Statins and osteoporosis

I've been on statins for 18 months. I recently finished a two-year course of Tymlos. My bone density improved 18 percent, and my calcium blood tests were always normal. My LDL went from 135 to 70. So, no issues on either side.

@njx58 I am six months into Tymlos and really don't have any issues with it but I'm concerned about what comes next! Would you mind sharing what you are taking now to maintain your bone density gain? I am 64 and have a -3.4 t-score in my spine. No fractures (I exercise and run/walk daily and was shocked to find out I had such a low T-score). Even six months into Tymlos, I still think of going off of it just to avoid taking drugs for the next 20 years. Thanks!

@njx58 I am six months into Tymlos and really don't have any issues with it but I'm concerned about what comes next! Would you mind sharing what you are taking now to maintain your bone density gain? I am 64 and have a -3.4 t-score in my spine. No fractures (I exercise and run/walk daily and was shocked to find out I had such a low T-score). Even six months into Tymlos, I still think of going off of it just to avoid taking drugs for the next 20 years. Thanks!

Dealing with both here... from what I've read, the evidence on statins and bone isn't really definitive yet - most of the research is based on lab studies and observational data, which don't always translate cleanly to real world outcomes.

I'm on rosuvastatin 5mg (+ezetimibe) to keep my LDL very low. Worth noting, i was on statin for about a year before I was diagnosed with OP, so it's unlikely the statin was a contributing factor for me. That said, I'm still not a great example to go by either way, since I then went on Forteo then HRT - two pretty powerful medications that make it impossible to isolate any statin effect on my bones.

The low dose vs high dose angle you mentioned is interesting, and worth discussing with your doctor!

This is interesting to me because I have severe osteoporosis, worse in my spine at -4.1. I am 76, no history of fracture, and not on any bone meds (which I hope to avoid).

I'm on the borderline regarding the need for a statin. I had a coronary calcium CT to help determine if I should start on a statin. I had a very low score (8), but since it wasn't zero, my doctor prescribed 5mg of Rosuvastatin, twice a week. I've been debating starting the med because I read statins don't offer much heart attack prevention after age 75. Now, I will have to look into this more if there would be some benefit to osteoporosis.

For anyone wanting more info, I googled "are statins bad for osteoporosis" and lots of articles came up. Most said low dose statin therapy would be beneficial but high dose treatment could be harmful, and that more study is needed.
https://aliyahealthcare.com/do-statins-contribute-to-osteoporosis.html
The above article says: "Although some studies suggested that low doses of statins are associated with a decreased risk for osteoporosis, high doses could potentially increase this risk. This contradicts the notion that statins, typically intended for lowering cholesterol, might serve as treatments for osteoporosis. Ultimately, further research is needed to clarify the relative efficacy and safety of statins in this context, taking into consideration dosage and patient profiles."

But it also said: "Overall, statin therapy is linked to a 48% reduction in new-onset osteoporosis risk and a significant increase in bone mineral density (BMD) by approximately 0. 030 g/cm², with no higher fracture risk noted across sensitivity analyses. A large-scale study... comparing osteoporosis diagnosis rates in statin users versus non-users. Various doses of statins were evaluated, revealing that higher doses, especially 40-60 mg of simvastatin per day, correlated with increased osteoporosis risk. Additionally, statin use in stroke patients showed decreased osteoporosis and fracture risks. Thus, low doses may provide protective benefits against osteoporosis, while high doses appear to elevate the risk of bone damage, underscoring the importance of considering dosage in treatment strategies."

Then it offered what seems to be conflicting data on fracture prevention: "While some observational studies indicated that statin users may have lower fracture risks or higher BMD, current evidence does not support a fracture prevention effect from statins. Specifically, randomized trials showed no association between statins and fracture risk...Although statin use was linked to a minor BMD increase, it did not correlate with a decrease in fracture rates. Meta-analysis of 21 studies involving over 1. 7 million participants showed statin users had a reduced risk of major osteoporotic fractures. Despite evidence suggesting statins enhance bone formation, their long-term effects on fracture risk remain uncertain. Some studies indicate a reduced risk for osteoporotic fractures in older adults taking statins. Overall, statins may increase BMD but not significantly lower fracture risk."

Here is another interesting article: https://www.ccjm.org/content/ccjom/69/4/277.full.pdf

@daisy17 im on 5 mg rosovustatin changed to this from 4 years ar from atorvastatin 40 mg is 40 mg considered high or low?

@mayblin what hrt medicine are you on? whats your approx age? hwhat is name, delivery way, and dose of hrt? is it helping bone density?

@lovesummer
I'm on transdermal estradiol patches (generic for Vivelle-Dot) 25mcg/day, changed twice weekly, along with oral micronized progesterone 100mg nightly.

I started HRT at 61, 11 years after menopause, to help preserve bone mineral density (BMD) after completing Forteo treatment. It's now been 2 years, and my DXA scan after 1st year and ongoing bone turnover markers (BTMs) suggest things are going well so far.

@mayblin Hi thank u for responding. if i may ask only because i think many medical people think osteoporosis and penia is hapoening to thin bone wonen and wondering if u are on the thinner side abd if hrt made u gain any weight. i had to have k4l5 fusion with rods and screws last may and osteopenia. did 1 year of evenity. now they want me on fosamax. scared to death of atypical femur and hip frc from that drug it lays down mottled irregular bone; not strong bone. plus the terrifying jaw rot risk. im 70. now i also have burden of wirry of loosening screws just from fusion that can happen to normal bone person. im trying ti lose weight now my ability to do aerobics as intense as i want to my music i love to dance is taken away for fear of stressing l3 and s1 l5 more cuz of fusion.trying zepbound but still after 6 mo only lost 15 lbs to presurgery weight now 172. sickening. cant fit any my nice clothes yet. dont want to gain on hrt. what do u think. ?