Osteoporosis needs help from specialist
Dear Dr. Gott: I was diagnosed with osteoporosis in 1998 following an abnormal bone-density test. I was first prescribed Evista, which I stopped after about a year due to side effects. The primary complaints I had were weight gain and hot flashes. I never had problems with menopause and didn’t have hot flashes until trying the Evista. After I stopped it, the side effects disappeared.
Next, my gynecologist put me Fosamax. I took that for about five years but stopped taking it because I couldn’t handle the side effects anymore. I experienced acid reflux that would come on at all times of the day and night. I had reflux problems about five days a week, but it stopped when I discontinued the Fosamax. Another problem I had with the drug was problems with my teeth. I had several root canals and even had to have a tooth pulled, which my dentist told me came out too easily.
When I next saw my gynecologist, I again told her I had stopped the medication. She ordered another bone scan, which showed that my bones had become even worse. This time she recommended Boniva. She explained that because it was taken only once a month, it should reduce my chances of having reflux problems again. I took it for a year but again experienced acid reflux.
Another trip to the gynecologist and another bone scan showed little improvement, so I was again put on Fosamax but at a lower dosage. Again, the reflux came back, so I stopped it in January of this year.
I don’t want to take another osteoporosis medication, but my gynecologist wants me on something to help my bones. I am currently taking two daily calcium pills that contain vitamin D but wonder what else I can do. It was suggested I try a medication that is given by daily injection or one that I get once a year, but I haven’t heard many good things about either and worry about side effects.
Dear reader: You clearly have a sensitivity to the side effects of anti-osteoporosis medication, and, while both the daily shot and yearly IV would bypass your gastrointestinal tract and likely eliminate the acid-reflux side effect, I wouldn’t recommend you try them. I say this because of the three medications you have been on, none has provided significant improvement. In fact, the Fosamax didn’t help at all, as your bone-density study revealed worsening.
Therefore, I urge you to ask for a referral to an endocrinologist, who can test you for other conditions that could cause weakened, brittle bones, such as vitamin D deficiency. A few weeks back, I responded to a letter about that very issue. Several studies have found that vitamin D deficiency is on the rise in all age groups and recommend that the current standards for supplementation be revised.
While you are awaiting an appointment with the specialist, Take calcium and vitamin D supplements. You say you are taking two pills a day, but you didn’t give the dosage. The current recommendation is 1,000 to 1,500 milligrams of calcium and 600 to 800 IU of vitamin D daily. If you are not taking in this amount, you should increase your intake to meet these levels.