Understanding how much is safe to lift with osteoporosis

@laren3 There is a table for estimating your One Repetition Maximum lift, without ever lifting anything that heavy, if you scroll down in the link below. The key is to start small and build up slowly with guidance. It usually takes months to get to the 80-85% of 1RM used in the LIFTMOR trials and ONERO.

The amount of weight that you can lift about 8 times in a row, but not 9 times, is about 81% of your 1RM. You do not have to lift it 8 times to test this, you can lift 5 times then ask yourself if you could possibly lift that thing 4 more times in good form. If yes, then you would add weight. If you could only lift it only one more time then you would need to remove weight.
https://strengthlevel.com/one-rep-max-calculator

@kfhoz
Thank you so much! Great info and explanation to refer to.

@jspr422

Bisphosphonates have the fewest problems and are usually the first line of treatment. I am on Atelvia. Not every MD likes or recommends it, but my specialist did (Rheumatologist, I also have Discoid Lupus that is well-managed). You take it right after breakfast. Atelvia doesn't build bone, but slows the loss. My specialist retired but she would have likely kept me on it until I fractured something or my bone scores dropped below a certain point. Twelve years on it, so far (with drug holidays). I just found another Rheumatologist I trust; we'll see what he recommends. I exercise just like you do (likely more walking and less lifting though). Besides a DEXA, you can also get a TBS (Trabecular Bond Score).

I have found that endos and PCPs want to prevent bone loss and put you on Prolia "right away" and "forever," which I consider an off-label use. I am unsettled by the fact that much or all of the bone Prolia builds can evaporate if you don't keep to the six months injection schedule or quit cold turkey (w/o going to another drug to mitigate but not eliminate the loss). What happens if I get sick or become senile and forget about the shots? I also call Prolia bone, "fake bone,". likely an unfair moniker for what some view as a miracle drug. I think PCPs, knowing how painful lumbar spine fractures/frailty can be, want to be proactive and prevent it. The research and recommendations however, are a little more conservative on when to switch from a bisphosphonate, but maybe the research/recommendations are behind the times with so much clinical experience in existence now. I found my new Rheumatologist on Castle and Connolly. If you Google the requirements for getting listed and how the company turns a profit, I think you will find their listed MDs as great a resource as I do.

@researchmaven

The current thinking seems to be anabolics first then bisphosphonates. The positive effects of the anabolic can muted with the old sequencing treatment plan but we are all are different with different needs.

@gravity3

Yes - that must be exactly it. My PCP thinks my retired specialist is behind the times. As a rheumatologist, osteoporosis was not likely her patients' biggest problem.

Since I have been on Atelvia for a long time, I don't know if that sequence would still work for me. My PCP advocates Prolia for life, as do some others.

My retired specialist cautioned that if I went on Prolia and then stopped, I would need to be on bisphosphnates for 1.5 years to stem some of the loss (some bone seems to be lost even leaving Prolia this way).

@gravity3

Oops, I erred. Prolia is not an anabolic. Maybe 12 years of Atelvia takes me out of the running for anabolics. With a bit more reading, I may be able to come to an answer that makes sense to me. Thanks, @gravity3. Very helpful comment!

@researchmaven

My own history of it helps. First to current.

Alendronate 3 years
Forteo 2 years very modest gains
Alendronate 2 years
Evenity 1 year great
gains
Prolia 4 shots so far

I have been on bhrt for 1 1/2 years: estradiol/testosterone pellet, estradiol vaginal
cream, progesterone

As you can see, even with the start on a bisphosphonate I still had modest gains on forteo and great gains on Evenity.
Some others may be able to comment on whether Prolia now rather than an anabolic might be suggested.
Have you already investigated whether there is an endocrinologist or rheumatologist who is well trained in osteoporosis treatment in your area. Or, as some others have done, you might seek a consult with dr. KeithMcCormick. He is a chiropractor and athlete who developed osteoporosis and in his efforts to get proper treatment he became a resource for others. His book is Great Bones

@gravity3

That is quite a progression. I have not run across anyone getting such a mix. I am glad it has worked for you and appreciate your sharing. I will definitely keep it in mind!

I have what I hope is a superior rheumatologist that I will see later in the year for my osteoporosis. I do not think I want to go the endo route just yet. My experience is that endos are laser-focused and rheumatologists are holistic. I think my health fits holistic better!

@researchmaven

This is definitely not the progression I would have chosen had I known more at the start.
And if I had known how to choose a physician.

In all the conversations about osteoporosis and weight bearing exercises like lifting and squats, etc., I haven't heard any conversations about osteoarthritis. Before anastrozole I had knee replacement surgery, a torn rotator cuff, 4 trigger finger surgeries, stenosis of the back and neck. After anastrozole (16 months), I now have osteopenia of my thighs, ache all over and 2 more trigger fingers. My Oncologist recommended I do weight bearing exercises. Have BE after radiation so gyms are not an option. Anyone else have osteoarthritis and osteoporosis or osteopenia and how do you manage exercises?