Bone Health

For vitamin K, make sure you check with your doctor and/or pharmacists: it has interactions with many medications. But yes, together with calcium supplements, those are the ones I've heard. Resistance training (e.g. weights or exercise bands) is also critical for preserving and building bone density.

Actually they don’t recommend more than 2000 of D3, more is not really necessary. What is necessary is calcium and calcium citrate is better absorbed by your body. I had a pharmacist tell me do not take calcium carbonate, Calcium citrate is much better for you. A pharmacist calls me every six months to discuss what drugs I’m taking.

My oncologist recommended 1200 mg of calcium and I’m also taking 2,000 units of vitamin D per day.

@florida11 That's almost the same as me: 1,000 mg of calcium and 2,000 IU of vitamin D daily (it's even on my hospital e-chart). And a 20-minute session 3 days/week on the basement weight bench with moderate weights: my goal isn't to bulk up, but just to keep my bones and muscles strong and flexible.

I mean to ask whether vitamin K would be safe with my meds, but forgot during the last oncology appointment.

p.s. I also do 30 minutes of physio exercises every morning, but that's more because of my spinal injury than the ADT.

I have thought about whether I need supplementation, butI need to research vitamin K more. My understanding is there’s two different kinds, one of which comes from dark leafy vegetables. Mostly vegan (with periodic seafood), I get the dark leafy vegetables every day. I blend about a quart of veggies in water every morning including kale, spinach, (this is also where I add a cooked tomato in olive oil every morning), etc. But I am likely missing the other source of Vitamin K that most people get from animal consumption. So I’ll keep researching. Thanks for mentioning.

I believe there is a lot of variation in what happens to individuals taking vitamin D-3 supplements. Some take daily doses of 2000 IUs, others take 5000 IUs while some - in admittedly rare occurrences - take 10,000 IUs.

The only way to really know is to have a blood test to check on your vitamin D level. I believe LabCorp will perform this test for $50 to $75. The goal is to obtain a "healthy" level measured in units of nanograms per milliliter (ng/mL).

Example: I take 5000 IUs daily and my vitamin D level is 60 ng/mL. But I also have a friend at my health club who takes 2000 IUs daily. His vitamin D level is slightly higher at 65 ng/mL.

As mentioned in another post on hormone blocking therapy bone health, I have collected advice primarily from Nurses (PAs, RNs, APNs). Doctors have rarely focused discussions with me on non-medicine bone issues unless directly asked.

First: Vitamins:
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1. Calcium Citrate (not carbonate)
2. Magnesium Glycinate
3. Vitamin D3

The amounts of these vitamins varies; there are many opinions. I'd suggest starting with a good (mostly vegetable) diet, looking at the the recommend amounts from the bottle labels, asking your nurses or doctors for more detailed advice, and looking at this web site. Opinions vary; bodies vary, results vary.

Second: MOVE:
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Exercise your bones with weights, floor exercises, FAST walking (especially up and down hills). It helps to have a willing partner for walking because on rainy, hot, or cold days having a scheduled walk with a partner helps one to get moving. BUT, don't walk on snow and ice; falls for people like us are dangerous.

As always YMMV (your mileage may vary). But if ever there was a time to focus, do smart things, and move, it is NOW.

@rlplaut
Unfortunately, this is not enough if you are on ADT. You really need to get bones strengthen ears like Fosamax, Xgeva or Zometa To have long-term bone strength.

This was not my opinion a bone doctor that is a prostate cancer specialist Send this at a conference about six months ago. He was pretty emphatic about the fact that people need those drugs to keep their bones healthy while on ADT.

What you have outlined helps but is not enough.

@jeffmarc Hi Jeff, these are forms of bisphosphonate drugs. If your DEXA scan shows you have osteoporosis, then perhaps they are appropriate.

If not (scan shows Osteopenia or better) then it’s safer to focus on vitamins and exercise and diet.

Bisphophonates are very strong drugs with some “interesting” side effects. Goggle is a valuable tool here.

Doctors like writing scripts for these drugs and they may be right for your specific condition, but get that DEXA scan first and then be an informed patient.

@rlplaut Same experience here. I didn't have a bone-density scan 4 years ago because I was in medical crisis and they were focused on saving my life and mobility, but earlier this year my oncologist noted the gap and ordered a baseline. At the time, I wa 3½ years into ADT+Apalutamide, 18 months of which I'd spent with extremely limited mobility (starting out immobile in a hospital bed).

The scan showed only very mild osteopenia, only a little worse than you'd expect for an average 60-year-old male without prostate cancer and a serious spinal injury, so, as you mentioned, he saw no point adding more polypharmacy complications to my life.

We'll do a follow-up scan in a couple more years and see if it has changed at all then. If it gets worse, then yes, bone-strengthening meds may be in my future.