Bone density loss and prednisone

Yes, my dentist noticed a marked decrease in jawbone and teeth after 18 months on Prednisone. I suppose the rest of my bones suffered as well.

@54pontiac

Absolutely ... dental side effects from long term Prednisone use aren't mentioned too often but they happen too. There is a section about dental side effects in the following link.
https://myacare.com/blog/the-effects-of-steroids-on-oral-health-applications-and-side-effects.

Had you had a Dexa scan in the past to compare with your recent one?

Yes, I had one from three years earlier.

I also had a bone density scan after a year of Prednisone; osteopenia had worsened. My primary doc put me on Fosomax which she said wouild prevent further bone loss and possibly slightly increase density.

I hadn’t thought about my teeth, which some mention in comments. Have to ask my dentist next time.

I have been on and off prednisone for the last 35 years, mainly on. Due to the excessive amount of exercise that I do from age 5 to now 80 my bone density is normal. I have had a couple of normal bone scan within the last 3 years. My rheumatologist wants me to take drugs like Fosomax, and I have refused due to my normal bone scans. He says I have a 10% chance of having a bone fracture in the next 10 years. My guess he has not see someone like me who exercises excessively.

@jfannarbor

My bone scans were interpreted as normal too in spite of decades of Prednisone use. I did high impact exercise all my life with the bones to prove it. My bone scans have positive T-scores which indicate denser bone than normal for a person my age. My lumbar T-score was interpreted as "normal" with a +5 but "clinical correlation" was advised. I asked the spine surgeon about my bone scan readings. He said I had a lot of bone but it wasn't good bone. He said arthritis gives falsely elevated T-scores on bone scans.

The spine surgeon was reluctant to do surgery on my lumbar spine because of Prednisone. The surgeon planned on removing most of the extra bone I have. He didn't think I would have enough good bone that was dense enough to hold all the hardware needed to fuse my lumbar spine.

Yes I also lost bone density in 17 months on prednisone. Now on Jubbonti ( Prolia look-alike) one shot every 6 months. Plus 3-4000 vitamin D every day. No calcium as I drink milk and doc says that’s sufficient.

@janetilley Please realize that milk is considered to be an adequate source of calcium but you must get a lot of calcium daily to maintain your blood calcium levels. Your body will rob your bones of calcium in order to maintain the blood calcium if your dietary intake is not sufficient. This is how most bone problems develop as we age and our diet changes.

One 8oz glass of milk has about 20-25% of your daily needs for calcium. At that rate you would need to drink 32-40oz of milk to get 100% of your requirement. You need to ensure your calcium intake is sufficient from other dietary sources if you are not taking a calcium supplement. You poop and pee excess calcium out so it is not a toxic problem when ingested within reasonable amounts.

I am now fighting hyper-parathyroidism and have learned that the wrist is one of the first places where bone calcium is taken if needed for blood calcium and not just any wrist but the opposite one from your handedness. I am right-handed and they did a DEXA scan on my left wrist to see how bad I was. I had moved from osteopenia to osteoporosis in my wrist but not in the remainder of my body. I was still in osteopenia except in my wrist.

Apparently your parathyroid is called into action to help keep blood calcium level in the Goldilocks (green) zone and mine was way high. We have been trying to get it down to the Goldilocks zone and keep it there for over two years without starting me on any drug. I have other medical problems that are not really compatible with standard osteoporosis meds. I'm getting closer every 90 days of testing,

We got my vitamin D in the Goldilocks zone with Rx strength every 3 weeks. We started at one per day since I was way low, then one per week, then one per month, then back to one every 3 weeks. Still working to get calcium right. Parathyroid blood work is better, just not in the Goldilocks zone yet.