Does reducing dosage of steroids help recover from low bone density?
Many years of steroids may have caused my low bone density. I am an 80 year old male in pretty good heath. The steroids are for treating lung diseases. What treatments work best? I increased my dosage of Calcium citrate with Vitamin D3 from 1 tablet to 3 tablets per day. I will start alendronate on Tuesday. My diagnosis was early this week. Weight training?
Interested in more discussions like this? Go to the Osteoporosis & Bone Health Support Group.
So far, reducing steroids is OK. But, just started a few days ago.
Here are my test results. Any ideas now?
BONE DENSITOMETRY (DEXA)
CLINICAL: Screening for osteoporosis. History of prior
fractures. History of long term steroid medication use for
treatment of asthma.
PROCEDURE: Bone densitometry, Standard.
BONE DENSITY:
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Region BMD T-score Z-score Classification
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AP Spine(L3, L4) 0.743 -3.5 -2.3 Osteoporosis
Femoral Neck (Left) 0.533 -2.9 -1.4 Osteoporosis
Total Hip (Left) 0.638 -2.6 -1.5 Osteoporosis
Femoral Neck (Right) 0.461 -3.4 -1.9 Osteoporosis
Total Hip (Right) 0.565 -3.1 -2.0 Osteoporosis
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10-year Fracture Risk:
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FRAX not reported because:
Some T-score for Spine Total or Hip Total or Femoral Neck at
or below -2.5
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My test results are attached to another comment. Any change or addition to what you wrote?
Roger, if you take alendronate before taking a drug that builds bone the effect of the anabolic drug will not be as effective.
It's L3, L4 that would be most concerning to me. Spinal fractures are the most frightening because that kind of fracture can't heal in its original configuration. The vertebral body loses height even with kyphoplasty --a procedure that attempts to restore the loss. The change in height alters the pressures and balance of your entire spine. Not to speak of the pain.
I wonder that your provider isn't suggesting a stronger osteoporosis medication.
Leg press resistance training is associated with increased vertebral pressures with prevalant injuries to the lower spine.
One trouble with osteoporosis is that your muscles can be strong enough for the weight, but the bones may not be.
You may have secured the decision to take alendronate and I wish you the best results. If you have second thoughts about taking a stronger medication, message your doctor. S/he'd be surprised and might recognize the wisdom.
Based on skimming an article from NIH, this is relevant to me after 3 or 6 months?
Are you suggesting a stronger medication might help?
I took my first pill of alendronate a few minutes ago. So far, no bad reaction.
If I understand my situation correctly, I have a dilemma. If I discontinue steroids, I risk getting pneumonia again. I have had pneumonia about six times, so it is a real risk. But steroids cause bone loss which can cause a fracture which can substantially reduce the quality and length of my health span.
After a couple months of this treatment, I plan to meet with my doctor to discuss a plan to maximize. Reading the expected lifetimes for people with osteoporosis is sobering. It is way lower than my expectation.
Roger, read this https://pubmed.ncbi.nlm.nih.gov/21282014/#:~:text=Testosterone%20is%20an%20immunosuppressant%20and,inflammatory%20processes%20that%20trigger%20asthma.
Yes, a suggestion. A moderator here is worried that you think I'm a medical doctor in disguise.
Tickles me.
The testosterone , too-- just a suggestion. I hadn't realized that it can help with asthma as well as the bones.
When someone's health span can be substantially cut, I understand some will become experts in one disease. Testosterone is a possibility. It could make it easier to gain muscle and help with bone density. Nice to know about helping with asthma which might have the effect of lowering reliance on steroids which apparently have several side effects.
roger, good point. We expect our medical providers to be versed in everything medical; it's impossible. Plus, here are all these researchers making it is difficult to stay abreast of the new information even in a single dedicated field.
For quality of life, patients do well to understand their disease, to question and suggest-- interact with their physicians.
It's great how you carefully read all the links and see how they apply or don't apply to you situation.
You'll do well and it won't be just luck.