To think osteoporosis is shockingly sidelined by healthcare professionals in the UK

Im a PT and I work with many menopausal women. HRT does work but so does really regular well designed weight training programmes, decent calcium and D3 supplementation. You can definitely make good gains with those approaches in the absence of HRT.

I had an osteoporosis diagnosis at 52. I managed to reverse it to osteopenia in 3 years mainly through diet and exercise (although I did take medication for 10 months too).

I found I had to pretty much research it all myself. I managed to see a specialist nurse at one point and she said I should avoid heavy weights and only do resistance bands! This is despite the fact that my osteoporosis score was only 2.6 and so I think it was pretty poor advice. The Royal Osteoporosis Society are great though and you can speak to an osteoporosis nurse on their helpline.

You need to be doing weight-bearing exercise, in fact we all do, HRT or not.

Well I don't walk the dogs without wearing headphones and a podcast or music.

I love lifting, I had to stop running so it's all I've got!

I recommend Bodyfit By Amy on YouTube. I'm 47 and I've been going her workouts for 6yrs.

How do people listen to podcasts when they exercise? I could go for a run (though I'd have to be super careful crossing roads) or do half an hour on the cross trainer with a podcast but not weights because I can't remember which exercises I've done or how many!

Lifting weights needn’t be dull.

Try Caroline Girvan.

Turn down the sound/music and listen to podcasts, Classic FM, Radio 4, whatever.

Best possible start to my day.

NB: I’m in my 70s….. and it’s so worth it.

If the hospital told you a bisphosphonate would cause your teeth to fall out, it shoukd be reported to the Trust's clinical director.

Zolendronate (infused) has a vanishingly rare side effect of causing something called osteocronosis of the jaw, whereby a bad tooth or invasive dental procedure can cause the site not to heal. My rheumatologist, world leading, told me it usually happens (in teeny tiny numbers) in people who have severe diseases and metatastic tumours in the bone for which they are receiving zolendronate much more frequently than once a year and are much more acutely ill than an otherwise well person with osteoporosis. It's about risk assessment and for 99.9% of people the risks arising from a fracture are significantly greater than developing osteocronosis of the jaw. It is however, important to maintain good dental hygiene and get any major work done before starting it, and to see the dentist regularly.

I do agree that HCPs chat shit however. I recall my GP tellimg me that the best thing I coukd do was go for a run every day. I pponted to the boot I was wearing. The most important thing for me is gentle weight bearing exercise, gardening and strenuous housework as well as a brisk walk for 30 minutes. With dyspraxia and osteoporisis I need to avoid activiities that could result in a fall and that also could damage my joints where there is already evidence of arthritis.

At 63 I was knocked over ("had a fall" in old-people speak) and broke my shoulder. As I was over 55 and broke a bone from a standing fall I was referred for a Dexa scan which happened about 9 months later. The scan found osteoporosis and osteopenia in my lower and upper back (I forget which way round)

So now I am on weekly alendronic acid tablets and daily Vit D but not calcium as the hospital did a diet check and said there was enough in my diet. The dentist needed to know and wanted to make sure my teeth were in good nick before I started but it hasn't harmed my teeth as far as I know. The injections are mostly used if you can't take the tablets.

I also asked the physio who I was already seeing for my shoulder and she pointed me at some weight-bearing and strength building exercises. Muscle strength (especially back muscles) helps avoid bone damage. Strengthening spinal muscles is important.

There is a lot of good information and especially exercise guidance on the Royal Osteoporosis Society website.

Good point.
It is not something that even crossed my mind. I've bee on the mini pill for a very long time.
It would be useful to know if it affects bone density and to what extent.
Only recently I read somewhere, I can't remember where, maybe it was a podcast not an article , that breastfeeding depletes calcium stores and those reserves cannot be replaced. I had no idea and I didn't do anything special to help this during breastfeeding. I did drink lots of milk whilst pregnant but no idea if that did anything useful or not.
The scans should be offered to all women from the age if 40 I think. Before menopause sets for most women.
The current thinking I noticed from some American doctors is that starting HRT within 10 years of the onset of menopause does prevent osteoporosis to a degree (amongst other health issues such as heart problems).
Nobody knows anything and there is no consensus or real up to date guidance.
This thread is very useful OP.
Bone health should be taken seriously and from an early age for all women all over the world.

I just asked my GP, but I’d had an x-ray that was suggestive of osteopenia.

Thank you. Yeah I thought it weird the guy said that. And that they had no comment on how low my t score was. I was only very early 40s!?

I am healthier now and do take lots of prescribed vitamins. But will try those supplements you mentioned.

That's nonsense, you can take alendronate once a week and you will find out long before your teeth fall out that you can't continue it. My teeth hurt too badly to chew but they were right as rain after 3 weeks off the drug.

That's a really bad score, it's out of 5. If the doc won't give you anything I strongly suggest you start taking the maximum dose of one or more of the common supplements that prevent osteoclast formation. MSM, liquorice root, curcumin (not turmeric).

Good luck!

I've got really bad osteoporosis and the hospital didn't even bother to tell me! They also said the only medication for it was an injection once a year that can make all your teeth fall out. As that's a massive phobia of mine I got scared so declined it.

But they never actually said the words 'you have osteoporosis. Your t score is minus 4.7' I had to email the secretary for them to send me the t score. And they haven't spoken to me about it since. This was 3.5 years ago!

I think the whole thing with running is that you don’t ‘shock’ the bones enough. Running with good form involves absorbing much of the impact, rather than landing ‘heavily’ iyswim. So activities like tennis, which involve explosive takeoffs, and abrupt stops and turns, especially combined with sideways pressure is beneficial.

And I agree dexa scans should be routine post menopause. Fractures and falls and so responsible for ill health and nhs costs in later life.

Thanks - I thought lifting body weight in running would be super protective. Running since my mid 20s. Have started lifting as well but find it so dull and always default to running.

Sometimes doing the right things doesn't make a difference. I tried to do it right after being terrified about osteoporosis in home economics class 40+ years ago. Then last year I fell and shattered my shoulder. Cue dexa scan and a subsequent diagnosis of severe osteoporosis at 52. It's shit.

Just to get things in perspective.
I was diagnosed after a slip and trip (a hard one) and cracked a metatarsal. Referral for dexa was routine.

I took alendronate for about 4/5 months then slipped hard on frozen ground and badly wedged L1. Referred to rheumatology and had three infusions of zolendronate which effected some improvement and i was put on maintenance infusions every 18 months and it deteriorated a bit.

Then had a horrendous fall (wet, slippery, slope). Badly broken wrist requiring surgery and T1 wedged badly.

Went back to rheumatologist who put me on teriparatide, injectible daily, two year course. NOT available on the NHS so you need 2.5k to spend.

Now on zolendronate again annually.

My situation is partly genetic, partly being a recovered anorexic and partly due to undiagnosed graves in my late 20s. I did do weight bearing exercise until my 40s when life and time intervened. Post 20s I have had a good diet and am never degicient in anything. I take 112.5mcg levo, calcium, turmeric, vit d. All bloods are good. I have learnt to slow down - the constant dashing about with a mild dose of dyspraxia caused the falls. I also do pilates which has been fabulous.

But, what I wanted to say is, yes, I have osteoprosis, yes I manage my back carefully, yes I am more cautious re dashing about, but I am not in pain, I still work a professional job, run a house, garden hard, have a great life and fortunately little to no pain. I'm 65.

Thanks. I was hoping there might be a way to be screened by the nhs before I sustain any fractures!

Those are all at least 2 1/2 hours away and cost £200 or more! Unfortunately out of reach for me.

This is not true according to what I'm reading. The whole point of bisphosphonates is that they show remineralisation after 5 years.

Does anyone know if long term asthma inhaler use impacts bones?

I've used a full salbutamol (or equiv) once a month since my teens, plus bethametasone (or variations of). I've been taking these drugs for 40 years.

I did ask the asthma nurse and she laughed at me. But there seems to be conflicting info on the Internet. You all seem to know so much I thought I'd ask.

These people.

https://uk.scan.com/?3Aadwords%3Ag%3A20836490144%3A157185311718%3A722421439816&nb_adtype=&nb_kwd=private%20scans&nb_ti=kwd-320607518838&nb_mi=&nb_pc=&nb_pi=&nb_ppi=&nb_placement=&nb_li_ms=&nb_lp_ms=&nb_fii=&nb_ap=&nb_mt=e&utm_medium=cpc&utm_source=google-ads&utm_campaign=uk_generic_scan_em&utm_agid=157185311718&utm_term=private%20scans&creative=722421439816&device=c&placement=&gad_source=1&gad_campaignid=20836490144&gbraid=0AAAAADKx-tBt2GBtgC_ib9fAN8vBe7cP_&gclid=Cj0KCQiAoZDJBhC0ARIsAERP-F89bpsWDApumLUIUNu_iZPTFc_98gL55pPz4xq6-LBRa4U7C8OMFBcaAj7tEALw_wcB

I can't. I tried alendronate but my teeth got extremely painful. Millions of people take them with no problem and they work. It's only once a week, it's a very safe drug that works.

I am taking supplements that do the same job, prevent osteoclast formation, Curcumin (not turmeric!), MSM, and liquorice root. I take these to keep my RA in remission but thankfully they work for osteoporosis too.

None of this is a substitute for good diet and exercise but I already had a good diet and got a ton of exercise within the capability of having RA that is triggered by too much stress on joints.

Related to that, I find it massively shocking that the mini pill has been available for so long, but still nobody seems to know if and how it affects bone density. My theory is that the body has lower estrogen for years than on the combined (or without) pill so there may well be an impact?
I don’t have a choice but to take it for medical reasons, but I do wonder.

Too right you are OP. I have 3 risk factors for osteoporosis. I'm thin boned, I had a relatively early menopause and didn't have HRT and I have rheumatoid arthritis.

I suggested a DEXA after hurting my wrist and my doctor brushed me off saying DEXAs don't do wrists. They can, actually, but it was irrelevant anyway, bone thinning doesn't just affect one bone!

So I took myself off for a private one, £240, and the result is that I have one vertebra in the middle of my back that is minus 3.9 out of 5, so really seriously weakened and osteopenia in my hips.

I do not understand why women with known risk factors are not routinely scanned. The treatment is as cheap as chips, never mind the deaths that are a direct result of a fall and a broken hip!