Younger than usual with severe osteoporosis

Posted by hopefullibrarian @hopefullibrarian, Sep 25, 2023

Looking for others with severe osteoporosis at a "youngish" age, for mutual support. I am 53 with severe osteoporosis---t-scores: lumbar -3.7, and femoral neck -3.2. I had a vertebral compression fracture at age 50, but wasn't given a DEXA scan until 2 years later.

Like so many, I did everything right in my adult life--exercise, healthy diet, supplements. It's at least, in part genetic, and partly because I am very petite and thin. My mother is almost 80, was diagnosed with osteoporosis in her 50s, but even now, without any treatment, her t-scores are not as bad as mine.

In May, I had my first Prolia injection. My insurance denied coverage for Evenity. No other options were given to me. The advice I received was, "Don't worry, take suppliments, keep exercising, and don't fall."

I am hopeful, while being realistic. I'm looking to connect with others who understand.

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

@beanieone

@healthmatters,

For what it's worth, I read an article that stated - and I forget the exact verbiage - that standing on one leg for one minute three times per day will help to strengthen the femur/hip. Apparently, every little bit helps. Anyone?

Cheers!

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I know that standing on one leg is recommended for balance. It probably strengthens the muscles around the femur/hip too. I work remotely, and do yoga tree poses while I'm reading email at my standing desk. As you said, "...every little bit helps."

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@activebcgal

Sorry to meet because of osteoporosis! But here we go. Maybe we can help each other. I'm 58 and got extreme pain in my pelvis while carrying some groceries. It turned out to be insufficiency fractures in my sacrum, plus a transverse fracture in my sacrum. It has healed now but the question was “why”? My GP ordered a DEXA scan and I was shocked to learn that my spinal T-score is -4.0 (hip not so bad, at -2.4). I have a very active life and a mostly-healthy diet that includes plenty of calcium. Like you, I’m trying to navigate the implications for my life. All of the clinical guidelines that I can find say medication is recommended, though there are serious and unserious side effects to many of them, and I wonder about long-term implications for those of us who could potentially be taking meds for 30”+ years!
I have done a lot of sports over my lifetime including running, hiking, biking, cross country skiing, and mountain biking. I want to continue my favourite ones (mountain biking and cross country skiing) but I now I’m afraid of fracturing if I fall.
I have started spine stability exercises that will help me hold my spine in neutral (which reduces the stress on the vertebrae and thus makes them more resistant to fracture).
I know that weight bearing and impact are important for maintaining the bone density that we have left. But!!! - I am not sure how much weight bearing my body can handle without fracturing.
I am learning as I go and look forward to exchanging information with you and with others on the forum.

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I am sorry you are going through the big challenge of osteoporosis at your young age, but you have come to a great source to help guide you through this. I am 74 and just found this site a few weeks ago after recent sacral insufficiency fractures were found after MRI and CT scans. Like you, I was initially diagnosed when I was 56, and after a very brief time on Fosamax and then six years on Fortical, opted to stop and focus entirely on diet and exercise. It seemed I was doing everything right, until this recent Bone Scan showed a significant decrease. I learned from this group to ask for a referral to an endocrinologist and that was the best and most successful medical intervention I could have found. She is guiding me through the process, and has looked carefully at all of my blood work, called the radiologist to get the age of the fractures, contacted other specialists about some questionable blood results that my primary care physician said were okay (Serum Protein Electrophoresis) and then changed her suggested course of treatment from Forteo, then Reclast, to only Reclast because of the blood analysis. After spending weeks reading the experiences of women posting on this site, and following up with suggestions, I now feel less anxiety and plan to go ahead with the first Reclast infusion that is being scheduled. It's not an easy path or one size fits all, and there is so much research and work that needs to be done to help find better choices for those of us with this condition. I wish you best of luck and am so glad you have found this source at your young age!

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@hopefullibrarian

I'm glad you're here, but feel the same way--I wish it wasn't because we have OP.
A lot has happened since I started this thread. I learned so much about the condition and treatments, both natural and pharmaceutical, and I decided that my bone loss was significant enough that I needed meds.

I did finally get approved for Evenity, an anabolic (grows bone). Fortunately, I had had only had one Prolia injection.. Anymore than that, and it wouldn't have been so easy to change course. I've now had 7 of 12 sets of monthly Evenity injections. Fingers-crossed I get good results.

Like @bcstephens, I don't want to spend the next 40+ years "...being so careful to not fracture something and restrict myself from doing the activities and exercises I love."
That being said, I have had to weigh the risks of some activities, and make decisions about what I feel I can safely do.

As far as weight bearing exercises, they are good for bones, but must be done safely with supervision by someone who has had special training on working with people with OP. Impact training is even more important. It's what stimulates bone growth. Again, it requires supervision by a trained professional. These things can be done safely, and they DO work
(https://connect.mayoclinic.org/discussion/onerno-exercise-based-program-proven-to-work/)

This group has a wealth of information and experience. Dig deep into the coversations, and learn all that you can so you can make the best decision for your treatment.

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I was diagnosed when I was 42 with osteoporosis as was my mom and my grandma. All very early in our 40’s. I ended up at the Mayo thank goodness and after many pills nothing would work. I did Tymlos for 2 years and finished that in December 2023. I did my first yearly injection of reclast in January 2024 and we will see what happens. I have learned that I had to spend a lot less time worrying about the effects and side effects and look at what the meds could do for me for the next 40+ years of my life. I also learned to watch what I read and decide what information to worry about. You need to trust your doctors and make sure you do what you can but don’t stop your life. It’s so hard but now I just hope and pray that this route is the best one for me!!

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@activebcgal

Sorry to meet because of osteoporosis! But here we go. Maybe we can help each other. I'm 58 and got extreme pain in my pelvis while carrying some groceries. It turned out to be insufficiency fractures in my sacrum, plus a transverse fracture in my sacrum. It has healed now but the question was “why”? My GP ordered a DEXA scan and I was shocked to learn that my spinal T-score is -4.0 (hip not so bad, at -2.4). I have a very active life and a mostly-healthy diet that includes plenty of calcium. Like you, I’m trying to navigate the implications for my life. All of the clinical guidelines that I can find say medication is recommended, though there are serious and unserious side effects to many of them, and I wonder about long-term implications for those of us who could potentially be taking meds for 30”+ years!
I have done a lot of sports over my lifetime including running, hiking, biking, cross country skiing, and mountain biking. I want to continue my favourite ones (mountain biking and cross country skiing) but I now I’m afraid of fracturing if I fall.
I have started spine stability exercises that will help me hold my spine in neutral (which reduces the stress on the vertebrae and thus makes them more resistant to fracture).
I know that weight bearing and impact are important for maintaining the bone density that we have left. But!!! - I am not sure how much weight bearing my body can handle without fracturing.
I am learning as I go and look forward to exchanging information with you and with others on the forum.

Jump to this post

Yes, it is unfair that you have osteo with such an active lifestyle and plenty of calcium. I am sure your doctor is measuring how much calcium you ingest is absorbed (a blood or urine test). I know my specialist likes her patients to get their calcium from food.

I haven't fractured yet. All I can add is that biking isn't weight bearing and neither of your current favorite sports are a good idea. I walk fast (not stroll) and lift 8 lb weights, the latter amount on my doctor's advice. Be sure and engage in balance exercises and keep flexible, but avoid twisty exercises (or strong twists).

Pill medication isn't bad. The risk of side effects are there, but what isn't often shared is their frequency. Plus, you have to weigh it all against the worse case scenario of a fall on your rear that nails your spine -- the risk is being bedridden and in chronic pain. I wouldn't dare risk a fall and neither should you.

REPLY
@hopefullibrarian

I'm glad you're here, but feel the same way--I wish it wasn't because we have OP.
A lot has happened since I started this thread. I learned so much about the condition and treatments, both natural and pharmaceutical, and I decided that my bone loss was significant enough that I needed meds.

I did finally get approved for Evenity, an anabolic (grows bone). Fortunately, I had had only had one Prolia injection.. Anymore than that, and it wouldn't have been so easy to change course. I've now had 7 of 12 sets of monthly Evenity injections. Fingers-crossed I get good results.

Like @bcstephens, I don't want to spend the next 40+ years "...being so careful to not fracture something and restrict myself from doing the activities and exercises I love."
That being said, I have had to weigh the risks of some activities, and make decisions about what I feel I can safely do.

As far as weight bearing exercises, they are good for bones, but must be done safely with supervision by someone who has had special training on working with people with OP. Impact training is even more important. It's what stimulates bone growth. Again, it requires supervision by a trained professional. These things can be done safely, and they DO work
(https://connect.mayoclinic.org/discussion/onerno-exercise-based-program-proven-to-work/)

This group has a wealth of information and experience. Dig deep into the coversations, and learn all that you can so you can make the best decision for your treatment.

Jump to this post

Thank you for sharing your experience as well as the link about ornerno. I will look into it. Were you already on meds before you started Prolia (which I know you had just once) and then Evenity? Is there a plan for what happens after your 12 Evenity injections are done?
My fingers are crossed for you.

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@kar50

I am sorry you are going through the big challenge of osteoporosis at your young age, but you have come to a great source to help guide you through this. I am 74 and just found this site a few weeks ago after recent sacral insufficiency fractures were found after MRI and CT scans. Like you, I was initially diagnosed when I was 56, and after a very brief time on Fosamax and then six years on Fortical, opted to stop and focus entirely on diet and exercise. It seemed I was doing everything right, until this recent Bone Scan showed a significant decrease. I learned from this group to ask for a referral to an endocrinologist and that was the best and most successful medical intervention I could have found. She is guiding me through the process, and has looked carefully at all of my blood work, called the radiologist to get the age of the fractures, contacted other specialists about some questionable blood results that my primary care physician said were okay (Serum Protein Electrophoresis) and then changed her suggested course of treatment from Forteo, then Reclast, to only Reclast because of the blood analysis. After spending weeks reading the experiences of women posting on this site, and following up with suggestions, I now feel less anxiety and plan to go ahead with the first Reclast infusion that is being scheduled. It's not an easy path or one size fits all, and there is so much research and work that needs to be done to help find better choices for those of us with this condition. I wish you best of luck and am so glad you have found this source at your young age!

Jump to this post

I'm glad I found this site, too. I love that it reduced your anxiety to have all this wisdom available and I'm certain it will have the same effect for me after I dig and "digest" what everyone has to say.
I appreciate your thoughts and feel inspired to ask for a referral to an endocrinologist. It sounds like yours is providing a good deal of information and expertise. So glad for you!

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@researchmaven

Yes, it is unfair that you have osteo with such an active lifestyle and plenty of calcium. I am sure your doctor is measuring how much calcium you ingest is absorbed (a blood or urine test). I know my specialist likes her patients to get their calcium from food.

I haven't fractured yet. All I can add is that biking isn't weight bearing and neither of your current favorite sports are a good idea. I walk fast (not stroll) and lift 8 lb weights, the latter amount on my doctor's advice. Be sure and engage in balance exercises and keep flexible, but avoid twisty exercises (or strong twists).

Pill medication isn't bad. The risk of side effects are there, but what isn't often shared is their frequency. Plus, you have to weigh it all against the worse case scenario of a fall on your rear that nails your spine -- the risk is being bedridden and in chronic pain. I wouldn't dare risk a fall and neither should you.

Jump to this post

Thanks for commenting. I'm glad you've been fracture free to this point. Way to go!!!
I've substituted vigorous walking for biking, so I can keep the risk level down while I decide what chances I'm willing to take, or not take, going forward.
To build my fracture resistance, I started meds (alendrolate) and I started a supervised program of non-twisting, spine stabilizing exercises and lifting of 5-10lb weights. So far, so good, though it's very early days.
On the subject of weights: I'm curious if your doctor has a rationale for the 8 lb weights. Do you know what led him/her to recommend that number?

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Does anyone know if a regular X-ray is sufficient to pick up a possible fracture in the sacrum. I suffered an injury from a ridiculous hip rotator stretch 10 months ago -- part of a personalized program put together for me by a kinesiologist I thought I could trust. I went to her to help me start a safe strengthening program for my severe OP. The hip rotator stretch was a type of twisting which caused immediate right groin pain. I thought I would adapt and pain would subside, but afterward I felt immediate grabbing pain under right buttocks, lower right back and hip and have had chronic SI pain since. I've been diagnosed with SI inflammation by a pain management M.D. and had an X-ray to rule out a fracture. The X-ray showed no fracture, but now I'm wondering if an X-ray is adequate to detect all fractures in the sacrum and if I would require a CT or MRI to be sure. The pain hasn't been debilitating or excruciating. It is chronic and fluctuates, has shut down my life and ironically my ability to exercise my back at all now except for walking. My DEXA spine result was -3.5 8 months ago. I have learned so much about OP since then and realize now how utterly lacking in knowledge this kinesiologist was who gave me the hip rotator stretch which is a so dangerous for OP. It is a miracle this stretch didn't cause a fracture. It was a hard lesson learned about not trusting a trained professional without thoroughly checking their qualifications, knowledge and experience and not assuming they will admit to their lack of knowledge. I am considering paying for a private MRI to be certain of no fractures. Any thoughts about this?

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@activebcgal

Thanks for commenting. I'm glad you've been fracture free to this point. Way to go!!!
I've substituted vigorous walking for biking, so I can keep the risk level down while I decide what chances I'm willing to take, or not take, going forward.
To build my fracture resistance, I started meds (alendrolate) and I started a supervised program of non-twisting, spine stabilizing exercises and lifting of 5-10lb weights. So far, so good, though it's very early days.
On the subject of weights: I'm curious if your doctor has a rationale for the 8 lb weights. Do you know what led him/her to recommend that number?

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I will check, activebcgal. I do have a small frame and my spine is my worst Dexa score. Maybe she has a range based on that.

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@activebcgal

Thanks for commenting. I'm glad you've been fracture free to this point. Way to go!!!
I've substituted vigorous walking for biking, so I can keep the risk level down while I decide what chances I'm willing to take, or not take, going forward.
To build my fracture resistance, I started meds (alendrolate) and I started a supervised program of non-twisting, spine stabilizing exercises and lifting of 5-10lb weights. So far, so good, though it's very early days.
On the subject of weights: I'm curious if your doctor has a rationale for the 8 lb weights. Do you know what led him/her to recommend that number?

Jump to this post

activebcgal,

I checked with my specialist and she said that the 8 lb recommendation for a weight limit was based on what she knew about me. I have a slight frame and tend to cardio and shun upper body exercises. She cautioned against generalizing the recommendation she gave me to others.

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