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Questions
this month have been answered by:
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Q:
Will Fosamax reverse the
osteoporosis?
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| A: A bone density of 0.91 is a fairly meaningless number by itself since I don't know what bone site was measured, nor by what instrument. If it was the spine that was measured it's an OK number. If it was the hip that was measured it's a great number. Fosamax is a very effective drug for treating osteoporosis. It helps put back some of the bone you might have lost but, more importantly, it has been shown to greatly reduce your risk of having a fracture as a result of osteoporosis. No drug comes with a guarantee of preventing fractures but the data on Fosamax is very good. I am not aware of Fosamax causing a metallic taste in the mouth but nothing surprises me anymore. If your friend also has this taste you might check what else you share besides Fosamax. For example, does your drinking water come from the same source? Do you shop for food and drink at the same store? Are there any other drugs, pills, vitamins, supplements, etc. that you might be taking in common? It's easy to blame the drug but it's hard to be sure that the cause. I suggest you (but not your friend for now) stop Fosamax for 2-3 weeks and see what happens to the taste. No harm will befall you if you go 2-3 weeks without Fosamax. Once you have done your experiment, regardless of the outcome, your friend should try the same. Let me know how this turns out! Michael Kleerekoper OBGYN.net Osteoporosis, Editorial Advisor |
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| Q:
Is it ok to switch from
Didrocal to Fosamax and weight training. Two years ago I had a bone density test done , and I was advised that since I have lost 2 inches of my height that I should consider taking the Drug Didrocal or Fosamax. I have decided after being on Didrocal to switch to Fosamax which I been taking for the last 5 months. I wonder if going on a weight training, and stretching exercise regimen as well as taking my Calcium with Vitamin D if I can interrupt this drug (Fosamax) for a while. I had breast cancer 18 years ago therefore I was told not to use estrogen , or any other form of Hormone replacement. I am a very healthy active person, and I do not like to be on medication for the rest of my life if there is an alternative. |
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| A:
While adequate calcium and vitamin D are basic in preventing and treating osteoporosis, if you have osteoporosis, they alone are not adequate treatment. If you are going to take Fosamax, you must have adequate calcium intake. If you live in an area where regular sunlight exposure is a problem, you should add Vitamin D. Vitamin D is found in milk in the USA and in almost any multivitamin pill. Weight-bearing exercise, muscle strengthening exercise, and exercise that improves agility and decreases the risk of fall are important too. Paul D. Burstein, M.D., FACOG OBGYN.net Osteoporosis, Editorial Advisor Clinical Professor Obstetrics & Gynecology University of Wisconsin Medical School |
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| Q:
Can I nurse another
baby or do these test results make it unwise? Today at a health fair booth I had a bone density test. I am a 32 year old, small boned, sedentary, white, female, 5'4, 125 pounds. I have had two pregnancies, nursed my first baby for fourteen months and am still nursing my 13 month old. (I am in the process of weaning) my test results were: T-score of Young adult -1.4 left Os Calcis BMD 0.380 g/cm2 Percent of Young Adult 76% I'm not sure what all this means except that it's bad. My question: I want to have another baby and nurse for about a year. Is this okay? Will the baby get the calcium he needs? Will it hurt me? I only had one cavity before pregnancies but after my second, I had 7 cavities! I am also large breasted and have poor posture. I have a "spot" next to my spine that knots up sometimes when I work leaning over a desk for a long time. Could that be related? Should I see a doctor because of these test results? I really want to have another baby! Thanks for your advice!! |
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| A: I guess I would not perform a bone density test on a 32 year old. Depending on type of bone, you reach your peak bone mass between 30 and 40. It is likely that the bone density test is meaningless in your case as it is generally useful in detecting bone mass lost after reaching your peak. I would suggest optimization of calcium and Vitamin D intake, getting enough exercise, and avoiding substances hazardous to bone health, such as tobacco, excess caffeine and excess alcohol. Hope this helps. Paul D. Burstein, M.D., FACOG OBGYN.net Osteoporosis, Editorial Advisor Clinical Professor Obstetrics & Gynecology University of Wisconsin Medical School |
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| Q:
Is Fosomax and Risendronate the one
ways to treat Osteoporosis in my case?
I am 42 years old, with regular periods. I have been diagnoses with osteoporosis. I tried the 70 mg dose of Fosomax and had severe side effects (muscle aches, joint aches, joint clicking, headaches, neck pain, abdominal pain, and complete loss of appetite). I am told Fosomax or Risendronate are the only ways to go and I will have to get use to the side effects. Any suggestions? My lumbar spine is the worst with a t score of -3.25 but no fractures. |
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| A: I would be concerned about finding such low bone mineral density in a young menstruating woman. I do not think there is much data in the use of either alendronate or Risedronate in young women potentially pregnant in the future. I would suggest a careful review of your medical history to look for secondary cause of osteoporosis. The list is a long one, and would include evaluation of thyroid, parathyroid, adrenal and kidney function. Have your been on large doses of prednisone or other steroids? Is there a history of long-term use of heparin or anticonvulsants? Heavy smoking, anorexia, etc.? Fosamax or Actenol might be the best choice. In that case, using 70 mg in a single weekly dose might be less tolerable than 10 mg (of Fosamax) daily. Talk to your physician. Paul D.
Burstein, M.D., FACOG
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| Q:
Do you know if Triest plus
progesterone, from a compounding pharmacy, is strong enough ERT
for my osteoporosis?
I have spoken to my gynecologist re: Fosamax. He doesn't want me taking this drug because of the side effects. If I have to I will demand it. I take Phenobarbital for epilepsy and the Phenobarbital depletes the estrogen. He is not certain which estrogen is depleted. He has asked me take saliva tests every three months so that he could monitor the estrogen. In the meantime, I must speak to my neurologist. However, I cannot get in an appt. until July. I will call again and see if this can be sooner. A health professional begged me not to give up Phenobarbital and mess with my brain. I haven't had an epileptic attack in 4 years and I don't want t have one now. However, I can find no information on Actenol. Can you possibly tell me where I could get information?? Do you know if Triest plus progesterone, from a compounding pharmacy, is strong enough ERT for my osteoporosis???? I am an absolute "basket case". I am only 55. I should have a long life ahead of me. I don't want a "sick life". |
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| A: At risk of treating sight unseen, I do not think measuring estrogen levels is of much value in a post- menopausal woman. While phenobarbital and dilantin might alter the metabolism of estrogen, using a higher dose might be appropriate. Actonel (risedronate) is new in the United States and is a bisphosphanates like Fosamax (alendronate). The side effects are mostly stomach and intestinal--heart burn and rarely ulceration of the esophagus. The medication must be taken first thing in the morning and only with water. You must remain upright and have nothing else to eat or drink for 30 minutes. While inconvenient, these are effective and well-tolerated drugs. After all, you want to live a long time and decrease your fracture risk. As far as compounded Triest, I would stay with a commercial brand, such as Estratab, Premarin, etc. Hope this helps. PPaul D. Burstein, M.D., FACOG OBGYN.net Osteoporosis, Editorial Advisor Clinical Professor Obstetrics & Gynecology University of Wisconsin Medical School |
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Q: What is the difference is between Fosamax and Actenol? Would you please tell me what the difference is between Fosamax and Actenol? I am a 33 year old female diagnosed with osteoporosis and my endocrinologist has put me on Actenol. Thanks. |
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| A: Both are drugs in the class known as bisphonphonates. They work in similar fashion and are most likely equally effective. There is less data about Actonel as it is newer, but it may have the advantage of being less likely to be associated with stomach-esophagus irritation. Time will tell. Paul D. Burstein, M.D., FACOG OBGYN.net Osteoporosis, Editorial Advisor Clinical Professor Obstetrics & Gynecology University of Wisconsin Medical School |
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| Q: Where can I find more information on osteopenia? | |||
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A: Please review these questions that have previously been asked regarding osteopenia: Here are some articles that may be of interest to you: What is osteopenia?
by Susan Ott, M.D., Associate Professor How
Can I Prevent Osteoporosis? Food and Our Bones: The Natural Way to Prevent Osteoporosis by Annemarie Colbin Information
for Women about Osteoporosis and Other Bone Diseases Protect
Your Bones Please visit our Women and Patients Links page for more information. |
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**Note: Opinions expressed here are for educational purposes only and, as such, do not constitute a physician patient relationship. This information is not intended to supplant the need for you to consult with your physician prior to choosing therapeutic options and/or interventions. Click here to see Previous Ask the Expert Questions and Answers |
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