Dexa scan scores and Ibandronate prescription?

Posted by oretsina @oretsina, Oct 29, 2022

Hi,
Recent bone density test results led my gynecologist to prescribe Ibandronate (Boniva) for a pre-osteoporosis condition, and told to take it for three years.

Results were:
Lumbar spine: -0.7 with a 2.6% decrease since test in 2019
left hip: -2.0 with a 8.8% decrease since 2019
Femoral neck: -1.9
10 year risk for hip fracture 1.7% and 10 year risk for major osteoporosis fracture 10%.

I am 5'2" and small boned and am concerned about the side effects, and also wondered if a referral to PT or OT or a dietitian to restore bones might have been an option other than a scrip. I average 8000 steps a day over month and am willing to make lifestyle changes rather than taking a med. Requested a second opinion and my doc did not think it was warranted. Suggestions?

I

Interested in more discussions like this? Go to the Osteoporosis & Bone Health Support Group.

If you have low bone density despite walking 8,000 steps daily, it sounds like Boniva could be a good next step. I’m 5’ tall, and have been taking it for almost 3 years. I was in the osteoporosis range when I started, and in the low density range after 2 years. I will likely take a break this coming spring. I had side effects the first one- two times I took it-I had significant body pain and I wasn’t sure I’d continue with Boniva. Fortunately, ibuprofen did the trick and I powered through! The worst part is delaying my coffee for an hour, but since it’s only once monthly that’s not too bad.

REPLY
@oceanblues123

If you have low bone density despite walking 8,000 steps daily, it sounds like Boniva could be a good next step. I’m 5’ tall, and have been taking it for almost 3 years. I was in the osteoporosis range when I started, and in the low density range after 2 years. I will likely take a break this coming spring. I had side effects the first one- two times I took it-I had significant body pain and I wasn’t sure I’d continue with Boniva. Fortunately, ibuprofen did the trick and I powered through! The worst part is delaying my coffee for an hour, but since it’s only once monthly that’s not too bad.

Jump to this post

What is your age, or if you prefer, your age range? also, wha tis the next step after you take a break from it? And do you just stop taking it after three years?

REPLY

@oretsina, many docs are not prescribing for osteopenia. I would get a second opinion. You could read "The Whole Body Approach to Osteoporosis" by Keith McCormick, who also does consultations.

Depending on your age, starting meds can mean you sort of run out of good options at some point. Say you take a bisphosphonate for 5 years, then what?

Your MD sees the 8.8% decrease in 3 years and is rightly concerned. However, I would hesitate to trust an MD who discourages a second opinioon. That is your right. I would try to see an endocrinologist who specializes in osteoporosis.

REPLY
@windyshores

@oretsina, many docs are not prescribing for osteopenia. I would get a second opinion. You could read "The Whole Body Approach to Osteoporosis" by Keith McCormick, who also does consultations.

Depending on your age, starting meds can mean you sort of run out of good options at some point. Say you take a bisphosphonate for 5 years, then what?

Your MD sees the 8.8% decrease in 3 years and is rightly concerned. However, I would hesitate to trust an MD who discourages a second opinioon. That is your right. I would try to see an endocrinologist who specializes in osteoporosis.

Jump to this post

Is an endocrinologist or a rheumatologist the best choice for osteoporosis?

REPLY

In reply to @bruceandruth1970
I was told to take calcium w/magnesium in it at that stage. I’m in the osteoporosis and osteoarthritis stage now and continue to take it. If a dr told you any different I’d get a 2nd opinion. A rheumatologist won’t see you at this stage. Do you have any skin problems? Psoriasis goes with psoriatic arthritis. My aunt has that and sees a rheumatologist. I have eczema, which some doctors agree should be in the same category as the psoriasis. It did get me in to see a rheumatologist and he agrees they should be in the same category but my eczema is not that bad. It’s only in my ears. If you have sugar problems or thyroid problems that’s where the endocrinologist comes in. I have hypothyroidism and hashimotos thyroid. In my twenties I all of a sudden started gaining weight and I never had a problem before. My thyroid was the culprit of that. My back is shot, can’t list all that, some dude ran into me sideways (he wanted in my lane) slammed me against the curb twice. Since I’ve found out my neck is shot. I just didn’t know it till then. It caused occipital neuralgia, and nerve compression of several nerves including my spinal cord. I don’t think I’ve ever been in so much pain. The meds I’m on don’t exactly help my appetite. I’m too thin. I’m scheduled for MRI’s after I get over the flu and pneumonia. I’m not a sickly person, but when I do get sick I do it up right geeze. Good luck to you. Calcium with vitamin D and K2 is what I take now. I’m due for a dexa scan soon. I’ll let you know what the numbers are 🍀

REPLY

In my opinion, diet would help a lot. I can tell a difference when I’m eating better for a while. Excersize is always good, as in strength training. Start low weight and slowly work your way up. I’ve had both hips replaced and one revision. Don’t have to worry about those much. In my opinion, the more people you talk to with the same thing, research for yourself. Here is great but there are other places but I use them for research. Like Johns Hopkins for example. If you feel you need a second opinion by all means get one. I’ve had 3 different opinions with surgeons on my neck. I’m still not satisfied. I have a MRI coming up and appointment with another. I will see how that goes. Talk to a nutritionist, I’ve heard very good things about diet. These days you have to be your own advocate. Let us know what you decide and find out! Good luck 🍀!

REPLY
@bruceandruth1970

Is an endocrinologist or a rheumatologist the best choice for osteoporosis?

Jump to this post

@bruceandruth1970 yes to endocrinologist or rheumatologist. I see an endocrinologist. It helps to look up their specialties and make sure the doc mainly does osteoporosis.

REPLY
@jojo58

In reply to @bruceandruth1970
I was told to take calcium w/magnesium in it at that stage. I’m in the osteoporosis and osteoarthritis stage now and continue to take it. If a dr told you any different I’d get a 2nd opinion. A rheumatologist won’t see you at this stage. Do you have any skin problems? Psoriasis goes with psoriatic arthritis. My aunt has that and sees a rheumatologist. I have eczema, which some doctors agree should be in the same category as the psoriasis. It did get me in to see a rheumatologist and he agrees they should be in the same category but my eczema is not that bad. It’s only in my ears. If you have sugar problems or thyroid problems that’s where the endocrinologist comes in. I have hypothyroidism and hashimotos thyroid. In my twenties I all of a sudden started gaining weight and I never had a problem before. My thyroid was the culprit of that. My back is shot, can’t list all that, some dude ran into me sideways (he wanted in my lane) slammed me against the curb twice. Since I’ve found out my neck is shot. I just didn’t know it till then. It caused occipital neuralgia, and nerve compression of several nerves including my spinal cord. I don’t think I’ve ever been in so much pain. The meds I’m on don’t exactly help my appetite. I’m too thin. I’m scheduled for MRI’s after I get over the flu and pneumonia. I’m not a sickly person, but when I do get sick I do it up right geeze. Good luck to you. Calcium with vitamin D and K2 is what I take now. I’m due for a dexa scan soon. I’ll let you know what the numbers are 🍀

Jump to this post

@jojo58 I was told to separate calcium and magnesium by at least two ours because they compete with each other. I see so many supplements that combine them but I buy them separately.

REPLY
@windyshores

@bruceandruth1970 yes to endocrinologist or rheumatologist. I see an endocrinologist. It helps to look up their specialties and make sure the doc mainly does osteoporosis.

Jump to this post

Thanks for your reply.

REPLY
@oretsina

What is your age, or if you prefer, your age range? also, wha tis the next step after you take a break from it? And do you just stop taking it after three years?

Jump to this post

I’ll be 60 in February. My last bone scan was pretty good, and I expect the next to be better to some degree. I assume I will stop taking Boniva at that time, and she’ll tell me to continue with weight bearing exercises (which I suck at keeping up with) and making sure I get enough calcium and vitamin D. It takes a long time for changes to bone density, so I believe she’ll go back to following me with biannual scans to see if and when I need to go back to Boniva. Taking ibandronites for too long can have adverse effects on your bones, although my understanding is that it’s not common.

REPLY
Please sign in or register to post a reply.