Is Osteoporosis reversible in post menopausal women?

Posted by leeosteo @leeosteo, Jan 28, 2023

I'm relatively new to this support group. I'm post menopausal with osteoporosis. I've been reading various group discussions here and doing a little bit of research via Mayo Clinic, Bone Health & Osteroporosis Foundation (BHOF), WebMd, and Drugs.com.

My simple question is: Can osteoporosis be reversed in post menopausal women (with no secondary medical issues) through diet and exercise?

In reading through this groups discussion on meds it seems the meds only buy you time.

Interested in more discussions like this? Go to the Osteoporosis & Bone Health Support Group.

@fearfracture

No, I didn’t have to twist his arm. If your doctor isn’t willing to do “secondary” testing to make sure you are receiving the correct treatment, the only option is to look for another doctor. Rheumatologists also treat osteoporosis.

Note, I’m being treated for 2 conditions, hypothyroidism and osteoporosis. Hypothyroidism effects bones.

The pathetic part is I can get my endocrinologist to order labs but he is so incompetent that he can’t help interpret the results so I’m left trying to figure things out for myself.

Someone in another osteoporosis group recently posted, “I asked my rheumatologist about "normal" BTMs, which I have, and bisphosphonates. Specifically, my CTX (bone reabsorption marker) was in the 200-something range. He said he wouldn't advise them for me.”

I think my interpretation was correct, meaning my BTMs are not elevated and bisphosphonates therefore are probably not the right option for me. The mind-blowing part is taking bisphosphonates before anabolics reduces the effectiveness of the anabolics so my endocrinologist screwed this up. Highly annoying.

The only thing stopping me from letting him have it is that I don’t want to take any osteo-meds. I’m leaning towards trying HRT. I spent yesterday reading

https://www.themenopausecharity.org/2022/04/19/starting-or-continuing-hrt-many-years-after-your-menopause/

and

https://theros.org.uk/information-and-support/osteoporosis/treatment/hormone-replacement-therapy/

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All, there is an article in American College of Physicians Jan 2023.

Basically it states first line of treatment is bisphosphonates.

https://www.medscape.com/viewarticle/986428#:~:text=New%20Osteoporosis%20Guideline%20Says%20Start%20With%20a%20Bisphosphonate,based%20on%20a%20systematic%20review%20of%20the%20evidence.
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@fearfracture

No, I didn’t have to twist his arm. If your doctor isn’t willing to do “secondary” testing to make sure you are receiving the correct treatment, the only option is to look for another doctor. Rheumatologists also treat osteoporosis.

Note, I’m being treated for 2 conditions, hypothyroidism and osteoporosis. Hypothyroidism effects bones.

The pathetic part is I can get my endocrinologist to order labs but he is so incompetent that he can’t help interpret the results so I’m left trying to figure things out for myself.

Someone in another osteoporosis group recently posted, “I asked my rheumatologist about "normal" BTMs, which I have, and bisphosphonates. Specifically, my CTX (bone reabsorption marker) was in the 200-something range. He said he wouldn't advise them for me.”

I think my interpretation was correct, meaning my BTMs are not elevated and bisphosphonates therefore are probably not the right option for me. The mind-blowing part is taking bisphosphonates before anabolics reduces the effectiveness of the anabolics so my endocrinologist screwed this up. Highly annoying.

The only thing stopping me from letting him have it is that I don’t want to take any osteo-meds. I’m leaning towards trying HRT. I spent yesterday reading

https://www.themenopausecharity.org/2022/04/19/starting-or-continuing-hrt-many-years-after-your-menopause/

and

https://theros.org.uk/information-and-support/osteoporosis/treatment/hormone-replacement-therapy/

Jump to this post

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@leeosteo

Right. So that is what western medicine doctors are being told to do. However, there is a lot of information out now that indicates the possible downsides of bisphosphonates and the order in which medications should be taken for optimal benefit. It's individually based because it has to do with age, family risk, previous fractures, etc...

Here are some helpful links: https://www.nytimes.com/2023/02/01/magazine/menopause-hot-flashes-hormone-therapy.html

https://gbmc.webex.com/recordingservice/sites/gbmc/recording/e6111214853f103bbf7e005056811e38/playback

Also, Keith McCormick's book, The Whole Body Approach to Osteoporosis is very good in explaining how the different medications work and when they should be used based on that.

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Thanks for the links. My big dilemma or “problem” is, although I‘m only 54, I went through menopause approximately 22 years ago. In the video, the doctor repeatedly states women under 60 who are w/i terms years of menopause. My father had a massive heart attack in his early 50s and died; however, he’d had cancer 5 yrs prior, and heart attack risk is higher for cancer survivors. I saw a cardiologist 1.5 yrs ago and my heart was fine then and U don’t think anything has changed. I don’t have high blood pressure.

The Brits seem to be willing to prescribe HRT to women who are more than 10 yrs beyond menopause and I’m really thinking it might be worth the risk. Most women who are 10 yrs beyond menopause are in their 60s and I’m not.

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@fearfracture

Thanks for the links. My big dilemma or “problem” is, although I‘m only 54, I went through menopause approximately 22 years ago. In the video, the doctor repeatedly states women under 60 who are w/i terms years of menopause. My father had a massive heart attack in his early 50s and died; however, he’d had cancer 5 yrs prior, and heart attack risk is higher for cancer survivors. I saw a cardiologist 1.5 yrs ago and my heart was fine then and U don’t think anything has changed. I don’t have high blood pressure.

The Brits seem to be willing to prescribe HRT to women who are more than 10 yrs beyond menopause and I’m really thinking it might be worth the risk. Most women who are 10 yrs beyond menopause are in their 60s and I’m not.

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I understand. Truly. There is no one solution fits all. I'm 55 but am only 18 months past my last period, so for me the timing is perfect to consider HRT with hopefully minimal risk. Can does run in my family, and one of my cousins had breast cancer and survived, but my mother was on HRT for a number of years and had no problem. I'm going to collect all the information that I can, send all my results and stuff to Dr. McCormick and get his input, and then make a decision by April/May whether or not to go on HRT, a bisphosponate, or nothing for now. If I do go on HRT, it will be the lowest possible transdermal patch to see how I react to it. The whole thing is causing me a lot of sleepless hours that's for sure.

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@kirstenlheld

I understand. Truly. There is no one solution fits all. I'm 55 but am only 18 months past my last period, so for me the timing is perfect to consider HRT with hopefully minimal risk. Can does run in my family, and one of my cousins had breast cancer and survived, but my mother was on HRT for a number of years and had no problem. I'm going to collect all the information that I can, send all my results and stuff to Dr. McCormick and get his input, and then make a decision by April/May whether or not to go on HRT, a bisphosponate, or nothing for now. If I do go on HRT, it will be the lowest possible transdermal patch to see how I react to it. The whole thing is causing me a lot of sleepless hours that's for sure.

Jump to this post

Sleepless nights I get. I may have gotten 5 hrs sleep last night. My sleep has improved over the last 3 months, last night was just a bad night and I have a lot going on that I’m sure isn’t helping.

Have you thought about having genetic testing prior to starting HRT? I have Ashkenazi DNA and I wondered whether or not I should get tested if I want to try HRT. Neither of my grandmothers had breast cancer, and I feel 100% confident that there’s no history of it on my mom’s side of the family. Neither my father’s mother nor sister had it either but I don’t know much about my paternal grandfather’s family.

A few yrs ago, we had to evacuate for a hurricane. We were only taking one car and I was trying to decide where the best place was to leave the other car (lived in a high risk flood zone at the time). As I debated where to leave the car, I finally blurted out, “There are too many variables,” and that’s exactly how I feel about dealing with my bone density issue. If I do HRT and end up with cancer because of it, then I’ll need cancer meds which could make my bones worse and mean that I’ll have no choice but to take even higher doses of zoledronic acid, and osteo-meds are what I’m trying to avoid.

I know it’s easy for me to say, because I’m not you, but I really think you should do HRT. Ask your cousin, or her mother, if the other side of your cousin’s family (meaning the side you aren’t blood related to) has a history of breast cancer—it might not be in your genetic makeup.

My 1st DEXA in July 2019, age 50, showed my lumbar spine t-score was -3.9. My most resent DEXA in December 2022, showed my lumbar spine t-score was -3.6.

I took alendronate for 1.5 yrs and had 1 zoledronic acid infusion in November 2021. My doctor expected me to have another infusion in November 2022, but I opted not to.

In addition to the osteoporosis, I have hypothyroidism and I’m not sure that bisphosphonates are the answer for some with BTM (bone turnover markers) in the normal range—I don’t have elevated BTMs.

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@fearfracture

Sleepless nights I get. I may have gotten 5 hrs sleep last night. My sleep has improved over the last 3 months, last night was just a bad night and I have a lot going on that I’m sure isn’t helping.

Have you thought about having genetic testing prior to starting HRT? I have Ashkenazi DNA and I wondered whether or not I should get tested if I want to try HRT. Neither of my grandmothers had breast cancer, and I feel 100% confident that there’s no history of it on my mom’s side of the family. Neither my father’s mother nor sister had it either but I don’t know much about my paternal grandfather’s family.

A few yrs ago, we had to evacuate for a hurricane. We were only taking one car and I was trying to decide where the best place was to leave the other car (lived in a high risk flood zone at the time). As I debated where to leave the car, I finally blurted out, “There are too many variables,” and that’s exactly how I feel about dealing with my bone density issue. If I do HRT and end up with cancer because of it, then I’ll need cancer meds which could make my bones worse and mean that I’ll have no choice but to take even higher doses of zoledronic acid, and osteo-meds are what I’m trying to avoid.

I know it’s easy for me to say, because I’m not you, but I really think you should do HRT. Ask your cousin, or her mother, if the other side of your cousin’s family (meaning the side you aren’t blood related to) has a history of breast cancer—it might not be in your genetic makeup.

My 1st DEXA in July 2019, age 50, showed my lumbar spine t-score was -3.9. My most resent DEXA in December 2022, showed my lumbar spine t-score was -3.6.

I took alendronate for 1.5 yrs and had 1 zoledronic acid infusion in November 2021. My doctor expected me to have another infusion in November 2022, but I opted not to.

In addition to the osteoporosis, I have hypothyroidism and I’m not sure that bisphosphonates are the answer for some with BTM (bone turnover markers) in the normal range—I don’t have elevated BTMs.

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@fearfracture lots of people have cancer without a family history.

“About 75% of those diagnosed actually have no family history,” she said. The No. 1 driving factor of elevated risk for breast cancer is being a woman, though men get it, too. Advanced age is another factor."

https://wtop.com/health-fitness/2020/10/having-no-family-history-does-not-mean-youre-immune-to-developing-breast-cancer/#:~:text=%E2%80%9CAbout%2075%25%20of%20those%20diagnosed%20actually%20have%20no,get%20it%2C%20too.%20Advanced%20age%20is%20another%20factor.
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@windyshores

@fearfracture lots of people have cancer without a family history.

“About 75% of those diagnosed actually have no family history,” she said. The No. 1 driving factor of elevated risk for breast cancer is being a woman, though men get it, too. Advanced age is another factor."

https://wtop.com/health-fitness/2020/10/having-no-family-history-does-not-mean-youre-immune-to-developing-breast-cancer/#:~:text=%E2%80%9CAbout%2075%25%20of%20those%20diagnosed%20actually%20have%20no,get%20it%2C%20too.%20Advanced%20age%20is%20another%20factor.

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Of those with no family history of cancer, I wonder what percentage smokes and/or drinks and/or does illegal drug.

A dear family friend died at age 50. Cancer. She smoked.

Both of my grandmothers smoked. One died in her late 70s from lung cancer. The other died in her late 70s because of complications caused by her smoking.

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@fearfracture

Sleepless nights I get. I may have gotten 5 hrs sleep last night. My sleep has improved over the last 3 months, last night was just a bad night and I have a lot going on that I’m sure isn’t helping.

Have you thought about having genetic testing prior to starting HRT? I have Ashkenazi DNA and I wondered whether or not I should get tested if I want to try HRT. Neither of my grandmothers had breast cancer, and I feel 100% confident that there’s no history of it on my mom’s side of the family. Neither my father’s mother nor sister had it either but I don’t know much about my paternal grandfather’s family.

A few yrs ago, we had to evacuate for a hurricane. We were only taking one car and I was trying to decide where the best place was to leave the other car (lived in a high risk flood zone at the time). As I debated where to leave the car, I finally blurted out, “There are too many variables,” and that’s exactly how I feel about dealing with my bone density issue. If I do HRT and end up with cancer because of it, then I’ll need cancer meds which could make my bones worse and mean that I’ll have no choice but to take even higher doses of zoledronic acid, and osteo-meds are what I’m trying to avoid.

I know it’s easy for me to say, because I’m not you, but I really think you should do HRT. Ask your cousin, or her mother, if the other side of your cousin’s family (meaning the side you aren’t blood related to) has a history of breast cancer—it might not be in your genetic makeup.

My 1st DEXA in July 2019, age 50, showed my lumbar spine t-score was -3.9. My most resent DEXA in December 2022, showed my lumbar spine t-score was -3.6.

I took alendronate for 1.5 yrs and had 1 zoledronic acid infusion in November 2021. My doctor expected me to have another infusion in November 2022, but I opted not to.

In addition to the osteoporosis, I have hypothyroidism and I’m not sure that bisphosphonates are the answer for some with BTM (bone turnover markers) in the normal range—I don’t have elevated BTMs.

Jump to this post

Well it's my cousin on my dad's side of the family. ALL of the cancer risk comes from his side of the family. His father died very young of throat cancer. and two of his sisters, including the mother of this cousin I'm speaking of, died of pancreatic cancer. The third sister and my dad are so far cancer free at 88 and 91 years of age, respectively. There is NO cancer on my mom's side of the family at all. I am really leaning towards doing HRT for at least five years or so having Dexa scans twice a year if I can get my doctor to say it's medically necessary, and then going off HRT by the time I'm 65 and the risks seem to go up. Aging is not for sissies. I think the most important thing is to NOT fall and break anything. And I still plan on doing all the exercises I currently do unless my numbers get much worse or I do suffer a compression fracture. Hopefully, we will both make the best decision for ourselves.

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@fearfracture

Of those with no family history of cancer, I wonder what percentage smokes and/or drinks and/or does illegal drug.

A dear family friend died at age 50. Cancer. She smoked.

Both of my grandmothers smoked. One died in her late 70s from lung cancer. The other died in her late 70s because of complications caused by her smoking.

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@fearfracture smoking does not cause breast cancer. The risk with HRT I believe, is breast cancer, and 75% of breast cancers are in people without family history.

I also want to emphasize that while falls may be the main cause of hip fractures, spinal fractures can happen, eventually, from sneezing, coughing, reaching, twisting- you get the picture. Even I have been told, from hugging. I just made one unwise movement and fractured three lumbar vertebrae. No impact from a fall, no dramatic moves.

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