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Osteopenia Supplements that work?

Posted by jime51 @jime51, Sep 23 10:16am

I had my first-ever bone density scan today, now at nine months on Orgovyx and after 44 weekday radiation treatments February-April. The evaluation indicates Osteopenia, and I'm wondering what you take that works. I will be talking with physicians, but you're in the middle of this!
HISTORY: osteoporosis screening, 74-year-old male, prior hip or vertebral fracture, initial encounter

TECHNIQUE: A dual energy x-ray assessment of bone mineral density over the left forearm and right proximal femur was obtained with the following results, utilizing Hologic instrumentation. The images used for this analysis appear to have been properly
positioned and acquired.

COMPARISON: No prior similar studies are available for comparison.

FINDINGS: (Measured Region, BMD in gm/cm2, Young T-score)

Left radius 33%: 0.762, -1.1

Femoral Neck: 0.668, -1.9
Proximal Femur (total): 0.728, -2.0

Impression:
IMPRESSION:

Osteopenia/Low bone mineral density. No FRAX analysis secondary to prior hip or lumbar fracture.

This can serve as a baseline.

Note: The International Society for Clinical Densitometry (ISCD) classifies bone densities as follows:

Normal: at or above -1.0 standard deviation below mean young adult (SD)
Low Bone Mass Density (Osteopenia): between -1.0 and -2.5 SD
Osteoporosis: at or below -2.5 SD
Established Osteoporosis: at or below -2.5 SD with fragility fractures
Thanks for any help you may be able to give!

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jime51 | @jime51 | Sep 25 11:02am
In reply to @mjp0512 "Question for the group. I've only been on ADT since 6/2025, but it appears this may..." + (show)
Profile picture for mjp0512 @mjp0512

Question for the group. I've only been on ADT since 6/2025, but it appears this may be a long-term treatment. Which doctor do I push for bone density testing and follow-up? PCP, urology, radiation oncology, urologic oncology, cardiac oncology or do I need to find another doctor to add to the list?

And...thanks to the jime51 for bringing this up.

ETA: Never mind...just got an email that DXA scan has been ordered for the week after IGRT ends.

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@mjp0512 I have three specialists: urologist, radiation oncologist, and surgical oncologist/hormone specialist. The third is the one responsible for follow-up after radiation. He is the one who ordered the bone density test, and I've sent him a request regarding supplement suggestions since my next appointment with him is in November.

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mjp0512 | @mjp0512 | Sep 25 11:09am
In reply to @jeffmarc "@mjp0512 You should contact the doctor that put you on ADT. You should get a Dexa..." + (show)
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@mjp0512
You should contact the doctor that put you on ADT.

You should get a Dexa scan immediately So you have a picture of what your bone health is prior to taking much ADT.

A bone doctor that specializes in prostate cancer said that everybody should be on a bone strengthener if they are on ADT. I took Fosamax for six years, A pill you take Once A week. I am now on Zometa infusion every three months. You can also take Xgeva infusion as well.. It’s important you get this started soon.

You should also be on calcium, preferably calcium citrate, which is easier on the body. 500 mg twice a day is the recommended dose by oncologist that know what they are doing. Another thing you need is vitamin D. All of these should’ve been recommended by your doctor.

Considering all the doctors you have, you should really have a Genito Urinary Oncologist, overseeing all the other doctors and treatments. Those oncologist specialize in prostate cancer, unlike medical oncologist, who work with all different kinds of cancer and can’t specialize in prostate cancer.

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Thanks, Jeff. See post above yours. Urinary Oncology is the dude that ordered the scan. Sorry, I was too slow editing my post.

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mjp0512 | @mjp0512 | Sep 25 11:15am
In reply to @jime51 "@mjp0512 I have three specialists: urologist, radiation oncologist, and surgical oncologist/hormone specialist. The third is the..." + (show)
Profile picture for jime51 @jime51

@mjp0512 I have three specialists: urologist, radiation oncologist, and surgical oncologist/hormone specialist. The third is the one responsible for follow-up after radiation. He is the one who ordered the bone density test, and I've sent him a request regarding supplement suggestions since my next appointment with him is in November.

Jump to this post

Thanks, jime51. I was too slow in editing my post above. All set.

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rbtsch1951 | @rbtsch1951 | Sep 25 12:39pm

Many medications are associated with bone mineral loss as well as ADT. I was diagnosed with osteoporosis on a DEXA performed 18 months ago for just this reason and have been on monthly ibandronate ever since. I also have a history of Vitamin D deficiency and take 2000 IU Vitamin D3 as well as 600mg Caltrate/D daily. I received my first Lupron injection 2 weeks ago (having newly arrived on the PCa treatment scene after 4 years on AS). Currently scheduled by my PCP to have a repeat DEXA 12/2025 (marking 2 years on bisphosphonate therapy).

The risks of osteoporosis of the jaw with bisphosphonates as well as denosumab are well established, but in practice quite rare.

I do believe these approaches are the current standard of care for osteoporosis in the absence of documented bone metastases.

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