Endocrinologist for bone density support?
Hello,
I am wondering how common it is to see an endocrinologist for questions or support with bone density concerns caused by hormone therapy. I was diagnosed last summer at age 36 and I am currently on ovarian suppression and tamoxifen. I know the ovarian suppression puts me at risk for osteoporosis. I just got a bone density scan today, so I don't have those results yet. My medical oncologist wants me to start zometa in August to prevent bone loss even if I don't have any bone loss yet. But, I am wondering if talking to an endocrinologist would make sense to help make the best decision about zometa, since it also has its own side effects and risks. I am wondering if others in a similar situation have found it helpful to talk with an endocrinologist or another specialist.
Comments
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blue_heron, my mom saw a specialist for her osteoporosis, but I’m thinking he was a rheumatologist. I have heard others here see endocrinologists, and almost all medical oncologists are hematologists. I was actually really surprised that orthopedic surgeons have zero interest in osteoporosis as they are who is likely to see a break. When I broke my arm a few years ago, I asked after surgery if he saw any signs of osteoporosis. He really dismissed the question and said to talk to my family doctor.
Since my medical oncologist ordered my DEXA scan and was treating me with anastrozole, I am very happy having her prescribe my Prolia injections. I knew that it and Zometa are actually meds that are used for some types of cancers, so feel confident not getting one more doctor for an issue she can manage. Plus, both of those meds are thought to help prevent bone metastases. I would alter that opinion if I didn’t feel she was treating me aggressively enough or if I questioned how she was treating it based on my reading.
I know that in my mid size city the endocrinologists are covered up treating diabetes. It would take a while to get an appointment, and since my husband has not found one where he is confident in both the doctor and his office manager, I would really prefer not to go down that path. -
Blue_heron, my previous osteoporosis doctor was a rheumatologist. After he retired, I began seeing an endocrinologist in the same practice. She orders my DEXA scans and related bloodwork as well as approves the Zometa infusions from my MO. This team approach has worked quite well for me.
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Blue_heron - I saw an endocrinologist regarding my osteopenia, but only because my calcium levels were consistently high in my bloodwork. I had primary hyperparathyroidism, which was resolved through a simple surgery last year. I'm hoping for an improvement - or at least no further worsening - on my next DEXA scan (TBD).
If high calcium is an issue for you, there are a couple threads about parathyroid on BCO. Parathyroid.com has a lot of very useful information about it, and they are who performed my surgery. If your calcium levels are normal, I would not worry over this possibility.
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What is a dexa scan?
Thanks to Thursday zoom, I asked for a bone density test. Excellent! 3 weeks from now with my other tests.
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KGobby the dexa scan is your bone density scan.
Blue Heron I would suggest an experienced endocrinologist to oversee your bone health simply because you are young so you want to make proper decisions on what medicines to begin with.
In the meantime, make sure you get 1200 mg of calcium per day, along with weight bearing exercise (walking running) Cycling doesn't count.
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Blue Heron- I see an endocrinologist who specializes in bone loss due to AI’s. My oncologist referred me to him once my active treatments ended and I started Arimidex. The endocrinologist took the lead on the bone loss and handles all my bone density tests/ issues and handles my Prolia injections. It’s his specialty/ passion and does tons of research. He also travels the country teaching and lecturing on bone loss due to AI’s. Although his beside manner could use some help and he’s not everyone’s cup of tea, I feel like I’m in good hands with him on my team.
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