Tuesday, August 23, 2011

To medicate or not to medicate, that is the question.

Early tomorrow morning I have an appointment with an endocrinologist.  I have a lot of questions, in particular, will mega doses of Vitamin D, Calcium, Magnesium, Vitamin K, Strontium and Boron be more beneficial with reversing osteopenia than medication?  

When the surgeon called to cancel the surgery, she explained my bone density results showed I am at the borderline of having osteoporosis.  Healthy bone density is a range of 0 to 1, osteopenia is -1 to -2.4 and osteoporosis is -2.5 and beyond.  The scores are measured by T and Z scores.  My T is -2.4 and Z is -2.0 for my lumbar density.  My hip and neck density is at the 97% and 99% normal range.  So how is it, that the rest of my body has normal dense bone but the lumbar does not?  Well, on the front page of the density results is a statement, "... the presence of severe dextroscoliosis of the lumbar spine may falsely elevate the bone mineral density."  Ok, so how do I know the accuracy of my lumbar result considering scoliosis is present which is possibly skewing the results.  So many questions.

There are a lot of medications available to slow down the loss of bone: Boniva, Actenol, Evista, Fosamax, etc.  All medications have their pros and cons, but I'm not getting a warm fuzzy feeling about them.  As far as I know (and my research just started very recently) there is one medication that actually promotes bone growth: Forteo.  From what I've read and from patients I've talked to who are taking Forteo, this is the granddaddy of them all by providing very fast results which is especially beneficial to patients looking to have spinal surgery.  You see, if a patient has osteopenia/porosis and undergoes spinal surgery, the hardware (rods and screws) that need to be implanted won't have solid, sturdy bone to anchor into.  Curve correction won't be as good if the bone is soft in addition to potential future problems with the hardware coming loose.

I read that regardless of which type of bone medication a person takes, at some point, if they stop taking the med, their bone loss will return.  In particular, Forteo is to be taken as a daily injection for 18 months to 2 years and no longer.  Why?  There are no long-term studies on the effects of taking Forteo beyond 2 years.  Another question I have for the doctor: Can I take Forteo in conjunction with mega supplements so that when I cycle off Forteo, the supplements will maintain the new bone?  

A blood test result from last year shows my vitamin D levels are low, healthy range is 20 - 100 and I'm at 33.  Vitamin D is necessary for the proper absorption of calcium in the body.  Could my density issue be something as simple as taking a boatload of vitamin D?  We shall see.


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