Has anyone had a large decrease in bone density after one year

Posted by trathfon62 @trathfon62, Jun 6, 2023

Hi,
My BMD of the lumbar spine decreased by 7% in one year. I feel this is a very large jump and wondered if this has happed to others out there. I had a surgery which
Kept me from exercising for a couple months but it seems so drastic. I appreciate any feedback. I’m also wondering if there was an error with my first or second Dexascan. So hard to tell.

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@lynn59

Interesting that your doctor said Prolia wouldn't work for you. May I ask what your T-score is and why your doctor doesn't think it will work for you? I am asking because my numbers dropped 5% in my spine to an average T-score of -3.1 (my hips are are -2.5). My doctor is recommending Prolia, but after hearing other people's stories on this website I have decided to get a consultation with Dr. McCormick before starting Prolia.

I am very interested in HRT as a stop gap solution. May I ask your age and your number of years since menopause. I am 64 years old and been in menopause for about 15 years. I've been listening to a lot of podcasts on HRT, offered by Peter Attia on The Drive. It sounds like many doctors won't prescribe HRT for women my age/length of menopause.

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I used HRT after Forteo to maintain my gains and I have been predominantly stable in the 5 years since. I was about 62 and 10ish years out of menopause. HRT not only benefits bone but so many other systems of the body. There are slight risks but there are also risks of osteo meds as well which benefits only the bone. If you are interested in HRT, I would highly recommend the book Estrogen Matters by Dr Avrum Bluming. If you've been listening to Peter Attia, you may have seen the 2 hour interview he did with Dr Bluming and his co-author. He really challenges the risks sited in the WHI study with studies and statistical evidence disputing the findings. Percentages of risk are so misleading and when you calculate them in actual numbers, you realize how low the risk actually is. I'm currently re-reading the book and one of the statistics that struck me is the breast cancer risk in the general population. He sites the risk as being 1 in 26 overall, not the 1 in 8 we've been led to believe. The 1 in 8 risk is only at the point you reach the age of 85 when your risk of basically everything is increased. Other experts to glean information from are Dr Mary Claire Haver and Dr Felice Gersh. Dr Haver has a very active IG account and posts daily. She is no-nonsense, disputes fiction with fact and sites pertinent studies. She posts powerful little snippets you can easily understand and integrate. Dr Gersh has been prescribing hormones for decades and is extremely knowledgeable. Not as active on IG but you can find several interviews with her.

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@teb

I used HRT after Forteo to maintain my gains and I have been predominantly stable in the 5 years since. I was about 62 and 10ish years out of menopause. HRT not only benefits bone but so many other systems of the body. There are slight risks but there are also risks of osteo meds as well which benefits only the bone. If you are interested in HRT, I would highly recommend the book Estrogen Matters by Dr Avrum Bluming. If you've been listening to Peter Attia, you may have seen the 2 hour interview he did with Dr Bluming and his co-author. He really challenges the risks sited in the WHI study with studies and statistical evidence disputing the findings. Percentages of risk are so misleading and when you calculate them in actual numbers, you realize how low the risk actually is. I'm currently re-reading the book and one of the statistics that struck me is the breast cancer risk in the general population. He sites the risk as being 1 in 26 overall, not the 1 in 8 we've been led to believe. The 1 in 8 risk is only at the point you reach the age of 85 when your risk of basically everything is increased. Other experts to glean information from are Dr Mary Claire Haver and Dr Felice Gersh. Dr Haver has a very active IG account and posts daily. She is no-nonsense, disputes fiction with fact and sites pertinent studies. She posts powerful little snippets you can easily understand and integrate. Dr Gersh has been prescribing hormones for decades and is extremely knowledgeable. Not as active on IG but you can find several interviews with her.

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Thanks again @teb for the great information. I'll look up that Peter Attia interview and look for Dr. Haver on IG. I'm wondering if I can start on HRT before going on any of the more potent osteoporosis drugs to help stabilize my current bone density while I'm deciding which way to go. Does anyone know if that is a good idea? I have an appointment with Dr. McCormick on October 26th, but wouldn't mind starting before then. @teb - what kind of HRT on you on?

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@teb what age group does the 1 in 26 statistic cover? If it covers all ages, and the statistic for 85+ is 1 in 8, then those of us in 60's and 70's must be closer to the 1 in 8 ( a stat I see everywhere).

I actually had a hormone-driven breast cancer. In some of my genomic tests, a risk above 4.7% of recurrence is considered "high." We all read stats differently and I think many of us feel that we are not the ones who will get cancer. I had no close relatives with breast cancer and no risk factors.

I am struggling with the need for Reclast after Tymlos so I understand the need for alternatives. But I also know that if any breast cancer cells lurk, hormones will often feed them. Eighty percent of breast cancers are fed by estrogen.

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@lynn59

The Drive by Peter Attia #253 Hormone replacement therapy and the Women's Health Initiative: re-examining the results, the link to breast cancer, and weighing the risk vs reward of HRT. I'm going to search his podcasts for another one on HRT as well. If you find anything useful, let me know!!!!!

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Got it!!! Thank you. I will send you everything I find. I also had a zoom consult with a functional doctor who feels I should go with hormones as well. He is a very respected board certified doc and works with Dr. Mark Hyman. He has done a bunch of test on me and I am just about to finish a 24 hour hormone saliva test.

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I was just recommended to listen to another Peter Attia interview with Dr. Avrum Bluming called Estrogen Matters. I'll try to find that one and let you know the number. What kind of tests did you doctor do? I'd like to ask mine to do the same!!!

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@windyshores

@teb what age group does the 1 in 26 statistic cover? If it covers all ages, and the statistic for 85+ is 1 in 8, then those of us in 60's and 70's must be closer to the 1 in 8 ( a stat I see everywhere).

I actually had a hormone-driven breast cancer. In some of my genomic tests, a risk above 4.7% of recurrence is considered "high." We all read stats differently and I think many of us feel that we are not the ones who will get cancer. I had no close relatives with breast cancer and no risk factors.

I am struggling with the need for Reclast after Tymlos so I understand the need for alternatives. But I also know that if any breast cancer cells lurk, hormones will often feed them. Eighty percent of breast cancers are fed by estrogen.

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Thank you Windyshores.
I forgot you mentioned that about the estrogen. I’ll make sure I ask before I do anything. I certainly don’t need that thrown into the mix.
All the best to you. You are such a blessing to everyone on this site.

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@windyshores

@teb what age group does the 1 in 26 statistic cover? If it covers all ages, and the statistic for 85+ is 1 in 8, then those of us in 60's and 70's must be closer to the 1 in 8 ( a stat I see everywhere).

I actually had a hormone-driven breast cancer. In some of my genomic tests, a risk above 4.7% of recurrence is considered "high." We all read stats differently and I think many of us feel that we are not the ones who will get cancer. I had no close relatives with breast cancer and no risk factors.

I am struggling with the need for Reclast after Tymlos so I understand the need for alternatives. But I also know that if any breast cancer cells lurk, hormones will often feed them. Eighty percent of breast cancers are fed by estrogen.

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the 1 in 26 is amongst all women. Dr Bluming has a chart of the risks broken down statistically by age group. Yes, the older you get, the higher the risk (as with all cause mortality). If you have had breast cancer, I can understand your greater concerns and HRT may not be the best way to go for you. And for others that have a familial risk or just a grounded and understandable fear, I really understand that it is not an option. But for others, it is something worth considering. For me, HRT was something that could maintain my bones in the way the body performs bone maintenance naturally. I did a round of conventional meds, using Forteo to build my bone as my loss was rapid and that was the best option for building my spine. But after I was done, the other pharm options weren't quite right for me, especially with autoimmune issues so after a deep dive into HRT, I felt more comfortable going on that than anything else. Dr Bluming explains how beneficial HRT is in most menopausal women and how it is protective of so many chronic diseases we are at risk for as we age, inclusive of osteoporosis but way beyond that.

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@lynn59

Thanks again @teb for the great information. I'll look up that Peter Attia interview and look for Dr. Haver on IG. I'm wondering if I can start on HRT before going on any of the more potent osteoporosis drugs to help stabilize my current bone density while I'm deciding which way to go. Does anyone know if that is a good idea? I have an appointment with Dr. McCormick on October 26th, but wouldn't mind starting before then. @teb - what kind of HRT on you on?

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@lynn59, I don't think anyone really knows that answer for sure as a it's a sequence that hasn't been extensively studied. But if you well into menopause, the sooner you go on HRT, the less risk there is (supposedly. that too is up for debate as all we have to rely on is the WHI study). I know that HRT is not something Dr McCormick generally recommended in the past but he seems to be recognizing the benefits as more info becomes available so I would be interested to hear what he has to say if you wouldn't mind sharing after your appointment.

If you want to go on HRT, I would highly recommend a consult with a specialist in hormones. I've been on them for 5 years at the lowest transdermal patch of .025 estradiol and 100 mg oral micronized progesterone (the safest kind). I just had a consult with Dr Felice Gersh who is a very seasoned practioner in the use of HRT and she would like to increase my dose (of estrogen, not progesterone - the 100 mg is a general standard). The low dose can maintain my bone but with an increased dose, I may have some bone building. I'll have another appt with her at the end of october at which point we'll go over blood work and determine dosing. She only tests levels via bloodwork as she says saliva tests do not give an accurate picture. Interestingly, she is not testing my estradiol levels, just my other hormones. She already knows my estrogen is low due to menopause and low dose therapy and is familiar with dosing related to bone health so there is no need to test. If anyone lives local to SoCal, I highly recommend a consult. If you are outside of CA, she does telehealth appts but the first visit must be in person (by law). She has people come in from all over the world to see her. The only downside is that she is expensive (but she is really worth it).

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-4% in 6 months... So yes, it is possible, sadly. I also hope that it was some kind of a mistake but I highly doubt it... The densitometrist did the scan twice because he couldn't believe it was possible.

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@lynn59

Interesting that your doctor said Prolia wouldn't work for you. May I ask what your T-score is and why your doctor doesn't think it will work for you? I am asking because my numbers dropped 5% in my spine to an average T-score of -3.1 (my hips are are -2.5). My doctor is recommending Prolia, but after hearing other people's stories on this website I have decided to get a consultation with Dr. McCormick before starting Prolia.

I am very interested in HRT as a stop gap solution. May I ask your age and your number of years since menopause. I am 64 years old and been in menopause for about 15 years. I've been listening to a lot of podcasts on HRT, offered by Peter Attia on The Drive. It sounds like many doctors won't prescribe HRT for women my age/length of menopause.

Jump to this post

I am 75. I had early menopause at 38. Had hrt for a period of years then taken off due to breast cancer risk. My endocrinologist said he does not prescribe hrt so I scheduled a consult with a woman gynecologist. She determined that it would not help me due to years between menopause onset, and length of time after ceasing hrt. I've had forteo and alendronate. 2nd month on Osteostrong and one day post first evenity shots.

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