Bone Health

@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
As I said, this was not my advice

This was not my opinion a bone doctor that is a prostate cancer specialist said 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.

ADT can very quickly, deteriorate your bones, That’s why the doctor said this.

I was on Fosamax for six years, Had no real side effects from it, but it did make my bones a lot stronger. I am on Zometa now, Had infusions every three months for about the last year and a half. Never had any side effects from it at all

@rlplaut
As I said, this was not my advice

This was not my opinion a bone doctor that is a prostate cancer specialist said 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.

ADT can very quickly, deteriorate your bones, That’s why the doctor said this.

I was on Fosamax for six years, Had no real side effects from it, but it did make my bones a lot stronger. I am on Zometa now, Had infusions every three months for about the last year and a half. Never had any side effects from it at all

@jeffmarc Hi Jeff, Thank you for the good news about your experience with Fosamax. If my upcomming DEXA shows osteoporosis and I need to go with a bisphosphonate, your input will be important to me.

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.

Many common medications can deplete bone mineral other than ADT. Proton pump inhibitors , for example, are offenders. I was diagnosed with osteoporosis on a bone density DEXA scan nearly 2 years ago and have been on a bisphosphonate since. I take Caltrate/D once daily and Vitamin D2 2000 IU daily (as well as occasional Tums, calcium carbonate). I just started ADT, receiving my first Lupron injection 3 weeks ago. I will be due for a follow up DEXA in December marking 2 years since my first DEXA.

A bone density is the best measure of bone health although imperfect. In the absence of a fracture history, a low bone density fails to fully assess the quality of bone matrix.

Everyone deserves an evaluation of their bone health and fracture risk, but I am not sure that everyone on ADT requires bisphosphonate intervention.

Bisphosphonates are not without side effects, but the most notorious association (osteoporosis of the mandible) is infrequent. After treatment of >5 years on bisphosphonates there are reports of atypical stress fractures of the femur, so most providers would recommend limiting the use of bisphosphonates to a 5-year interval and then considering alternative pharmacologic approaches if the bone density remains low.

My urologist checks my calcium and D3 every 3 months as part of all the other tests he runs every 3 months since I have been on ADT. As a result he prescribed 5000 iu d3 and 600 mg of calcium. My d3 was slightly low at first, but is now in the normal range because of the supplements. I take citracal brand calcium which is calcium citrate. As far as vitamin K2, I don’t supplement, but try to eat foods rich in it such as Gouda cheese, etc. Also spend 4 days a week lifting weights to help protect my bones.

My urologist checks my calcium and D3 every 3 months as part of all the other tests he runs every 3 months since I have been on ADT. As a result he prescribed 5000 iu d3 and 600 mg of calcium. My d3 was slightly low at first, but is now in the normal range because of the supplements. I take citracal brand calcium which is calcium citrate. As far as vitamin K2, I don’t supplement, but try to eat foods rich in it such as Gouda cheese, etc. Also spend 4 days a week lifting weights to help protect my bones.