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.

Thanks @Smileyoriley
That’s actually good to hear about the Alendronate. I’ve been slightly dreading when I have to take it but you are a good reminder that you only read the negatives about that too.

@rifling

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

How were you diagnosed? I had an x-ray for something unrelated and that suggested I may have it. But no follow up except the Vit D/calcium tablets. I had to push for a DEXA scan after posting on here. I'm presuming this will get followed up regularly but may have to push for that as well?

I do wonder how common it is as without that x-ray, I'd still be blissfully ignorant.

@SwedishEdith I had to push for a DEXA scan after a simple "going over" on my ankle caused a break. A friend was the one who mentioned osteopenia and encouraged me to ask for a scan. Glad I did otherwise I'd be oblivious.

I'm not sure if it varies between areas and health authorities but I don't get an automatic recall every 2 years, I have to request it via my GP.

How were you diagnosed?
I had hip pain and had an xray which found nothing wrong with my hips but osteopoenia in my spine.

I appreciate this won't work for anyone who has had breast cancer but HRT and the oestrogen part of it increased my bone density after I'd slipped from osteopenia to full-blown osteoporosis after I stopped HRT for 18 months.

Well I've seen my doctor and talked things through but ultimately it's my decision from the following options:

• alendronic acid - GP said to have dental check up first but the jaw necrosis really petrifies me as my teeth aren't great
• HRT - not without it's risks as my mum had breast cancer (ductal carcinoma that was treatable) but, as GP said, regular self-checks and mammograms would hopefully detect any problems early on.
• continue with just calcium/VitD and see what my next scan in 2 years shows

I'm still in the osteopenic bracket rather than osteoporotic but have 2 fragility fractures under my belt.

I have Rheumatoid arthritis and have been on steroids for two years (much against my wishes). I have a family history of osteoporosis and finally got a dexa scan last year which revealed I have osteoporosis.
i have a history of breast cancer so no HRT for me.
The drugs are bisphosphonates. Alendronic acid by tablet and zolondronic acid by infusion.
I went to see my dentist before starting alendronic acid as I have a mouth full of fillings. He was quite reassuring.
It was a tough decision but fractures and spine crumbling cause dramatic life changes, so I have started taking it for probably two years.
The risk of osteocronosis is higher with the infusion.

I also take vit d and calcium.
I spoke to a very helpful nurse at the National Osteoporosis society and she gave me lots of advice about diet and exercise.
Essentially she said to increase my protein intake, a lot. Also as others have said weight bearing / impact exercise. Not always easy when you have RA.