bone density improvement while on tamoxifen: anyone else?

peggy_j

Has anyone else seen a significant increase in BMD while on tamox?

I just got my DEXA scan and it showed improved BMD in two of the three measurements and only a slight decline in one. I'm on tamoxifen and am peri-menopausal (no period since last summer). Last year I took ruthbru's advice and ate prunes daily and also did that little walk/jog style of walking (to increase stress on my bones). I haven't consulted with my endocrinologist yet but this was surprisingly good news to me. Previously, he'd cautioned me to not think of tamox as "building bone" but as slowing the rate of bone loss. But it looks like good news to me.

FWIW, I had seen bone loss on tamox while I was still have my period (I'd taken it 2011-2013, at age 46-48, and saw bone loss. My endocrinologist said that SERMs work differently in pre- and post-meno women, when there are different "estrogen milieus." I took a one year break and then restarted, coincidentally, when my periods stopped). For me, it looks like this strategy worked. But my MO was not happy when I suggested a break. My endocrinologist said that when women go through meno they have a greater rate of bone loss during the first three years post-meno, so my plan going forward is to stay on tamox for three more years and then call it a day (so a total of 6 years on tamox spread out over 7 years). I was born with a rare bone condition so I can't take a bisphosphonate so I don't want to chance it with an AI.

Lolis197138

I have that Tamoxifen helps with the health of the bones in postmenopausal women but has the opposite effect on younger women. Not sure if this helps you at all

ICanDoThis

Peggy, I struggled with the same issues when I started, as I had hyperparathyroidism, and was like 14 months from my last period. I was osteoopenic (-2.4, with -2.5 being osteoporotic). The docs didn't care much -- my endocrinologist was inclined to defer to my oncologist, while my oncologist kept asking what my endocrinologist recommended.

So, I finally decided to simply take tamoxifen. At 3 yrs, my oncologist said that she preferred that her postmenopausal patients not be on tamoxifen for more than 2.5 years, as there can be uterine issues after menopause. She wanted me on femera.

I thought about this for a long time, but finally decided that, since my tumor was grade 1, stage 1, I had very wide margins, and did rads.
So I decided I was done.
When I went off tamoxifen, my bones rapidly degenerated into osteoporosis, so my endocrinologist referred me to a surgeon, and I had my hyperparathyroidism corrected.

I am now 7 years out, and I am fine.

peggy_j

ICanDoThis, thanks for sharing your experience. I finally dragged myself to see my endocrinologist yesterday (am I the only one sick of doctor's appointments?) Anyway, thanks you to I asked that when I stop tamox will I see bone loss then and he said yes, but we can discuss what to do then. I didn't "drill down" to ask how rapid the bone loss will be etc (largely because we can't predict and...can't do anything about that now). But the good news for me is that he confirmed I read the DEXA scan results correctly. My bones are stable and even *improving* significantly on tamoxifen, now that I am post-meno. (yay!) He also said that SERMs may not show dramatic improvements in bone density but that the bone quality is considered very good. Currently we have tools that measure bone density but not bone quality so their opinion is based on results--fewer fractures. (he's an academic doctor, so he's tied into all the research). So it looks like for people who can take them, SERMs can be very good at improving bone health.

FWIW, he reminded me that Fish Oil also acts as a bit of a blood thinner so between that and my daily baby aspirin, I have two things helping to mitigate the risk of blood clots due to tamox.