Osteopenia

[C40_guy]

For the older riders and/or medical experts in the room...

If you saw this in a diagnosis, what preventive measures would you take...

Osteopenia of the lumbar spine and left hip.
Ten-year WHO fracture risk of 13% for major osteoporotic fracture and 3.2% for hip fracture

Male subject in their 60s, currently active, a pescatarian, on long term low dose (5mg) prednisone (unavoidable)...

[deluz]

I think pretty much anybody older than a certain age has it.
There are drugs you can take, talk to your doctor. I am not an expert.
I think men do not get tested that often because doctors think its mostly a women's disease due to menopause.

[vav]

Weight bearing exercises

[thwart]

With the low-dose steroid risk factor, you are likely to wind up on medical therapy.
Some docs don’t like to pull the trigger until the actual ‘osteoporosis’ threshold has been reached on bone densitometry, which may be unwise for some folks. Especially those who cycle around corners at speed, sometimes on loose surfaces…

Obviously, talk with your doc/rheumatologist.

[C40_guy]

@thwart

That's something to consider...with the increased risk of an active lifestyle, getting off prednisone is worth trying. Cut it once by 50%, liver didn't like that and ALT/AST numbers started to rise.

I think another conversation with the liver specialists is in order... Maybe another approach to managing the ALT/AST levels...

[deluz]

Do you take statins?
That causes liver enzymes to rise.

[C40_guy]

Originally Posted by deluz

Do you take statins?
That causes liver enzymes to rise.

Nope. Can't take them. Liver is the reason for the steroids, which is driving the inquiry regarding osteopenia...

[OtayBW]

Osteopenia - I originally tried to infer the meaning on this, but I got a mixed message....

[rockdude]

Loss of bone density is a part of aging but here is an article that gives insight on how a new diagnoses is driven by profits in the medical industry.

https://www.npr.org/2009/12/21/12160...e-prescription

[verbs4us]

Been living with osteopenia for years and recently (age 67) tripped into osteoporosis territory. The former is due to long-term Synthroid, required due to thyroidectomy from cancer (suppressive dose L-thyroxine known to waste calcium). This is what I have learned so far:Calcium citrate is apparently better absorbed than carbonate (tums).Like others said, weight-bearing exercise is key. Swimming and biking are not weight-bearing.Some people just don't absorb and metabolize Ca well. As one of them, have been on calcitriol for year with no side effects. It is a vitamin D precursor and enhances Ca absorption.Your doc may order a 24-hour urine capture to measure calcium excretion.Unclear if cycling accelerates bone density lose. Some early papers note a correlation between hours in saddle and bone density, perhaps compromised by sweating. I think the jury is still out. Anyone know?

[dgauthier]

If I got that diagnosis I would remember that cycling does nothing to increase bone density, and large volumes of cycling may even *decrease* bone density. So osteopenia goes with the territory.

Osteopenia is a just warning sign. I wouldn't take drugs to treat it, I would change my activities and have my doctor monitor it. Lift weights and/or run if you don't already. Here's a good list of the activities you can do to increase bone mass:

https://www.trainingpeaks.com/blog/w...are%20inactive.

[C40_guy]

Originally Posted by dgauthier

If I got that diagnosis I would remember that cycling does nothing to increase bone density, and large volumes of cycling may even *decrease* bone density. So osteopenia goes with the territory.

Lift weights and/or run if you don't already. Here's a good list of the activities you can do to increase bone mass:

https://www.trainingpeaks.com/blog/w...are%20inactive.

Thanks, very useful. Here's one excerpt that caught my eye:

Mountain bikers, however, were found to have higher bone mineral density than road cyclists. One reason given for this was the vibrations endured off-road. Depending on the level of mountain biking, the increased short durations of high force to get over obstacles may also help.

So...gravel riding is actually good (or at least less bad) for maintaining bone density. Makes sense...

[Flinch]

Originally Posted by verbs4us

Been living with osteopenia for years and recently (age 67) tripped into osteoporosis territory. The former is due to long-term Synthroid, required due to thyroidectomy from cancer (suppressive dose L-thyroxine known to waste calcium). This is what I have learned so far:Calcium citrate is apparently better absorbed than carbonate (tums).Like others said, weight-bearing exercise is key. Swimming and biking are not weight-bearing.Some people just don't absorb and metabolize Ca well. As one of them, have been on calcitriol for year with no side effects. It is a vitamin D precursor and enhances Ca absorption.Your doc may order a 24-hour urine capture to measure calcium excretion.Unclear if cycling accelerates bone density lose. Some early papers note a correlation between hours in saddle and bone density, perhaps compromised by sweating. I think the jury is still out. Anyone know?

What he sez... +

Vitamin D + Calcium is essential. BUT, the OP really needs to consult with a doctor. Internet medical advice is worth what you pay for it. You may need a drug to slow/stop bone loss, such as Alendronate (Fosamax™, Fosamax™ Plus D) - NOT medical advice, just something to ask your doc.

Weight bearing exercise is also essential. Especially important are the lower back, hip, and arm bones/joints.

I speakuth from experience with a family member who has density issues.

[C40_guy]

Originally Posted by Flinch

...the OP really needs to consult with a doctor.

OP is consulting with doctor(s). PCP and specialists. Going to take a more aggressive approach WRT exercise - more running and lifting. Already doing much that's recommended WRT diet and calcium supplements.

Would prefer not to get into *more* meds, plus I thought I saw some conflicting results regarding bone brittleness...

Not sure that something else can be subbed in for the low dosage prednisone...that will be explored with specialists shortly.

It's a journey.

[C40_guy]

Just had a follow up with one of my specialists who suggested that I will probably be on low dose prednisone forever. Oh well.

They also suggested that I consult with an endocrinologist to discuss steps beyond exercise and supplements to slow the bone density loss.

So...I'm looking for a recommendation on a good endocrinologist in the Boston area. I've done some searching and haven't found an obvious choice in the area.

Thanks!