Osteoporosis at age 48

[user1471471849]

Hi there,

I had a dexa scan recently as I was going to go on HRT and my doctor wanted a baseline scan. Much to my shock, it showed I have osteoporosis (T score of -3.3) in my whole spine and osteopenia in both hips. I went to one specialist who seems to think I should go on prolia as my risk of fracture is high, but my GP thinks this is not recommended for someone my age and thinks HRT/diet/weight bearing exercises will be enough for the moment. I'm going to go to another specialist to get their opinion, as it's a big decision.

In the meantime, I'm wondering if anyone has any experience of getting osteoporosis at this age ( or any age) and successfully reversing it with HRT, calcium rich diet, VIT D, exercise?
From my reading, it seems prolia does increase bone density but you can't stop taking it or other meds as the bone density reverts to how it was.

Thanks so much for your help. Any success stories or experience would be much appreciated!!

Older than you but I was diagnosed aged 63. I take Bisphosponates plus calciumm / Vit D. My bone density improved slightly after two years.
I thought Prolia was for post menopause and only after other drugs tried? Perhaps you are not in the UK.
I couldn't take HRT due to breast cancer but it is definitely known to protect bone density, whether it can reverse bone loss I don't know. Impact exercise also good.
I recommend the Royal Osteoporosis society website and helpline. They have some excellent specialist nurses who can tell you the ins and outs of all options.

Thanks a mill for the reply Zerro. I'm in Ireland. I was looking at the Royal osteoporosis website. Lots of good info. Yes, from my reading, prolia is for post menopausal women so I'm really reluctant to take it. I read that there is usually a primary cause in premenopausal women and to treat that first. I was very low in Vit d a few years ago and got supplements but maybe I was low for a long time and that contributed to the problem. Have you had any fractures? The specialist I spoke to was saying I shouldn't bend forward or I might fracture my spine! I feel like a fragile doll now though maybe she's just being over cautious. Definitely going to get another opinion.

Diagnosed 48 after a fall and a fracture.

I get romosozumab which apparently increases bone density. I think it's only available after a fracture.

My scores are on a par with yours.

I was told some medicines will prevent further bone loss but some like romo actually work to increase it.

I haven't had a follow up scan to see the outcome yet.

Thanks for the reply Aubree17. Have you been on the medication long?
I think prolia increases bone density but I haven't had any fractures so not sure if it should be the first port of call. From my reading, it seems that when you start to take prolia you're on medication for life (which I'm ok to do if it's the right thing but would rather avoid if I can).

Do you mind me asking if there was an underlying cause for the osteoporosis Aubree?

I've been diagnosed too and I'm the same age as you! I just listened to a brilliant podcast with loads of great advice, it was the Steven Bartlett Diary of a CEO interview with Dr Vonda Wright, well worth a listen

I was diagnosed at age 50. Mine was almost certainly caused by beast cancer treatment (wiped out my oestrogen and caused an early menopause). I obviously can't have HRT, Im on Alendronic Acid (helps to build some bone density I believe),I take calcium and Vit D, and try to eat a calcium rich diet. I also do lots of Countryside walking/yoga/pilates. I've also become mire aware of the importance of getting enough protein.

It's an interesting question on the underlying cause. I asked for tests but the GP seemed to be of the opinion that you've got it and identifying the cause won't help now.

I was low on vitamin D.

My calcium was ok although I thought my diet was low in calcium.

I was fit - gym, walking and hill climbing,

I drink a lot of fizzy caffeinated drinks ........ I don't suppose you do?

But I do also have family history of bone issues. Grandmother had a hip replacement at a young age.

The nurse told me diet and exercise were a small part of it (I think she said 10%) and it's largely down to genes. Diet was cancelled the next day

I would also be concerned about medication for life. The romo is 12 months followed by another infusion treatment which isn't long term.

The ROS is helpful and have a free telephone line you might find useful.

Oh it's a 12 month course and I'm almost half way through. It's monthly injections.

I've recovered from the spinal fracture and to be e honest life is just normal again.

The risk as you will know is further fractures but apparently there is high success rates with romo.

Thanks floppybit, I'll check out that podcast.

MissyB, thanks for your reply. I did wonder if low estrogen has caused it for me but I took the blood tests after starting HRT.

yeah, I'm hyper aware of my diet now and trying to take in enough calcium and protein.
Aubrey, I'm not a fan of fizzy drinks so that's definitely out for me but I probably haven't been eating enough nutritious food (nothing crazy, probably what most people eat). After having my 3rd child at 42 I did ease up too much on exercise though. My mam and grandmother got it late in life (I just found out about my grandmother) but apparently that counts as a family history of osteoporosis.

Do ye find you get over the fear of falling and feelings of being overwhelmed by it all? As it's a new diagnosis I'm very worried about the whole thing. Worry is apparently not good for your bones either (high cortisol):-)

Thanks so much for all your replies. I really appreciate it.

I'm guessing if you hadn't had a bone scan you would have went through life and perhaps found out about it at the same age as your relatives!

In some ways it's good it was identified so you can take some action,

I guess no one ever plans to fall. I'm maybe more cautious now.

I recommend a non slip shower mat and look for other tips for your home.

I do think unfortunately for me it's possibly genetics, not helped by early menopause. I went through a phase of worry. Now 6 months on it doesn't impact my daily life and I don't think about it much.

Massive family history of osteoporosis but I also had breast cancer and lots of steroids. One small fracture a couple of years before diagnosis.
On the fragility. My scores were similar to yours and I do feel vulnerable even 3 years after diagnosis. I don't take risks, don't do anything that might risk a fall. I do still do pilates but I'm careful about twisting moves.
Also, you need far more protein than you think.

How much protein do you have? I probably haven't been getting enough. Husband is vegetarian and I've def been lax about diet. Also, I found out I'm gluten-intolerant and apparently gluten can stop absorption of vitamin d. For anyone reading, it won't necessarily show in tests but it's not normal to be bloating after eating and this might signify you are gluten- intolerant. I've cut out all gluten now.

Osteoporosis can be reversed but it takes effort and the quick fix of medication will never be the answer. You generally need lifestyle changes - diet and exercise. The exercise needs to be impactful, walking will not cut it, skipping, jumping, running are good. You should incorporate weights in a daily exercise regime and I strongly recommend following Lauren on SeniorShapeFitness on Youtube, she is wonderful for beginners and people of all ages. Your strength training needs protein to complement it and you need 4,000 iu Vit D (with K2), Omega 3 and of course calcium. I also strongly advise you to look at the website Algecal.com who guarantee that their supplements will reverse Osteoporosis (warning it is quite expensive but I think worth it), the website will give you loads of information even if you do not buy the product.

I was diagnosed last year at the age of 54. I am -3.3 in one area of my spine, not quite as bad in others and osteopenia in hips.

Both the report I got with the scan and my GP said that diet and exercise would not be sufficient at this level and recommended Alendronic Acid which I have been taking for a year (once a week tablet). No idea if it has helped as I haven't had a repeat DEXA yet.

Luckily I have had no fractures. I also take Calcichew and exercise maybe 3 times a week with handweights, I do various YouTube workouts, also do skipping, running up and down stairs (actively rather than just as part of my day!) every day. GP and physio both said walking is not much use, you need to 'shock' or 'jar' your bones.

I have a strong family history - sister, mother and grandmother all had it so GP reckoned no amount of diet or exercise would have prevented it.

It's a shock diagnosis I know but I honestly don't give it a second thought these days.

Oh, I also do a variety of balance exercises (well, about 10 minutes a day) as recommended by my physio to improve balance and present falls. I also bought a balance board (on her recommendation) which I spend about maybe 5 or 10 mins on each day and my balance has hugely improved so hopefully all of this will help.

Thanks Tessa, do you have experience of reversing it? I've started exercises the physio gave me. I feel I could definitely do more so I'll see what ones he's suggests when I return to him. I'm on HRT since last month and had been on Vit D anyway and I'm being careful to have enough calcium in my diet.

I read that HRT can be a good treatment for people my age. The specialist I saw seemed convinced I needed prolia on top of that so I'll see what the other specialist says. I need a second opinion as my GP was adamant that I was too young for prolia! My concern is that all these drugs have a finite use and what happens if I've done everything for the max amount of time and I'm only 65 or something (and at greater risk of falling).

Wishimay- It seems I have a family history of it too. My mam and grandmother had it and my mother remembers her granny being very hunched over so she probably had it too and didn't know about it.

Thanks for the replies!

Anecdotal, but I've seen a lot of women on the Irish Menopause fb group saying their osteoporosis was reversed to osteopenia or their osteopenia was reversed completely after a period on hrt. I'd go for hrt before prolia if it was me.

Vitamin K is important to take with D. There are a couple of calcium, D and K products, nutrinua and macánta both have one. The calcium is in a more available form than the usual carbonate.

The osteoporosis organisation mentioned by a pp has good info on hrt, iirc.

I was osteopenic and my stats are improving. I am 64 and have been on HRT since menopause, I was surprised that this did not protect my bones. At age 54 I had an NHS dexa scan which I did not pay enough attention to as its complicated to understand, I should have been followed up but I wasn't. A few years later I was severely depleted of Vit D and I started walking a lot, I also started pilates. I had a private dexa scan in 2020 which really made me sit up as my figures had got worse so my exercise regime got tougher and my next dexa scan in 2022 showed an improvement. I then started taking Algaecal in 2022 and added weights/kettlebells to my exercising, here is the rub: although dexa scans' radiation are less than a day's exposure to natural radiation you cannot have more than one every 2 years so if you have not been doing things right it will take 2 years to realise! My next dexa scan is Nov 24 and I am hoping for a bigger improvement.

Do not delay implementing changes to your lifestyle.

PS if anyone wants to come kettlebell classes with me and a bunch of women its great fun and takes place on a Weds 7.45pm at Hillingdon

One other point to bear in mind is that you must use the same dexa scanning machine if you want to check progress.

Thanks for the info Tessa. Great you've improved your t scores with exercise and HRT. I'm getting over the shock of the diagnosis now and feeling more positive about it. I've already started to make lots of healthy changes to my lifestyle so this will definitely ultimately be for the greater good. It's good that I can do something about it now too and be more diligent when it comes to my long term health.

I'm coming to this thread a little bit late having just had a DEXA scan this week and found out that i am in the osteopenic range in both spine and hips.

I am a 54 year old Pilates teacher and chose to have a scan because I've just qualified as a Buff Bones instructor and wanted to find out what my current bone density score was. I'm a bit sad that it's low, but know that there are things I can do to help.

I'm not currently on HRT, so I'm going to investigate that with the doctor. Also going to get some vitamin D tablets (especially as we're heading into winter). Anything else I should be doing?

Luckily, I'm feeling fully equipped to manage the exercise side of things - for anyone else who wants a good exercise programme I'd really recommend the buff bones website. buff-bones.com/ The founder of Buff Bones was diagnosed with osteoporosis when she was 28, but 20 years later she's improved her bone density score so that she's now osteopenic. You might be able to find an in person teacher near you, and there are also lots of online classes.

Regarding underlying cause what is your frame size? I am 44 and my bone density has been -2.4 for 4 years. I was tested due to early peri menopause but have been on hrt since peri symptoms started.

I don't have any other underlying risk factors and my diet is good, I also strength train. When I spoke to Rheumatology I was told that it is likely linked to having a tiny frame (my wrists are 13cm). She didn't seem too concerned and thought it would likely remain at -2.4 and just told me to keep up with the diet and exercise.

I don't take vitamin d but monitor my levels 2x a year to make sure they are at least 70. I eat a lot of canned sardines as they have vitamin d and calcium.

Just been looking into Algaecal to see if the research evidence justifies the cost and found this for anyone who is interested
nwhn.org/have-you-ever-heard-of-algaecal-im-being-deluged-with-ads-saying-any-nutrient-supplied-in-natural-form-such-as-from-plants-is-better-absorbed-than-nutrients-supplied-from-rocks/#:~:text=While%20these%20studies%20reported%20positive,health%20than%20other%20calcium%20supplements.

The weight bearing exercise doesn't only help with bones but the key reason is building muscle around the bones. So you'll be offsetting the stress on bones by being stronger and more muscular.

Focusing on the quads and hamstrings building up leg strength and squats will set you up long term for hip issues.

If I was you with that diagnosis I'd be off to the gym and get a PT, obviously I don't know your financial situation but gym and weights are going to be your friend.