Osteoporosis and Frax score?

Hi lamay:

Fill us in on your diet and exercises.

When I had the DEXA scan, they did the TBS score which shows the % of fracture danger.

Do not know if another mammogram site can take your DEXA and convert it to a TBS score. TBS here is $155 without insurance. Insurance brought cost down to $11.00

Hi Timely,

What is the TBS score? I don't think I had that, sounds similar to Frax?
I wasn't getting enough calories, nor calcium, have absorption issues so even with high supplementation my D3 is always low, I'm stuffing in the food now, hope to gain weight, and counting 1200 mg of daily calcium, hoping that I'm absorbing more. Currently I'm working on an online balance program, started doing Dr. Fishman's 12 yoga poses for bones (sounds to good to be true though), squats with a weight, and I meet with a personal trainer next week to get a program started to build muscle and hopefully slow bone loss. It's all new to me. I've recently heard of vibration therapy the astronauts do for bone loss, but don't know much about it.
Thank you for your thoughts and info. on TBS, I will look into that.

The TBS score takes your DEXA scan and converts it to a percentage. Mine was 28 % risk of fracture.
A friend's test came back at 38% risk of fracture.

I looked at Dr. Fishman's yoga for osteoporosis.

It is impossible to do if you have arthritis in both knees. I will look at it again. One needs perfect balance to do those.

I take 5,000 mg of vitamin D.

I think that the vibration therapy is on a trampoline like-device which would also be a hazard with knee arthritis.

I am looking into finding a treadmill with arm rests on the sides to prevent slips and falls while on treadmill. I am really afraid to go walking as sidewalks are not level or safe.

Would appreciate any treadmill recommends.

@lamay I don't know why but my femur neck is always well below the other scores. My report says it is "unreliable to measure changes." I don't know what that means, honestly.

I had osteoporosis for years before doing meds. Unfortunately I fractured but that was due to cancer meds and a delay in meds due to COVID.

I am very pro med (and anti-fracture!) but in a case like yours, it might be good to consult Dr. Keith McCormick, an author and provider (chiropractor) many of us have met with. His first book was "The Whole Body Approach to Osteoporosis" and his most recent, 700 pages long, is "Great Bones.

Two things: once you take Reclast, some studies show less effectiveness of Forteo, Tymlos and Evenity. Unfortunately insurance does not consider this issue of what order you take meds in.

The other thing to think about is time. You probably don't want to do Reclast long term. It is possible that one or two doses will bump you up and with monitoring, you can stop meds (Reclast stays in the system a long time). Just in case, what would your follow up be and how long would you be on that?

Your doc and Dr. McCormick are both great resources to answer these questions about sequence and timing. I did not do meds at your stage but others have and maybe they can chime in.

ps another question is whether Reclast is good with the femur neck. Tymlos was amazing with my spine and pretty good with my hip but my femur neck is still a problem!

Timely,
I hear you on the yoga. My experience has been that a good yoga teacher will always tell students to hold on to a table or chair for balance when needed and to only move as far as is comfortable. I found a bunch of videos with the 12 poses, some better taught than others. Your treadmill idea sounds great, perhaps a PT office would have a recommendation.

This is a link to the original vibration plate referenced in the comments: https://marodyne.btt-health.com/. It's pricey, and there is a warning that if one buys a cheaper one to make sure it adheres to the vibration standards or else you risk health side effects. I had researched the device earlier in my journey. Some people swear by it, probably more than than the medical research indicates, so personally I haven't made a decision on whether to plunk down that amount of money. If you do get a vibration plate please update us!

A great way to get Vitamin D is by sitting in the sun 10 - 20 minutes daily or as often as you can. Morning sun is best.

@lamay You are smart to gather info and not make an impulsive, quick decision re: meds. As an FYI, when I learned I had osteoporosis, I asked my doc when I needed to make a decision re: meds and she said 3-6 months (my lowest score was -3.6, spine). IMHO, -2.6 is borderline osteoporosis / osteopenia so it's quite possible you may benefit from just natural approaches like diet, strength training, weight-bearing exercise, stress reduction, etc. But I say that as a layperson who does not know medicine, you, or your medical background.
Yes, I think seeing a PT is a great idea! (I did, she was helpful, gave a lot -- many too many -- exercises). As an FYI, I am taking online classes through drsherribetz.com (Sherri Betz) and ourstrongbones.com (Joanne Fagerstrom), both PT's focusing on clients with osteoporosis. And Margaret Martin is great too. In her most recent live webinar ("Ask Margaret Anything"), she briefly discussed Loren Fishman's 12 yoga poses (it's towards the end).
You may also benefit from talking with a registered dietician, especially if you have absorption issues (celiac?). IMHO, it's not just calcium and vitamin D, it's protein, vitamin K2, etc. -- all covered in Keith McCormick's 2023 "Great Bones" book that @windyshores mentioned. The books also discuss DXA equipment and technician errors. I mention that because also find it puzzling that your hip has a lower T-score than your spine but what do I know!
Two other resources I find super helpful: OsteoBoston YouTube channel and Margie Bissinger's Happy Bones, Happy Life podcast and YouTube's. They have interviews with Keith McCormick, whose info I trust.
I also thought about getting a vibration platform, specifically Marodyne LIV. But ultimately I decided not to -- too expensive ($3200+shipping) and not yet enough evidence for me to spend that kind of money. Keith McCormick also discusses them in his "Great Bones" book. Use this forum's search facility to get additional comments about vibration platforms.
Best wishes, and remember: you've got this!

windyshores,
Doesn't look like my reply to you published yesterday, but thank you for your response and Dr. McCormick's name, I've not heard of him -- this is all brand new to me. Did you also do Reclast or only Tymlos? I'm so sorry to hear of your fractures and delayed meds, Covid is/was terrible for so many reasons, delayed care is awful.

tetris,
Your reply is so very helpful. I will look into all your suggestions.
I've been using consumerlab.com (there's a subscription fee but I've consulted it so often it's worth it) for independent information on supplements and also on the recent findings about lead and cadmium in dark chocolate, flax, and other products. It sounds like one would have to supplement with a very high dose of K2 that just isn't commercially available right now. If more evidence emerges on the Marodyne LiV I could see splitting the cost with a couple friends who also have early osteoporosis, or perhaps a chiropractor or another provider has one around here.
Thank you for such a thoughtful and thorough reply.