Help Please, Bone Density results, somewhat surprising

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brandy
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Help Please, Bone Density results, somewhat surprising

Post by brandy »

Hi Tex,

Can you give me the links to get more discussion amount of calcium to take and also amount of Vitamin D to take?

I've seen some discussion but don't know how to do searches on the site.

Age 50, f, have taken supplemental calcium for decades, 1500 mg, have lifted weights for decades and have walked for decades..7-10 miles per week. Have been "heavy" much of that time...i.e. 5'7 weight of 160-185 pounds which is on the heavy side. Also lived, and still live in North Florida for around 25 years.

Had first ever bone density scan, secretary called with results, said mild osteopenia and I am to work out 30 min per day and take 1500 mg of supplemental calcium and retest in 2 years. Duh...I've been already working out for decades and taking calcium for decades.

I "flared" for 4 months this summer in which I took zero supplements so I'm sure I had bone loss then. Also have been on entocourt for 3-1/2 months now presently taking 1 pill every four days. I've been on the lowest dose of HRT that is prescribed for about 2 months. (that will be another post.)

Even with the 4 month flare and steroid use I'm still surprised at my results. I'm thinking I really need to beef up my vitamin D and calcium.

There has got to be a huge genetic component to the bone situation as my mother and grandmother had and have huge issues with osteoporosis despite both of them being extensive "walkers."

Thank you in advance for your feedback. Brandy....now I'm off to go walk for 30 min.
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Post by Deb »

Brandy, I have been watching my bone density closely too (an early hysterectomy) and am currently in a bone density study. I personally think vitamin D is at least as important as the calcium supplement. From what I've
learned, I believe it helps the bones absorb the calcium. Someone else here can probably provide more detailed information. I think I probably haven't absorbed proper nutrients for
years due to my gluten intolerance not just last year when I was flaring. I'm hopeful that has improved and I will see
continued improvement with my bone density. It was recently a bit better but that could be due to variations
in the readings of the machine. I have been supplementing vitamin D for about 3 years but rely on my diet for calcium.
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Post by tex »

Hi Brandy,

Sorry that you had such disappointing results, but it seems to come with the turf - gluten sensitivity is almost surely the biggest cause of long-term bone density loss that we face these days. And, as you have already discovered, throwing calcium at it just seems to make it worse. In fact, the countries that have the highest dairy consumption, also have the highest rates of osteoporosis, and the two seem to be linked proportionately. As you have concluded, vitamin D seems to play a vital role in the utilization of calcium for the production of new bone tissue. An adequate supply of magnesium and phosphorus also seems to be an essential part of the process.

In order to do a search of the archives, just click on the red link below the Google search box, that says, "Search The Archives of This Discussion Board", and in the form that will pop up, enter the key words that you are interested in searching for. Be sure to click the "search for all terms" option, if you're using more than one word, and then just click on the "Search" box, below. Searching for the words "osteoporosis vitamin D magnesium", for example, I found 13 old threads, and one of them, ( http://www.perskyfarms.com/phpBB2/viewt ... +magnesium ), contained the following link to what I consider to be a very excellent discussion of the topic. I found this observation in that article to be very interesting:
For decades doctors and scientists have assumed that osteoporotic fractures happened because bones were thin. They were confident that once bone reached a certain level of thinness (that is, 2.5 standard deviations below the average BMD of 25-year-old females), it was subject to fracture more easily. The thinking was that if we could measure bone density we would be able to predict who would experience an osteoporotic fracture and intervene before this happened.

But almost three decades later, we realize that we cannot predict fracture based only on measurements of bone density because bone does not fracture due to thinness alone. We know this because more than half of the people with thin, “osteoporotic” bone never fracture, while many people with normal bone density do. For example, a study done in 2005 followed more than 8000 women aged 65 and older to assess hip fractures over five years. Out of those women who fractured (243), 54% did not have osteoporotic bone density. Bone density is only one piece to a much more complex picture.
The red emphasis is mine, of course.

http://www.womentowomen.com/bonehealth/ ... rosis.aspx

Here's another thread where Polly made some very interesting observations, (in case you're not aware of this - Polly is an MD):

http://www.perskyfarms.com/phpBB2/viewt ... +magnesium

And Mary Beth, (who is a licensed nutritionist), made some interesting observations in the thread at this link:

http://www.perskyfarms.com/phpBB2/viewt ... +magnesium

IMO, the bisphosphonates are counterproductive, since they pretty well guarantee that the growth of new bone tissue will be impossible. I find it difficult to believe that preserving dead bone tissue is a healthy option.

Tex
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It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
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Post by brandy »

Hi Tex,

Thanks for your quick reply. I searched vitamin D3 with your directions and I'm increasing my vitamin D3 to 3000 to 5000 mg per day.....less if I'm in the sun a lot. Also your quote regarding those with thin bones aren't always the ones that fracture kind of makes me feel better plus definitely was the case with my grandmother who had severe osteoporosis but never had a hip fracture but again she was a big walker even in her late 80's and I think maybe there is something to the excercise thing contributing to good balance etc.

Thanks for all that you do. Brandy.
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Post by maestraz »

Brandy,
FWIW, when I went for my GYN annual exam, and filled my GYN (who I have been with for 32 years) in on my LC history of the last year, including that I had taken myself off of Fosamax because I believed it was aggravating the situation, no argument from him, and his response was, let's sit tight for a couple years, and if you need something down the road, it won't be a bisphosphonate.

I had a bone density test this spring, and it was stable from two years ago. My GYN and I had previously discussed taking a break from Fosamax in that scenario. My response has been to up my vitamin D. I have been told that because of my GI issues, I would be a candidate for the infusion bone density drugs. I have decided I will not do that, nor any bone density drug, in the future.

I have come to believe that the major reason that all these bone density drugs are being pushed is because someone (probably affiliated with a pharmaceutical company) invented a bone density test that tells women MAYBE they are in danger of osteoporosis, allowing the pushing of those meds. This is, of course, only my personal opinion. But I'm buying out of the bone density meds, in favor of increased vitamin D and strength/weight training.
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Post by suzieq »

Hi Brandy,

I am 57 and I have osteoporosis, took Fosamax for 7 years and have had 2 Reclast infusions. I am not a steady exerciser. I am due for a bone density scan this month and I am scared. I have CC and I was on Entocort from June to mid November. My scans never got better by much after taking all of the medications and calcium with D3. Because of changing health insurance companies, I have to find a new Dr. None of my Drs. have been supportive of going gluten free. I have been a failure at being gluten free by the way, the D hasn't returned but so many of my aches and pains have.

I want to have the bone density scan but I would like to take a break from the medications for it because I know that they could have contributed to the CC.

I am trying to go GF again but I always seem to stray. What I want for Christmas is some will power and to get back on track!!!

Happy Holidays to all...

Susanne
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Post by tex »

Brandy,

Yes, exercise definitely helps bone integrity.

That sounds like a good plan for vitamin D. I take 2,500 IU during the summer months, and I'm taking 5,500 IU during the rest of the year when sunlight is much less effective.


Suze,

FWIW, I totally agree with your reasoning. The pharmaceutical industry has convinced virtually all doctors, and most of the general population, that certain "pre" conditions should be treated, such as "pre-high blood pressure", and "pre-cardiovascular disease". Those conditions are certainly not diseases, but by convincing doctors to aggressively treat them as if they were diseases, they sell a heck of a lot of blood pressure meds, and statins, that would never be sold, otherwise.

Tex
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It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
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Post by brandy »

Hi Susanne,

Keep us posted on your results of the scan. I'm somewhat comforted by Tex's comments about 1/2 the people with hip fractures had regular bones. My grandmother always was a tiny woman, had osteoporosis, lived to be 96 and lived in her house, never fractured a hip, and really had good quality of life I would say until her 90's.

Have a great holiday! Brandy
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Post by tex »

Brandy,

Here's some information that might be useful to you, as well. I copied most of this from a post that I made in another forum on this board, a few minutes ago.

For example, if you're taking a vitamin A supplement that contains a significant amount of retinol, it could he causing bone resorption. Here's some good information that Polly posted on the vitamin A issue:

http://www.perskyfarms.com/phpBB2/viewtopic.php?t=12600

Vitamin A, (retinol), dilutes the effectiveness of vitamin D, so the more vitamin A one takes, the more vitamin D is needed, to keep the 25(OH)D level up where it needs to be. However, as you can see by the last link in this post, from a bone health perspective, vitamin A appears to always trump vitamin D, so that too much vitamin A in the form of retinol can weaken bones, regardless of how much vitamin D is available. Here's another reference on vitamins A and D:

http://www.vitamindcouncil.org/news-arc ... nd-cancer/

The study at the following link shows that, (in rats, at least), retinol induces bone resorption, regardless of the amount of vitamin D available, so I have to conclude that one is probably better off taking a minimum amount of vitamin A supplement in the form of retinol, (as far as bone health is concerned).

http://jn.nutrition.org/content/133/3/777.short

Here's another research report that shows that the calcium response to vitamin D is restricted by vitamin A:

http://www.ncbi.nlm.nih.gov/pubmed/11585356

Tex
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It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
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Post by brandy »

Hi Tex,

Thanks for the Vitamin A update. It's given me alot to think about and review for what I'm doing. Brandy
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Post by Gloria »

Brandy,

I had a DEXA scan last week and my scores were:

Lumbar spine: -3.4
This is a 9.6% decrease in bone density since Feb. 2009, when my score was -2.8

Hip: -2.9
This is an 11% decrease since Feb. 2009, when my score was -2.1.

I was on Fosamax for a few years and it did help keep my bone loss down. The loss I've had recently is the worst it's been.

I've taken calcium and vitamin D supplements since I've been off dairy and have been taking Entocort. My vitamin D level at the last testing was 62 IUs, and my serum calcium was 9.6 out of an acceptable range of 8.6-10.2. My loss doesn't seem to be due to a lack of calcium or vitamin D.

I have several of the risk factors for osteoporosis: I weigh 99 lbs. and am very small-boned, I'm of white European descent, and I'm taking a steroid (Entocort). I also don't do weight-bearing exercises, but I walk and ride my bike.

I have been taking Doctor's Best Strontium Bone Maker since receiving my test results, which is an OTC strontium citrate medication. Strontium ranelate is a widely prescribed prescription for osteoporosis in Europe. The difference between strontium citrate and strontium ranelate is the type of salt used. Strontium works by slowing down resorption (bone loss) and building up existing bone. It's not clear what mechanism encourages new bone formation. We may never know since it's an OTC medication and pharmaceuticals would have no interest in funding any studies on it.

The bisphosphonates, such as Fosamax, stop resorption, but also stop any new formation of bone. As Tex has pointed out, you're left with old, brittle bone after using Fosamax. It also has a half-life of greater than 10 years.

You may want to read this website on osteoporosis: http://courses.washington.edu/bonephys/ ,maintained by an MD professor at University of Washington.

Gloria
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Post by Deb »

I'm sure that was pretty unsettling, Gloria. I sure hope things improve now that you're off the Fosamax.
My fat absorption rates improved (checked through Enterolab) after a year so I'm hoping that my calcium absorption is as well. I can't help but think that my darker hair is an indicator of better health and hope my bones eventually reflect that.
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Post by brandy »

Hi Gloria,

Thanks for the weblink that you provided. I've scanned it quickly twice and really need to take my time reading it. Already I can see some minor things I need to tweak, like less caffeine and take one dose of calcium later in the day and some things to help my mother. I really appreciate the info. I've already increased my vitamin D to around 5000 and am analyzing anything that has A in it and I guess I'll come up with a plan to stick with the next two years until my next bone scan.

Found your comments interesting about your vitamin D and calcium levels. Keep us posted. Brandy
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Post by brandy »

I had a follow up Dexa scan as part of a medical study that I am in and my osteopenia has progressed to the cusp (start) of osteoporosis with a -2.5 T score (age 55). When I found out I was angry and kind of depressed. I thought I would give background info, what I'm doing, and I'll probably have questions for my fellow MCers.

Background: 3rd generation with bone issues, genetic link, all 3 generations had mostly gray hair in our 20's--another link to bone issues; currently age 55, from age 18-age 50 my weight averaged around 160-165 pounds. I've been as high as 185 pounds and as low as 140 pounds. I am presently 5-6-1/2" @ 135 pounds. I've never been a small or petite woman and pre MC would have been considered on the heavy side.

I was very, very sick with MC when I got my osteopenia (early) diagnosis. My test was around Dec 1st 2011. Looking back over the last 4 years it is surprising that my scores now are not worse. I got off of Entocort around Feb 15th 2012. I suspect that I had a lot of bone loss in 2012 and 2013 just recovering from MC. I had severe fatigue until the end of 2013, brain fog the first 9 months of 2012, almost no iron in my body discovered end of 2012, no testosterone, low DHEA etc. Apparently bones need testosterone, dhea and a little iron as well as other stuff. It wasn't until the end of 2013 that I started feeling better due to iron supplements and bioidentical hormones.

I had about 9 months of doing well in 2013 then Oct 1 I got a new boss and assistant boss and extreme stress. Oct 1 2013 thru Dec 2014 was characterized by extreme job stress. It was sad as I'd been with the company for 12 years and prior to that it was the job of a lifetime. I've since learned that bone loss in heavier people can be tied out to stress.

I've been on bioidenticals since 2013 and average walking 10-12 miles per week. Except for 2015 when I got lazy I lifted weights in gym once a week.

My next posts will be on what I am doing re: Stress Management, Exercise, Foods, and Supplements. I will have questions for you all when I get to the foods and supplements posts.
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Post by tex »

A thought just crossed my mind. I wonder if Dexa scan results are totally machine-interpreted or if the operator (or radiologist) plays a role in the interpretation of the results. Even if the interpretation is strictly machine-based, computer algorithms can change, and they can make a lot of difference in how the results are interpreted/reported. And operator bias is so common with medical testing that at EnteroLab, only one person (who holds a PhD in chemistry) does all the testing, in order to rule out operator bias. As far as I'm aware, that individual has performed every test since EnteroLab was originally founded, and no other lab in the world takes operator bias that seriously.

IOW, I'm wondering if your Dexa score actually declined, or if the reported results were lower because of an algorithm change or possible operator bias.

This is a very educational thread — a graduate-level seminar on understanding osteoporosis. Looking forward to more data.

Tex
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It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
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