Bone loss while on anastrozole

Sophiee

Has anyone not taken anything for bone loss while on anastrozole and not had bone loss

flannelette2

Me. I took arimidex from 2009-14. I had a bone density scan in 2008 when dx. Normal. Then had the usual side effects on arimidex - super stiffness, hair thinned, carpal tunnel, somehow they forgot to give me another bone density test part way through the 5 years.

Had one a few months ago. I'm 69. Still normal bone density. For a while I probably took some calcium supplements, but stopped for some reason, I forget why I no longer bothered. I have always eaten lots of cheese, some yogurt, milk in my tea but very few glasses of milk.

ruthbru

Me. I took extra calcium plus vitamin D, did weight bearing exercises like crazy, had two servings of dairy every day, and a serving of dried plums (prunes), which actually build bones, every day, AND was lucky.

Sophiee

Good for you zucchini and ruthbru! Thats awesome! They want me to get Reclast injections to prevent bone loss but I really don't want to because of the side effects. I am also on Aciphex for acid reflux which also causes bone loss so I probably should go on it. I take liquid calcium with D. My bone density t score is 1.1 right now 1 is normal. What did you do for weight bearing exercises ruthbru? I have to get some prunes!

ruthbru

I walk, I go to Zumba twice a week and another exercise class the other two days, lift light weights a couple times a week, and do yoga a couple times a week. Swimming & biking are good for cardio but don't build the bones because you have to pound them a little. If you want some exercise buddies; check out the Let's Post Our Daily Exercise thread on the Fitness Forum. A great group of fun, encouraging ladies in all stages of treatment & beyond. I wasn't offered, and would have been reluctant to take another drug unless I needed it. One thing I asked for, and my doctor agreed to order, was a yearly DEXA scan (instead of every two years). I figured that way, if my bones started to go, I would be one top of things & could have started the bone building medications before things got too bad.

ChiSandy

Sophlee, I am osteopenic partly because I must take Dexilant, which is a PPI, for severe GERD—and one of the side effects of its desired effect of reducing stomach acid secretion is impaired absorption of the cheapest form of calcium: calcium carbonate, aka TUMS, Viactiv Chews, Caltrate, OsCal, Citracal Pearls. So my MO had me switch to calcium citrate, which can be absorbed far more readily in patients taking PPIs and H2 blockers. The downside is that it's a bit pricier, the pills are bigger (even the “petites," two of which need to be taken three times a day to deliver the recommended 1200 mg. of calcium), and you have to take more of them. But I found that one Citracal Ultra twice a day (large but coated and easier to swallow) delivers 1300 mg. of calcium plus D3. (I supplement with a 2000 IU D3, K2, and magnesium as well). Just remember that if you're taking iron or eating iron-rich foods, take the cal citrate more than an hour before or after—calcium interferes with iron absorption. (And if you're eating creamed spinach or a spinach quiche, know that you are getting little-to-nothing but fat from the former and maybe some protein and carbs from the latter—leave the crust if you don't want the carbs).

You are wise to be hesitant about Reclast/Zometa (BTW, they are not “injections," but intravenous infusions—they take longer to administer and if your veins are difficult, just getting the I.V. started can be an ordeal—especially with both arms at risk for lymphedema). The side effects are considerable, they can cause paradoxical fractures (i.e., the kind they're supposed to protect against) without any trauma to trigger them, carry a higher risk of jaw osteonecrosis (ONJ), protect (if at all) only against vertebral fractures—not against those of weightbearing bones—and are inferior to Prolia when it comes to preventing, delaying, or slowing mets. Yes, it's cheaper than Prolia (which not all insurers will cover because it's five grand per shot), but Prolia can be given in your thigh or buttocks if you can't use your arms for injections.

I had an awful time with Zometa, which my PCP advised I refuse (for the reasons stated above) but my MO insisted I get because my Medicare part B supplement wouldn't cover Prolia (because it's not a “treatment" but a “drug") and neither would my Part D carrier (too expensive, and Zometa is “good enough"). It took 5 tries to find a usable vein (despite using the Accu-Vein lamp) and then I got severe flu-like symptoms for several days. My MO didn't do a good enough job (IMHO) in her request to Humana for “prior authorization" which Humana denied. My PCP is going to bat for me this time, citing written records of my I.V. difficulties and severe side effects from Zometa. He still would rather I just do the aforementioned supplements and increase my weightbearing exercise.

You’d think annual DexaScans would make sense, since they’d monitor what AIs are doing to your bones. (Mine was a baseline, taken just before my rads sim and two months before starting hormone therapy—and it nonetheless showed I’m already osteopenic). But most insurance companies (including Medicare supplements or Advantage plans) will pay no oftener than every 2 years.

You may, like Grazy here on BCO and another woman in my support group, sail through Zometa. But Prolia is less risky and works better.

Sophiee

• Thank you for your responses. They are truly helpful. ruthbru you sure do a lot of exercise! I'm trying to get motivated but am having a hard time! I will check out that thread you mentioned. I had a bone density test a year ago and my score was 1.4. that was before the anastrozole. Now that I am on anastrozole they want me to have Prolix injections, I said I wanted to wait till I had another bone density test. Well I had it about a month ago and it improved to 1.1. They then said Reclast to prevent bone loss because of the improvement, almost normal. I think I'll wait a year and have another bone density test and see what happens. I'm not going to take anything right now. My insurance said I can have one every year they also approved the Prolix injections. I take the liquid calcium citrate, the liquid is absorbed by the body better so they say. I know I have to exercise more. I read that jumping up and down is good for the bones so I do that 50 times a few times a day.

Blinkie

ChiSandy -

What a wealth of information you share with us. Thank you so much.

Claire_in_Seattle

Sophiee.... I still have normal bone density post 5 years of AIs. Like Ruth, I exercised like crazy. One thing I did was add running into the mix to pound those bones into staying strong. I also do endurance cycling to stay fit. I do x-country skiing in the winter, hiking, and just plain walking. I lift free weights and do crunches on an exercise ball each week day (boring, but effective). I had a minimal amount of bone loss, years 3-5 (not statistically significant).

As for anything else special, only calcium and vitamin D supplements. As an editorial, all these are things we need to do anyway. This to keep our hearts/lungs strong, maintain flexibility, keep our bones strong, preserve balance, and preserve muscle mass - all important as we get older. I like being sculpted, and I like being able to rock a leather mini skirt.

Skiing and cycling require expensive gear, but everything else is dirt cheap and stuff you can do alone. I loathe gyms, and don't do formal exercise classes. I love being outdoors and exploring the countryside on my bicycle or skis. Which brings me to the bigger point: make sure that whatever you do is something you love!!!! - Claire