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How worried should I be?
60F . My primary care doctor really wants me to start taking drugs. I pushed for a dexascan this year , because I’ve been having a number of dental problems which my periodontist thought was possibly autoimmune or menopause related. I also have a history of low vitamin D. The autoimmune tests came up negative, but dexascan showed I had osteoporosis. I’m so mad because I brought up getting a dexascan several years ago , and the doctor just dismissed it even though I’m at high risk for it (petite and family history). Here are my t-scores:
Hip -1.5
Neck -2.2
Lumbar -2.9
Frax score: hip - 0.7%
Spine/forearm/hip/ or shoulders - 5.1%
Currently, trying to get an appointment with a knowledgeable endo. Unfortunately, there’s only a handful around that have a lot of osteo patients and many are not taking new patients. Waiting to hear back from one office and it may not be until next year until I am able to see someone. My GP thinks I’m wasting my time.
I have an appointment with my GI doc since I’ve been on Prilosec for the last two years and I’m hoping to switch to a different med. My GI doc insisted that PPIs don’t cause osteoporosis, but I’m skeptical.
I have also made an appointment to start PT. Doesn’t seem like there are too many who have an in depth knowledge of working with osteoporosis patients so we’ll see how this goes. I think I also have osteoarthritis in my spine so I don’t know what exercises I’ll be able to do. I do have low back pain , but I’ve had it for many years.
My periodontist also wants me to have some gum grafts done next year and I know many of the drugs are big no-no if there is any dental work to be done.
Should I be worried and can I just put off taking any meds at least for a year while I try a more natural approach ? The conversation I had with my doctor’s office made it seem I was in the severe category and I had to take action now. They want me on bisphosphanates.
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Just spoke to my GI doc and he’s going to have me wean off Prilosec and switch to Pepcid ( famotidine) . He still insists there’s no correlation between PPIs and osteoporosis based on the studies he’s seen though.
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1 ReactionI think you should see a rheumatologist if there really might be something going on. Negative often don’t mean much with autoimmune. If you want to try a more holistic approach it would be wise to find someone like a functional medicine specialist to work with you. I think you would have a better shot of it working but you probably need to do some serious weight/resistance training. Consider all your options before you let your PC push you into a drug you might not want to take…especially if you don’t have a history of fractures. I saw a functional medicine doctor when I lived in Montana and I know that natural methods are working for her and helped her mother. If it doesn’t work you still have the option to do traditional meds. The reverse is trickier!
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1 Reaction@samclembeau yes, one must consider the steps that follow ‘step 1’ …well said !
@momto1
Here's a nice review of current (2022) thinking about PPIs and osteoporosis.
https://pmc.ncbi.nlm.nih.gov/articles/PMC9504265/
Bottom line is that "long-term PPI use is associated with a modest but rather consistent increase in the risk of fragility fracture." Your GI doc may have been misled by the fact that PPIs were not shown to reduce bone density (the article suggests that they may affect bone structure more than density).
Regardless, fractures are what we care about. And PPIs increase that risk.
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3 ReactionsMy advice is that worry solves nothing and can create additional issues. Relying on people on a page such as this for decisions can provide some things to consider, however you never know all the details of a stranger’s situation. Take it with a grain of salt and rely on your trusted medical providers who know you and your medical history for the best advice for your situation. I hope the best for you! 🙂
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1 Reaction@momto1 People, if you want to get better see a functional doctor for your bones. Traditional doctors are not trained in bone health. They will not take the time to find out why you loss your bone thickness. They are trained to give you a drug. Most women lose bone due to lack of hormones. So we need to put the hormones back in our bodies if you can. Gyno's have 1 class in menopause. PPI's do cause bone loss due to no acid in the stomach. We all have to do our own research and make individual decisions.
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2 ReactionsDo not use a GP to treat osteoporosis. They generally are clueless about it. Go see an endocrinologist. Besides PPIs, thyroid issues can cause problems.
As for being worried, I get it... but take the warrior's attitude and confront medical issues head-on. 🙂
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2 Reactions@momto1
I would consider going to theosteocollective.com and sign up for the free masterclass, online, ASAP. Get started on the many lifestyle aspects you can control while you await your md appointments. YouTube videos by Dr Doug Lucas will be helpful right away to get started on factors you can control. Are you on HRT? strongly consider this, an enlightened PCP can evaluate and get this started as current evidence strongly supports this for most women for the many health benefits.
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