Is Osteoporosis reversible in post menopausal women?

Do you log your foods on an app to see that you are getting the nutrients you need?

Fearfracture. Once again thank you for the additional info and your insight. My DXA results are pretty extensive and I believe they include TBS. I don't see a "TBS Score", however, they include xrays of individual vertebrates, hip, femoral neck, forearm with BMD and other info in great detail. None of it is good. I have not fractured yet but feel I may be close to fracturing if not careful. Everything I've read about HRT indicates it may be an option for postmenopausal women in 40-50's, but the risks are much greater for older post menopausal women. Between my previous PCP and current PCP we've assessed the usual secondary causes and my tests have been normal. I do think my diet and exercise is significantly lacking and has been for 15 or more years. I eat whole foods in general, however, I a very picky eater. I've been keeping a food log and was shocked that I was not getting the necessary nutrients for bone building. It's not just calcium and D. It's actually 20 essential vitamins and minerals. And you really need to ensure your eating the right combination of foods to allow your body to absorb and process the nutrients. You can't go overboard on any one nutrient because your body won't absorb them and you end up with bone loss. As example, a diet high in phytates (beans, nuts, seeds) leads to bone loss. Spinach is oxalic acid that doesn't allow calcium to be absorbed. Apple cider on dark green leafy veggies allows the nutrients to be easily absorbed. I could go on and on. My point is a balanced diet is key and with the right mix of nutrients (at each meal) that allow your body to take them in and support bone building. I think a nutritionist is key to my overcoming this challenge. Most probably with osteo meds for a while. I just want my doctor to work with me e.g., bone markers prior to meds, so we can monitor this is one more data point (other than just DXA) to we jointly can make the same call whether this is working or not. I'd be interested to hear how you make out with HRT. Like everyone else, I'm doing a lot of research trying to figure out why this is happening to me.

@fearfracture I have had osteoporosis since 2007-
16 years now. I tried a lot of meds and worked with a doctor most of that time including 5 years on a cancer med that caused bone loss (and my docs would not put me on Reclast due to afib). I had traumatic fractures from a fall in 2006; more fractures from an unfortunate movement (and yes am careful, do tai chi, and had PT training on movements to avoid, but mistakes are made) in 2021. I finally managed to get on Tymlos in 2021. Because the dose is adjustable.

So I was very aware of my osteoporosis before my osteoporotic fractures and well aware of how to move. But for complicated reasons, I was not medicated- at all- despite my best efforts (I even went to an immunologist to try to get on Forteo).

My post wasn't really about myself. My point was simple: don't wait for fractures. People may feel strong and not be strong! I don't want others to go through what I have gone through. It is just so hard to accept side effects until you have fractured.

I included the opinion in my last post that insurance needs to approve anabolics before anti-resorptives since the latter can affect the effectiveness of the former. I am not sure but I think the insurance criteria for anabolics may be failing at two drugs, and/or serious DEXA/fractures.

ps when people talk about spinal fractures "healing" I am just not sure what that means. Vertebrae don't "heal" the way an arm break does. They stabilize, which is termed "healing," but the spinal distortion, pain and disability remains. Tymlos has made me a lot stronger but I will be grateful to have scores below -3 if ever possible. I accept my pain but hope others avoid it.

Yes, I get that vertebrae don’t heal the way an arm would. I hope you aren’t in too much pain and I get your point of view, especially given you personal experience, but so many women are scared into taking osteo-meds before they have a chance to even process their condition. My point, to the person I was responding to, was give yourself a minute to breathe and think and to come up with a plan that would suit her.

You have been through a lot and everything you wrote confirms exactly what I was saying, osteoporosis is not a one size fits all disease. You had cancer. That changes every thing. I think, depending on the cancer/cancer drugs, it’s pretty common to experience bone quality issues w/ cancer treatments. According to my endocrinologist, when ppl talk about bisphosphonates causing ONJ, most of those cases are in cancer patients who took higher doses of zoledronic acid. The other day, I took a 65 y.o. friend to the dentist to have a tooth that was cracked, pulled. Note, he does not have osteoporosis. While there, I asked the periodontist’s medical assistant, if they ever ran into patients with ONJ. She said there had been one person but that he’d also had cancer. I asked her specifically about ppl taking zoledronic acid for osteoporosis and she said, they’d never had any issues with their patients with osteoporosis who were on bisphosphonates. Again, my point is, we aren’t all dealing with the same issue.

I had osteoporosis long before cancer.

The risk of jaw necrosis is said to be low with bisphosphonates and most cases are with the higher doses given (Reclast or Zometa) for cancer.

I think docs were medicating far too early. But once DEXA's show a more serious situation, fractures are a constant risk for most. You can learn how to move, and be careful (I never open windows) but there can be a time when you make a random mistake.

The anabolics improve bone quality as well as density. The problem is that insurance doesn't cover them initially. But there are patient assistance programs (I get Tymlos for free).

It’s great that you were able to get Tymlos. What happened to you is one of my concerns about having zoledronic acid infusions now. If those of us w/ osteoporosis take bisphosphonates for a few years and are later diagnosed w/ cancer and have to take cancer meds that then require that we take even larger doses of bisphosphonates where does that leave us.

Yes, one movement can be the last straw and then one has a fragility fracture and there seems to be no way to know beforehand what movement will be that last straw.

Once everything started to re-open (after COVID), I joined a gym at age 53. I’ve been going for a little over a year, 3 times a week. Before joining, I tried to get advice from my endocrinologist regarding what was safe for me to do exercise-wise, considering my impaired bones, but he didn’t have any advice. I then scheduled an appt with an orthopedics doctor so I could get a referral for physical therapy. I went to physical therapy a few times but they really didn’t have an exercise plan for people with osteoporosis and the exercises they had me doing were way too easy for me. I also searched for osteoporosis appropriate exercises on-line. Much of the info I found is geared toward ppl who are much older than me.

Then I read about the Australian LIFTMOR study—how women in their 70s and 80s were lifting heavier weights and building bone and not fracturing and that is when I joined the gym.

I started slow and have gradually increased the weights on the weight machines I use and I do joke that since no doctors can give me any real advice about what my bones can handle that I guess I’ll keep going (increasing weights) until something snaps—I hope that doesn’t happen but it’s like you said, you never know.

The supplement is made by Algaecal. It includes the calcium/ mineral supplement plus strontium citrate. I'm taking it now. Just started because all of the medicine my pcp wants to put me on scares me.