Prednisone and osteopenia how to control

Hi Alan,

Thank you for asking such a great question. It is always a good thing to question and learn everything you can about a drug before taking it. As much as I respect doctors, (IMHO) they determine or diagnose the problem, look up the treatments and find a drug that is used to treat those symptoms. Call me a skeptic, but I want to know what I'm taking and what the side effects are. My example - my doctor thought my cholesterol was a little high and wanted to put me on a statin. I told her I'm not taking a statin because they are a known cause for making neuropathy worse. Since she already knew I had PN, I was a little surprised when she suggested the drug to lower my cholesterol. I said I would work on my diet to lower it since it was borderline anyway..

I had a bone density scan earlier this year and my doctor suggested I started taking 1200 mg of Calcium daily. I have Osteopenia also. I started taking the calcium but stopped because it really plugs me up. I told the doctor I would work on adding more calcium rich foods into my diet and that I'm already taking a high level of magnesium along with Collagen Hydrolysate (water soluble beef protein) which are both good for bones and joints. I think the alendronate also has it's own long term side effects so it's good to look at them - one being it can lower your calcium levels.
http://www.mayoclinic.org/drugs-supplements/alendronate-oral-route/precautions/drg-20061571
Prednisone has a lot of side effects also and could be partly the cause of my osteopenia but I'm not sure since I'm 74 and I think it's hard not to get thin bones as one gets older. My first round with PMR when I was put on prednisone was back in 2007. I started with a 20 mg dose and it took me 3 years to taper off which happened in 2010. The PMR went into remission and stayed gone for 6 years until a year ago last August. I started taking prednisone again at the 20 mg dose and I'm now at 4-1/2 mg daily and hoping to get off by the end of the year but that may be a little aggressive on my part.

I don't have any medical background or training so it's just my thoughts on the drug. As nasty as I think prednisone is, I can't imagine doing without it when the pain comes out with the PMR. Weight gain has been my biggest side effect the first time around. I've been really careful this time around and have changed my eating habits quite a bit so I have gained about 5 pounds but have been able to keep going up and down with the 5 pounds.

Hopefully some others will jump in here and offer their experiences.

Thanks again...John

Hi @alanbruce,

John has offered some incredible insight, and you may also wish to view this discussion, https://connect.mayoclinic.org/discussion/hi-im-new-to-the-site-and-am-interested-in-treating-osteoperosis/, where you can meet others who have discussed osteopenia and Fosamax.

Thank you. I appreciate the link information

Hello @gailb @jo54 @dolan @rnwholovedtowork @painwarrior @marield65 @ujeeniack - I tagged you because you have posted about treating osteopenia or osteoporosis in other discussions. Do you have information you can share with @alanbruce on prednisone and osteopenia how to control?

John

My experiences are limited to my having Osteopenia in my forearms but not elsewhere and being low on Vit. D3 part of the year. I discovered this last month via a bone density scan, my first in over ten years, at my request.

I now take it in pill form but it should be done via sunshine and food/drink.
I live in a senior residence in the Bronx,NYC and do not get out often for sunshine!

We often have our seniors breaking leg bones and hip or pelvis,usually from falls,;there are about 3 times as many women as men and so the odds of fracturing from falls and,or, osteoporosis are much greater.

I recommend seniors spending most of their time indoors, get a bone density scan no later than age seventy-five,every five years or sooner. I also recommend that they have their Calcium,Phosphorus and Vit.D3 levels checked at least every six months. For those living in areas with little sunshine most of the year, such as the NE,NW and Northern states be more vigilant about these matters.

Do not rely on your doctors to recommend tests;be informed and proactive!

Prednisone can cause problems, depending on the dosage and length of time.

Thank you @ujeeniack, that is great advice.

Hello @ujeeniack

You have offered a lot of good suggestions to our Members dealing with bone loss! Thank you for your contribution to this discussion.

I was curious about your osteopenia beginning in your forearms (as did mine). I have since had endocrinologists tell me that this is an indication of hyperparathyroidism, which I have. I would encourage you to see an endocrinologist and ask about having a blood test to check on the levels of your parathyroid (not the same as the thyroid gland). If that is the problem, the treatment might be different and you could avoid more bone loss.

Teresa

I was diagnosed with PMR in April 2020 (although I had had it since January and it took that long to diagnose). I started on 10 mgs of Prednisone,, got down to 4 mgs before having to go to 5 and then to 6 which is where I am now. I still have pain in my legs, knees and shoulder so contacted the doctor to see if I should increase the Prednisone again. He asked (via private message through our medical portal) why I was not taking the Hydroxychloroquine he suggested. This is the first I have heard of this. I do have osteopinia. Does anyone else take Hydroxychloroquine? Trying to actually talk to a doctor these days is difficult.

@ncgal, Both times my PMR was active I was started at a 20 mg dosage of prednisone but was not given any other medications for the PMR. I think in some cases doctors or rheumatologists weigh different patient considerations when prescribing drugs for conditions. Here's some information that talks about using Hydroxychloroquine (Plaquenil) with prednisone.

Hydroxychloroquine (Plaquenil®) Drug Information Sheet: https://www.hopkinsarthritis.org/patient-corner/drug-information/hydroxychloroquine-plaquenil/