32 with Osteoporosis

[TXGal]

So as many of you may know, long term use of anticoagulants such as Coumadin/Warfarin can lead to osteoporosis. I broke my wrist a couple of years ago at home in my living room and asked my physician to run a bone density exam to see if Coumadin has effected my bone density.. the results were yes, I have osteopenia, but with an actual break, he said that means I have osteoperosis. I'm taking 1200 mg of Os-cal plus D.

My question is.. has anyone else been tested and told they have osteoperosis? What have you taken or done to prevent further damage? Has anyone tried Fosomax? He said there are many medications I could take, but they effect either my Coumadin or Lanoxin.. He suggested at some point taking a daily injection of (I can't remember the drug!) for 2 years which can actually reverse bone density, but that it interferes with my Lanoxin.. so we may check with my cardiologist to see if I can get off of Lanoxin for a little while.. but these injections he said have many side effects.. Any input from anyone would be greatly appreciated!

 

[markp66]

Hey Kristen

Sorry to hear about that. I know that good exercise, vitamin d and calcium along with low alcohol intake, not smoking all prevent osteoporosis for people who don't take warfarin. Vitamin k plays a role by binding calcium to bones. Warfarin obviously inhibits vitamin k therefore resulting in weaker bones. I've heard before that osteoporosis is a complication although from what I know it's relatively rare. Pradaxa, a potential future anticoagulant does not effect vitamin k levels so this would eliminate any risks of osteoporosis. I'm sure there will be people who will be able to give you much more useful advice. Good luck with your progress.

 

[TXGal]

Hi Mark,

It's interesting you brought up Pradaxa.. my cardiologist mentioned it a couple of months ago.. that would be wonderful if an anticoagulant would be approved that didn't affect vitamin k levels.. we can only pray something better will come along!

Yes, after my results you can bet I'm going to swallow those horse pills every day.. as much as I hate huge pills, I have to stay on top of this.. He also mentioned to take the calcium/vitamin d at a different time as the coumadin so it's absorbed sufficiently.

 

[Jkm7]

Zometa or Reclast are IV drugs administered once a year for treatment of osteoporosis........ however, there is some history of them causing a-fb.

Perhaps you could speak with your doctors about that?

 

[MS2]

edit...sorry, im correcting myself for my original post.

I was trying to think what drug you had forgotten the doctor mentioned that you injected daily for two years. I do not know the brand names of the drugs, but I know that one form of treatment is injecting parathyroid hormone daily for 2 years (and 2 years only!)...or there are oral/injection methods of administering bisphosphonates (some generic names are Alendronate, Risedronate, Ibandronate and Zoledronic Acid) which have shown to reverse bone loss (increase bone density). Just trying to see if this helps you remember what the doctor may have suggested. I was wondering why he suggested injection over oral, but I suppose that injection would not interfere so much with your coumadin?

 

[catwoman]

Kristen:

I have osteoporosis and osteopenia. I have taken 3 different Rxes (oral) for osteoporosis. They never affected my INR. I liked the monthly pill best, but then my insurance no longer covered it -- had to go back to weekly, so I got the generic Fosamax.
My PCP told me -- and I've seen articles about this -- that you don't have to stay on these Rxes forever, that after several years, the benefit has built up and you can discontinue the Rx. So, I am off Fosamax for the forseeable future.

Not sure how insurance handles the yearly infusions. Insurance companies will probably want you to try the pills first.
My dad has had osteoporosis for years -- always been very thin -- and he had to give himself injections for a year or two. That built up enough of the drug in his body that he didn't have to take any more.

 

[Adrienne]

Hi TXGal. I just want to mention first that for the calcium supplement to be absorbed fully, you should take it during meals.

I also want to say that I took Actonel for about 3½ years because I have osteopenia of the spine. It improved significantly after a couple of years and then basically stayed steady.

I read somewhere that nitroglycerine (that is given to people with angina) has been found to be good in treating osteoporisis!! You could ask your doctor.

 

[TXGal]

Jkm7 - thanks for the suggestions.. i'll look into those
MS2 - actually I'm starting to think he didn't give me the name of the injections.. first he pulled out some information on Fosamax and Forteo and reviewed with me the interactions with coumadin/lanoxin.. then I believe he started speaking of injections I could take for 2 years, but he may not have actually said the name to me.. because the names you mentioned don't sound familiar.. I may email him and ask the name, I'll definitely report back what he says!
Marsha - good to know.. I really don't want to add another medication that I take forever, so it would be nice if I could start something soon and eventually taper off.. Do you have any side effects with Fosamax? You are awesome Marsha, you always have the greatest advice :thumbup:
Adrienne - thanks, yes he did say to take the Calcium with meals, thanks for mentioning that! hmmm, interesting.. I'll have to look into those 2 as well. Thanks for the tips.. looks like there are several options I need to look into!

 

[Bina]

Kristen, sorry to hear that you have osteo. Many women are plagued with this problem but not usually
at such a young age.

At a routine physical 2 years ago, at age 50, my doc sent me for a Bone Mineral Density Scan,
and it showed quite advanced osteoporosis. He put me on Calcium/D3 supplements, and a bone replacement med
called Actonel. If you do a search here on VR you will find the thread that I started regarding it.
Well, I took the Actonel for 16 months and this summer I decided to take a break from it because I was getting
some headaches on the day that I took the pill each week.
Last week I had another BMD scan and am waiting for the results but I'm sure that I will be back on the Actonel.
Doc said that it is a 5 year plan with that med.

Oh, by the way, there is a really good calcium supp that is available in chewable form, I buy the little chocolate
squares and eat it after a meal and not with any other meds.

Regarding warfarin and osteo, I'm not convinced that it had a huge part in my getting osteo. My Mom had bad osteo
at middle age due to menopause and taking prednisone for kidney transplant and never took warfarin at all.
We are both small boned but no other similar medical history.

 

[Paleowoman]

Hi Kristen,

I'm not in the same situation as you as I don't have a mechanical valve but when I do get my replacement I will opt for tissue so I don't take warfarin (coumadin) - one reason being the osteoporosis risk with warfarin. I already have osteoporosis, diagnosed on DEXA when I was 53 but I would have had it for many years before. I live in the UK and am prescribed Strontium Ranelate which isn't available in the US except in supplemental form as Strontium citrate. I'm not sure if you can take that when you are premenopausal, it's something you might like to look into. As well as Strontium I'm prescribed a high dose of vitamin D3, 1,500 IU per day in summer, 3,000 IU per day in the winter and my levels of 25(OH)D are checked regularly, currently in the optimum range of 60 ng/mL (150 mol/L). I cannot tolerate calcium supplements so my consultant told me that I could get all the calcium I need from my diet, that's despite the fact I am dairy free - calcium rich foods I eat are sardines with bones, almonds, sesame and leafy green veggies. I have an alkaline loaded diet to stop calcium leaching from my bones, that's something you might like to look into too. I also take vitamin K2 - you would have to advise your doctor if you were going to add K2 because it can affect warfarin. In addition to this I do weight bearing exercise, a specific weight lifting technique, originally devised for osteoporosis called SuperSlow, twice a week, I walk several miles per day and I do gentle exercise on a vibration platform twice a week. I've not fractured anything...don't intend too

all the best,
Anne

 

[Duffey]

http://www.fda.gov/Drugs/DrugSafety/ucm263320.htm

I think I've seen a release this past week where they are recommending no one take these drugs for more than 3 years duration.

 

[Paleowoman]

http://www.fda.gov/Drugs/DrugSafety/ucm263320.htm

I think I've seen a release this past week where they are recommending no one take these drugs for more than 3 years duration.

One reason I'm glad I can get Strontium Ranelate prescribed as it is not a bisphosphonate like the ones in that drug review and is proving safe for long term use. Lots of other reasons I wouldn't take Fosamax or any of the other bisphosphonates - they have bad side effects such as oesophageal problems, osteonecrosis of the jaw, as well as hardening of bones which leads to atypical fractures, they don't build bone, they just stop bone resorption as well as stopping new bone formation. Couple of good websites for peeps in the US: http://www.betterbones.com/ and http://courses.washington.edu/bonephys/ophome.html

Anne

 

[sarahsunshine]

I’m surprised that no one has mentioned magnesium. For calcium and vitamin D to absorbed properly, you need to have suffuent magnesium in your body, and something astounding like 80% of the north American population is low in magnesium. Magnesium supplements are easy. We have one in the form of a powder that tastes like lemonade. I don’t mind it a bit. Magnesium is also a supplement that my stepson’s cardio recommends for heart patients. Also, my stepson has annual bone density exams because he’s been on warfarin since he was 5 months old. So far, his bone density is in the normal range, and he’s 12!

Has anyone discussed supplementing magnesium with the calcium and vitamin D for you?

 

[njean]

My doctors have told me that they do believe that the long-term use of anticoagulants (coumadin, warfarin), does contribute to the loss of bone density.

I was diagnosed with osteopenia and osteoporosis 5 years ago....I've been on coumadin for 36 years.

I take 1000mg of Os-Cal w/Vit D daily and also Boniva once a month. I'm scheduled for a bone density test in November....it's been 2 years since my last one, so I'm eager to compare. The doctor did mention the injections but opted to try the pills first because I was so against getting injections. I might mention that I take magnesium too but it was recommended to help with heart rhythm problems.

Wishing you the very best!

 

[Bina]

You had to go and remind me that I'm not taking my magnesium lately....CRAP...too many sups and pills.

 

[Paleowoman]

I'm not taking my magnesium lately....CRAP

I don't take magnesium supplements for that very reason - CRAP :mad2: There's enough magnesium in the foods I eat, especially green veggies, so when I've added supplemental magnesium it's a hurried visit to the loo :mad2: But if you're not getting enough magnesium in your diet then it's easy and cheap to buy the supplemental stuff...beware magnesium oxide, magnesium citrate is much better on the tummy.

Anne

 

[njean]

You had to go and remind me that I'm not taking my magnesium lately....CRAP...too many sups and pills.

Ha, ha, ha! That's why I have two pill boxes....one for the morning regimen and one for the evening. Total of 15 different pills a day!!!
But whatever keeps me tickin'.......right?!

 

[Bina]

Those magnesium pills are chalky and yukky.....at least I eat a good, salt free, oil free, natural nut and seed mix daily.
Ya know this middle age stuff is alot of work, so I had a nice treat of honey in my yogurt today. YUM.
Aiming for ice cream this weekend before it's too damn cold. Ice cream has calcium right? Keep it on the good list.

 

[catwoman]

Marsha - good to know.. I really don't want to add another medication that I take forever, so it would be nice if I could start something soon and eventually taper off.. Do you have any side effects with Fosamax? You are awesome Marsha, you always have the greatest advice :thumbup:

Kristen:
No, I did not have any side effects from taking Fosamax. I also took Actonel and Boniva. I liked the Boniva, only having to take 1 tablet a month -- not having to jump up to take a tablet one morning a week 30 minutes before eating anything was great. Then my insurance changed and I couldn't get Boniva cheaply, so I went to the generic Fosamax.
The generic Fosamax was $24 for 12 weeks at Walmart, much cheaper than the others.
From what I've read, bone loss actually starts in the early 20s. At age 34, I had a complete hysterectomy due to endometrial hyperplasia and endometriosis. I took progesterone for a year or two, then quit cold turkey. A few years after that, I was DXed with MVP. I don't think the hormones would have been advisable at that point, since there's a connection with clots and HRT use.

 

[TXGal]

Thanks everyone for your wonderful advice & suggestions.. I plan on looking into each & every one of them. Another reason I love this board.. I can always depend on all of you when I'm down and feel like I have a mountain to climb.. thank you!!! :biggrin2: