1. < Osteoporosis & Bone Health

Osteoporosis: What tests confirm diagnosis and treatment options?

Posted by leeosteo @leeosteo, Jan 12, 2023

I was diagnosed with Osteopenia in 2014 which progressed to Osteoporosis in my spine in 2016 (as result of DEXA tests). I was on Alendronate for almost 5 yrs and have been on a medication holiday since 2019. My 2022 DEXA now shows progression to Osteoporosis in spine and hip. I'm meeting with my PCP next week to discuss next steps. Net, I'm really worried with disease progression and frightened with going back on Osteoporosis meds. I've read that Osteoporosis should not be diagnosed only on DEXA. What has been your experience? Are there other tests that should be considered? Are you using a PCP or other type doctor to walk you through your options?

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leeosteo | @leeosteo | Jan 15, 2023

Hi, once they found abnormally high calcium amount in your urine, did they perform the PTH (parathyroid) test? The reason I ask is because I asked my prior PCP (left practice) for a 24 hr urine test back in 2020. I also had abnormally high calcium in my urine. I was told it just shows you have osteoporosis and nothing was done. Then she left the practice and the pandemic hit. Now I have a new PCP and I'm hoping he will dig dipper rather than just put me on meds. My mother had osteoporosis but she also had serious heart disease (the latter which I do not have). I'm also unwilling to settle for your small frame and your mother had it with no tests to determine or rule out root cause.

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curious10 | @curious10 | Jan 16, 2023
In reply to @artscaping "Good afternoon @leeosteo. Unfortunately, I do not personally know the answer to your question about calcium...." + (show)
@artscaping

Good afternoon @leeosteo. Unfortunately, I do not personally know the answer to your question about calcium. I had real digestive difficulty with a daily supplement and ended up with high calcium. So I talked with my PCP and here is what we figured out. She gave me a list of other ways to ensure sufficient calcium. I tried some of the suggested foods and was concerned about the reaction to other medications. I also found the sugar-free plain yogurts to be pretty tasteless. So my current solution is simple: Chobani makes a Zero Sugar "flavored" yogurt with calcium. I then add Fairlife non-fat milk with 30% of the daily dose and recommended fruits. I end up with at least 60% of my daily calcium goal and find the rest in dinner with salmon and high-calcium veggies.

PS: I sneak in iced yogurt bars for a treat in the evenings. Don't tell anyone!!!!!!!

Hope this gives you a headstart. What have you been using?
Chris

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I find plain yogurt tasteless but don’t want to use artificial sweeteners. I have found Nature’s Wild Berry to be the answer. Eating one berry changes anything you eat from sour to sweet for about 20 mins. It is strange but yogurt tastes like a bowl of cream! Delicious! Such a great hack to eat and enjoy yogurt but avoid sugar and artificial sweeteners. Available on Amazon , expensive but one a day and they last a long time.

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1 reply
Mentor
Chris Trout, Volunteer Mentor | @artscaping | Jan 16, 2023
In reply to @leeosteo "I've been keeping a food log for a suspected allergy. In this process I realized I..." + (show)
@leeosteo

I've been keeping a food log for a suspected allergy. In this process I realized I was not getting enough calcium through food. I do take a multivitamin in the morning and Caltrate calcium pill with dinner. This still did not get me to my calcium target. My diet is good with whole foods but more acid then alkaline and low calcium. I know it's best to get calcium from food vs supplements. So now I've been adjusting my diet to include more calcium rich and alkaline foods (mostly fruits/veggies). I'll keep taking my multivitamin and calcium supplements and look for further direction from my PCP.

For now, I've added Simply Orange Juice with calcium/vitamin D, Cabot vanilla yoghurt with calcium/vitamin D (BTW, the only yoghurt I've found that includes vitamin D). These may have natural or added sugar so I'll work to find the equivalent with low fat/sugar. Baby steps!

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Baby steps are much better than doing nothing. It sounds like you are becoming educated about calcium in both food and supplements. Please let me know what you PCP recommends at this point.

Chris

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oretsina | @oretsina | Jan 17, 2023
In reply to @curious10 "I find plain yogurt tasteless but don’t want to use artificial sweeteners. I have found Nature’s..." + (show)
@curious10

I find plain yogurt tasteless but don’t want to use artificial sweeteners. I have found Nature’s Wild Berry to be the answer. Eating one berry changes anything you eat from sour to sweet for about 20 mins. It is strange but yogurt tastes like a bowl of cream! Delicious! Such a great hack to eat and enjoy yogurt but avoid sugar and artificial sweeteners. Available on Amazon , expensive but one a day and they last a long time.

Jump to this post

Experiment with making your own; it is easy. Not as sour as some of the commercial products.

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loplady | @loplady | Apr 2, 2023

Hi all - With the following DEXA T-Scores, can anyone tell me how my T-score is -2.9 and they are recommending Fosamax? Yes, I asked my PCP and she has no idea. She sent a follow-up email to the endocrinologist who said TBS scores are different than T-scores, which I was not looking at. My TBS is normal and my FRAX results show for Major Osteoporosis 7.8% and hip 0.9%. The T-Scores are as follows: L1-L2 -1.7, L1-L3 -1.9, L1-L4 -1.4, L2-L3 -2.4, L2-L4 -1.6, L3-L4 -1.1.

I'm not understanding why my spine T-score for WHO Classification shows Osteoporosis and -2.9. The website for the endocrinologist says they take the lowest score. That would be -2.4. Am I missing something?

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saba | @saba | Apr 3, 2023
In reply to @maggieb892 "I went from oseopenia to osteoporosis in what seemed like a short time. I was a..." + (show)
@maggieb892

I went from oseopenia to osteoporosis in what seemed like a short time. I was a very active women, walking 4 miles a day and my bone deterioration did not make sense to me. I had a urine test to determine that I had abnormally high calcium amounts in my urine. I saw an endocrinologist who determined that one of my parathyroid glands (we have four) was overactive and needed to be removed. I am two years post surgery and due for another dexa scan and blood work to see improvement in my bone density. Last year my dexa showed a marked improvement. I am on Fosamax weekly and toleranting it well.
I refused to settle for "older people lose bone density" My mother died at age 90 and never had a broken bone or on any medication. Good luck with your decisions and testing.

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If I may ask, where did you have your parathyroid surgery? I have the same issue.

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1 reply
saba | @saba | Apr 3, 2023
In reply to @maggieb892 "I went from oseopenia to osteoporosis in what seemed like a short time. I was a..." + (show)
@maggieb892

I went from oseopenia to osteoporosis in what seemed like a short time. I was a very active women, walking 4 miles a day and my bone deterioration did not make sense to me. I had a urine test to determine that I had abnormally high calcium amounts in my urine. I saw an endocrinologist who determined that one of my parathyroid glands (we have four) was overactive and needed to be removed. I am two years post surgery and due for another dexa scan and blood work to see improvement in my bone density. Last year my dexa showed a marked improvement. I am on Fosamax weekly and toleranting it well.
I refused to settle for "older people lose bone density" My mother died at age 90 and never had a broken bone or on any medication. Good luck with your decisions and testing.

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Maggieb892- If I may ask, where did you have your parathyroid surgery? I have the same issue.

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maggieb892 | @maggieb892 | Apr 3, 2023
In reply to @saba "If I may ask, where did you have your parathyroid surgery? I have the same issue." + (show)
@saba

If I may ask, where did you have your parathyroid surgery? I have the same issue.

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I live in Colorado just south of Denver. I went to the University of Colorado Medical Hospital. I had two tests that showed the problem. First a 24 hour urine test to determine the level of calcium lost. Second I had an ultrasound of my neck to show the over-active parathyroid gland. Good luck with your choices and options available where you are.

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2 replies
somde | @somde | Apr 4, 2023

My test for osteoarthritis in my hip and knee was diagnosed by x-rays. I wonder after reading your comments if I need any further testing. As certain types of cannabis oils are legal in Canada now, for the pain I am now taking low dose of CBD and TCH oil 0.03 ml Amazed at the pain relief. I wanted to make sure it was the oil was helping so I stopped for a few days and pain started to come back. It is amazing how much pain relief I have now. I almost feel normal pain free. So glad to be off all the Tylenol #1 I was taking. My kidneys appreciate it. Thanks for listening. Debby

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1 reply
saba | @saba | Apr 4, 2023
In reply to @maggieb892 "I live in Colorado just south of Denver. I went to the University of Colorado Medical..." + (show)
@maggieb892

I live in Colorado just south of Denver. I went to the University of Colorado Medical Hospital. I had two tests that showed the problem. First a 24 hour urine test to determine the level of calcium lost. Second I had an ultrasound of my neck to show the over-active parathyroid gland. Good luck with your choices and options available where you are.

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Thank you for sharing. Would you say the surgery “cures” osteoporosis?

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