04/25 Found a great orthopedic Dr. He read earlier X-ray as suspicious trouble in spine's thoracic region. An MRI showed T-5, 7, 9 compression fractured. Surgery (kyphoplasty) corrected those.
2 weeks later found T-6 & 8 had just fractured; repaired those.
Since then it’s a long recovery to fight the osteoporosis with Vitamins C & D3 at 6k IU per day and starting Prolia injections.
My orthopedist discounts use of Ca supplements. He says we get plenty of that in food. But C & D3 activate the Ca we have to strengthen the bones. Additional, Ca could encourage kidney stones.
I had been taking increased Ca before his counsel and on 12/26 and 12/27 had sharp pain episodes on my left side. A CT scan showed a stone in left kidney that I passed naturally on 12/28.
My oncologist wouldn’t attribute my fractures to Lupron nor would he not. I guess it’s possible but not common.
So talk to your oncologist AND at least PCP if not orthopedic doctor about osteoporosis risk in any bones.
Good luck my buddies!
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@jeffmarc
Jeff- do they make Xray of your bone and determine if you need Fosomax or they prescribe it automatically no matter how your bones look like if you need an ADT ?
@surftohealth88
For me, it was automatically Prescribed, Probably because they figured I’d be on ADT for a long time since I had two reoccurrences already.
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1 Reaction@surftohealth88
I should’ve mentioned this, and I’m sure you are aware of it, but at the most, you would just need a DEXA scan to figure out whether you needed bone strengtheners.
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1 ReactionI have been waiting for 4 years to get my testosterone back. I realize it is probably my age (88). @jIeffmarc
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2 ReactionsI'll repeat two comments to support Jeff's comment:
My Traditional Medicare only covers DEXA scans once per year. Though that's probably enough.
Also, some hospital groups (like one of mine in the Detroit area) only scan one arm and one leg. That left my osteoporosis in my spine unknown; and the spine is where I had 5 compression fractures of vertebrae - very, very painful and I lost a full 2" of height.
Be cautious and vigilant and proactive, brothers.
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8 Reactions@jeffmarc Did you have any side effects from the Fosamax? How long did you take it?
I’ve completed 19 (of 26) radiation sessions and I received a 4-months dose of Lupron on 1/16. When should I schedule a bone scan? After the 26th session? After 5/16 when Lupron dose winds down? Or…? Thanks!
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1 Reaction@jimbo12
I’ve run into a few people at the weekly Meetings I go to that had the same problem you have. It usually is somebody that’s a lot older mid to late 80s is not uncommon. When I was 77 I stopped Seven months and my PSA went up to 50, Rising at 25% a month. That was after being on ADT for seven years. I have run into younger people that have also had their testosterone not return. It’s totally unpredictable.
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5 Reactions@service1010
I never had any side effects From Fosamax. Be aware, however, that there are some pretty rigid rules you have to follow When taking it. The good thing is, he only have to take it once a week.
You should take it first thing in the morning. After taking the pill, you need to either stand or sit up very straight so that it doesn’t burn your esophagus. I would get in bed and just sit up really tall, Never had any issues.
I also have to take Prilosec first thing in the morning. Had to take Fosamax first, Which meant getting up half an hour early so I could do one followed by the other.
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4 Reactions@jeffmarc Thank you