Osteopenia and beyond .... what's next if Calcium/VitD supplements are not enough?

[WellThatsATurnipForTheBooks]

I was diagnosed with osteopenia nearly 10 years ago when I was in my mid 40s and have had DXA scans every 2-3 years since. I'm now mid 50s, take Calcium/VitD supplements, exercise (mainly walking), not really overweight, diet is pretty good etc

My most recent scan (delayed due to COVID) has apparently shown my bone density is worsening so I have a phone consultation with my GP booked in for next week where he apparently wants to discuss further treatment.

What is the treatment/medication likely to be offered? What are the side effects? If anyone has experience I'd love to hear from you please.

Allendronic acid is what dm has been given.

OP I’m in a similar situation. I was diagnosed last summer with Osteopenia, GP had organised a dexa scan because of the medication I take for breast cancer, and because I’ve had my ovaries and womb removed.
I was advised not to take calcium supplements but to increase it in my diet. No one really seems that interested in osteopenia and I think it’s just considered inevitable that I will get osteoporosis and should just suck it up!!

It's not true that people aren't interested in osteopenia. I have it and have treatment successfully via a yearly infusion.

@Slowfoxfast

It's not true that people aren't interested in osteopenia. I have it and have treatment successfully via a yearly infusion.

Infusion of what and by whom?

You need to do weight bearing or resistance exercise - walking on its own is probably not enough. Walking with a weight vest, resistance band work, weights, jogging, elliptical, rowing machine. That type of thing.

Infusion of what and by whom?

I'd like to know too please @Slowfoxfast

My only "treatment" for osteopenia so far has been advice ie. calcium and Vit D, exercise, healthy diet

@Slowfoxfast

It's not true that people aren't interested in osteopenia. I have it and have treatment successfully via a yearly infusion.

Are you in the UK?

@TooManyPJs

You need to do weight bearing or resistance exercise - walking on its own is probably not enough. Walking with a weight vest, resistance band work, weights, jogging, elliptical, rowing machine. That type of thing.

It's mainly walking but I have tended to go to the gym once a week too (resistance machines, elliptical, treadmill on an incline) although this stopped for a while after I broke my ankle - I'm just getting back into it now.

I am in the UK. You can have weekly tablets for it prescribed by your GP or you can see a consultant who can prescribe tablets or an infusion at the hospital. I've had two infusions and will have another DEXA scan in two years to see how my bone density is.

The National Osteoporosis Society has a lot of information and can send you booklets with advice and the sort of exercises you can be doing. There is a lot of info online.

I also have full on osteoporosis, and take vit D and good calcium supplements. The ones you get from the NHS have a very low absorption rate. I bought a second hand heavy duty vibration plate and used it everyday for a few minutes. My numbers stopped going down and then they started coming up again, 6% up last time. If it's good enough for astronauts it must be good. I don't want to go down the Allendronic acid route as it works by stopping all the dead bone cells from being reabsorbed by your body so your bones become denser but also more brittle. So if you do have a fracture it's more of a shatter than a normal break. It also can have a major side effect on your jaw bone which is horrifying.
Weight bearing yoga and/or Pilates, take the best supplements you can afford, get a kettle bell or other weights and either go to a class or Youtube it. Also green vegetables with everything.
I am not a medic and this is my opinion from lots of reading.

@PerseverancePays please can you explain to me about the vibration plate? How does that help?
I do Pilates but probably need to do something else too. What supplements do you recommend?

I have no choice about the alendrotnic acid and they do warn you about your jaw but the risk is low. I don't take calcium any longer as it has its problems as well. Nothing is without possible side effects.

Vibration plates like they have at some gyms. The action of the vibration makes your muscles twitch , I think, and that in turn makes your bones denser. It does takes some getting used to, you can feel your teeth rattle in your head and your brain! But I did get used to it and even got to like it.
I get my supplements from Nutri , Cal Mag and Osteo P complex. I also take zinc and a big vit C . They do ask for the name of your nutritionist when you call them direct. They are available on Amazon but you don’t get the discount of the fifth one free.

alendronate or denusomab are treatment options
both are not without side effects.

whatever you are offered, you need fo make sure your mouth/teeth are in good condition as there is a risk of bone dying off (osteonecrosis).

The osteonecrosis of the jaw does bother me as unfortunately I have a lot of root canals, fillings and crowns (combination of genetics, an accident and a dodgy dentist many years ago)

I also have osteopenia, age 47. I had a DEXA scan before starting hormone blockers for breast cancer. I'm having 6 monthly infusions of Zoledronic Acid for 3 years to help my bones, this would have happened whether or not I had any bone thinning.
I had a bone profile blood test to check everything too and all was ok except phosphorus was just under the ok level so need to make sure eat my pulses and dairy (I'm vegetarian). Also, to take Vitamin D and weight bearing exercise.
I would ask about Zoledronic acid or similar.

I was advised to check with my dentist before starting treatment. I also have a lot of root canals and crowns but he said the risk was low and I should go ahead with the treatment. As I mentioned upthread, The National Osteoporosis Society has a lot of information and a helpline. Really, talk to the experts and then weigh up your options.

Urgh, I've been recently diagnosed with this so thanks for starting this thread, OP.

I've been given those calcium and Vit D tablets and have started on HRT patches as well. I hate exercise but realise I'm going to need to do something. What happens with the vibration plate - what does that do? And kettle bells - what weight should I be looking at to make any sort of difference?

I have osteopenia and following a fragility fracture was advised to take Alendronic Acid- I am glad to say I have had no side effects. I have also upped my weight bearing exercise and altered my diet as I am determined to stay as healthy as possible.

Do any of you also have really achey joints? Or have any other medical conditions?

Is osteopenia or osteoporosis ever a symptom of another condition?

I just feel such a physical wreck sometimes and have wondered in the past whether or not I have an underlying condition.

Yes OP I have achey joints and also get very stiff. Swimming and Pilates help a bit.

I’ve currently got achey joints but I put that down to decreasing exercise, sleeping awkwardly and increased weight since my fracture, so I’ve started exercising again- aqua fit classes have been amazing for my joint pain, although it’s weight bearing exercise I need for bones.
My diagnosis came from a specialist consultant clinic who ordered a whole raft of blood tests to rule out any underlying health conditions (all clear) so if I were you I’d ask for the same.

Osteoporosis here diagnosed early to mid 40s.

I have 6 monthly injections with denosumab. Zero side effects so far although after the 5 year course I will have to take oral medication for 6 months (alendronate or something) to prevent complications when coming off it. Follow up scan after 3 years of treatment so far showed c10% increase in bone density 😄. I don’t know if it would be offered on the NHS but on a self pay basis I think it’s been in region of £1,000 to £1250 a year including consultant plus cost of 2 scans so far.

The night before I started treatment I went down a rabbit hole of reading an anti denosumab blog and nearly chickened out. Thank goodness I didn’t and listened to the doctors instead!
The way I make myself look at it is in a funny way we are the lucky ones who know we need treatment (although of course I’d rather not have it).
Also interested in the vibration plates - am going to look into that!
Good luck OP

Following. I was diagnosed with osteopoenia 3 years ago ....and then nothing. No follow up or suggestions on what to do.

@Cumbercat
Great news about your scan result!
I got terrified by the anti Alendronate blogs too but like you, decided to go with the medics.
I have had fantastic treatment on the NHS but I think as with everything it’s a bit of a postcode lottery!