41 with pre-treatment bone loss

Hi, I am sorry I don't have a solution, just a very similar problem.

I did chemo with ovarian suppression as I am high risk for recurrence, grade 3, very high Ki67. Before starting the AI, my MO sent me for a baseline DEXA scan with no worries whatsoever, because I am very active and eat healthy.

Well, the T-score in my spine showed -2,6 = osteoporosis - bummer!! At 38! But both femoral necks are in the green zone, not even osteopenia.

My bone turnover is fine (from blood + urine). Blood showed low vit. D.

I received vit D3 in two various forms and vit. K2. I was told to get enough calcium in my diet and be very cautious of calcium supplements.

My MO proceeded with starting me on an AI on top of the ovarian supression. This should be more effective to keep my high risk cancer away. I don't really know what happens to my bones!

I have osteoporosis so I’m surprised they didn’t prescribe something like Bonita which is what I take monthly. I have heard taking too many calcium supplements is not a good thing. You can get calcium from food obviously do that helps too.

Osteoporosis is painful. There were a couple of times the pain was unbearable. I have it in my right hip. I took Arimidex the first year I was DX which attacks the bones. I reminded my MO of my condition and she switched me to Tamoxifen. It was after 1 year on the drug so no telling what additional damage I did to my bones. Thanks doc.

I bought a donut pillow to sit on and it helps. I even went to a chiropractor but he thought the severe pain I was having was caused by my sciatic nerve. My internist said it was the osteoporosis but at least I didn’t have any fractures.

It’s much better now but it flares up every now and then.

Diane

OTMom, osteopenia is painful, and so is osteoporosis. This is a case of dr. having no idea what they're talking about, the same as "breast cancer isn't painful" .

I had a similar dx and also had low BMD pre starting Arimidex after chemo, 40 when diagnosed -10;yrs ago.I went into menopause during chemo. Hips in osteoporosis range and spine osteopenia, small frame and low weight most of my life probably contributed to the low BMD. Onc really wanted to try Arimidex with vit D and calcium suppliements, after 1 yr my BMD fell 11% so ceased the AI, no other hormonal treatment recommended due to low BMD, my period returned at the 2yr post chemo mark alwhich helped with BMD also.

I Did Zometa x4 infusions over 2 yrs which really increased my BMD back into low normal range. 2yrly Dexa scans since have shown BMD decline despite doing crossfit 3-4 times a week for 4 yrs, and eating lots of calcium rich foods , vit D has always been ok.

BMD now back into the osteopenia range - just off osteoporosis in hips, spine a bit better but still ostopenia. Happy to be monitored at present but may consider densumab in the future as now back in menopause.

Jaboo, you are right, it's impractical to compare your bone density with that of an average person,since you are petit and slim.

My local doc found osteoporosis a few months after I finished my treatment. He wanted to put me immediately on Evista. I went for a second opinion in one of the places associated with Harvard medical school. The doc there made the comment that is not that straightforward to made a diagnosis of osteoporosis since I did not have a early DEXA to compare with. She said some people may never reach the average maximum bone density, to which Dexa results are normalized.

So she put me on high intensity resistance training, 30 min twice a werk ( one does this with a fitness instructor, or at physical therapy) and asked me to take 1200 of calcium suplement (broken in two doses per day) and vitamin D until my blood work shows values are around 50. She recommended New Chapter brand for calcium supplement.

She said if within one year dexa does not show new bone loss, I will avoid medication. However, if I will still have bone loss despite this regimen, I will need to start meds.

Here is a good comprehensive link from Mayo concerning calcium needs, sources, and dietary vs supplemental calcium. If you are taking Vitamin D supplements you should take them with food that contains fat to help them work better. Also below is a link about when and how to take mineral and vitamin supplements.

I was osteopenic prior to diagnosis of breast cancer. I fit the physical profile, petite Caucasian with low BMI, so I may have developed it anyway, but a total hyst/ooph at 45 had a definite impact. I had a number of DEXA scans after the hyst/ooph, and did try oral bisphosphonates for a bit, but a previous stomach repair surgery made taking them too difficult, and I remained stable anyway. Chemo and six months of Femara did cause marked bone loss - and I had a good pre-treatment baseline as I had a DEXA same day as mammo and US that preceded the breast cancer diagnosis. I started on Prolia in Feb of 2012 and had my last injection in March of 2018. I was an exceptional responder in that after 4 Prolia injections I had normal density. My MO discontinued the Prolia as he wanted a break, a check on density, then resumption if I needed it. I just had a DEXA, almost a year off Prolia, and I have lost zero density - still maintaining normal status.

https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/calcium-supplements/art-20047097

https://www.consumerlab.com/answers/which-vitamins-and-minerals-should-be-taken-together-or-separately/how-to-take-vitamins/

Yes, thank you very much SpecialK!

rah - check out Garden of Life, link below.

https://www.gardenoflife.com/content/product/vitamin-code-raw-calcium/

Oh yes, I forgot to mention the splitting of calcium. The body can only process 500 mg at a time, the rest gets excreted in urine, puts a strain on your kidneys and you might even make some kidney stones. Also, a lot of people don't metabolize calcium well because they lack enough magnesium and zinc, so supplementing those two also is a good idea.

My biggest problem with taking calcium is the size of the darn pills. They're so huge I choke on them. Fortunately I found a couple of years ago that Puritan's Pride has a gelcap version, it's called "Absorbable Calcium" and it's so much easier to take.