Bone Mineral Density Question

[lag713]

Questions: What are your experiences with bone mineral density changes? For those with low or decreasing bone mineral density, what did your doctor recommend? Changing medications? Lifestyle changes? Any advice or stories would be appreciated!

My bone mineral density test results show a 5% decrease in my hip and spine since my last test 2 years ago. My results are still in the normal range but my rheumatologist wants me to collect urine over 24 hours to evaluate how my body is absorbing calcium. I'm a female around 30 years old and I don't think my lifestyle has changed since diagnosis. I know rheumatoid arthritis can decrease bone density and it is a possible diagnosis if Wegener's isn't correct (symptoms: mild, recurrent ENT problems, joint pain/swelling/stiffness in hands, fatigue; cANCA Pr3 is positive but not elevated; clear ENT exams; nothing to biopsy).

Medications that may reduce bone density:

1. Two corticosteroid shots a couple months apart when I was first diagnosed 2 years ago (never taken prednisone)
2. Prevacid for 6 months or so
3. Methotrexate (does this change bone density?) for 20 months (stopped 6 months ago)

Lifestyle:

1. I probably exercise far less than I should with both intensity and duration
2. I have calcium in my diet from milk, yogurt, and cheese.

[drz]

Vitamin D is needed to absorb the calcium.
Are you taking any or had those levels checked? Too much Vitamin D is bad but you need enough to absorb the calcium. There are two kinds of extra calcium generally used--those in Tums or generic version and calcium citrate. I take both along with the vitamin D to try keep my bones strong along with generic Fosomax.

[lag713]

My levels were checked over the past 2 years and I've taken Vitamin D supplements (daily multivitamin to prescription strength) on an off. My recent blood work showed a slight insufficiency of Vitamin D (26 with an optimal range of 30-100) so my doc prescribed a supplement. I've never had a calcium supplement beyond my daily multivitamins. I'm supposed to hold off changing calcium supplements for the 24 hour collection urinalysis to see my calcium utilization (or lack thereof).

[greenjeep]

I have osteopenia but I cannot remember if it was from cytoxan or steroid use. (I also have memory loss it seems). I take vit D but my nephrologist suggests lifting weights - even if light weight. I would be a little more compliant if I weren't so tired.


Sent from my iPhone while driving on the freeway, eating salt, and drinking a 78oz soda.

[lag713]

I know corticosteroids like prednisone often cause bone density loss. I haven't taken prednisone so that wouldn't explain it.

Memory loss is expected when there's so much to remember!

I know weight lifting and weight bearing exercises can help improve bone density. I completely understand having problems being compliant because you're tired. Something as simple as walking can have benefits for bone density.

Thank you for your reply!

[Pete]

I have osteopenia but I cannot remember if it was from cytoxan or steroid use. (I also have memory loss it seems). I take vit D but my nephrologist suggests lifting weights - even if light weight. I would be a little more compliant if I weren't so tired.


Sent from my iPhone while driving on the freeway, eating salt, and drinking a 78oz soda.

Osteopenia likely results from long-term steroid use. You may also want to take calcium supplements such as caltrate+D which would give you both calcium and vitamin D.

As for the exercising, I understand not wanting to do it when you're constantly tired. Start slow - maybe 100 yards round trip. Add as you feel stronger -- one foot in front of the other. Just do it!!