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Q: At beginning bone loss and begin regimen of Calcium/D, why do you need to take Actonel until you see if the Calcium/D is not enough?
Hi Diane, welcome... If you don't want to take this treatment, you need to tell your Dr. and see why he or she thinks this is necessary for someone with osteopenia. Usually these drugs are reserved for those with osteoporosis or someone who's at high-risk for fracture. If that doesn't describe your situation then I would have a conversation with the Dr.
Also, we have to decide what's best for ourselves, with the help of your Dr. If you really don't want to take this you need to speak up. Here's an article from the National Institute of Health that explains who should take these meds. The above article is actually on the recent bisphosphonate warnings (Fosamax, Actonel, Boniva and Reclast) but in paragraph 13 it explains who should take these drugs and why. Read it and see what you think.
I would also have your vitamin D and calcium levels check to see if you are getting enough of both supplements. Most of us are D deficient, so have that checked.
Good luck...
My physician ordered Calcium/D 2 years ago at exam time due to age 56 as a general regimen (bone density x-ray was okay) but I did not follow through with supplement. (I did not have a bone density test last year). This year's bone density x-ray revealed t-score -1.0 thus immediately began Calcium/D approximately one month ago. Dr's nurse called last week for a 2nd x-ray due to possible spinal compression fracture in the 1st x-ray and suggested Actonel on the phone (not an office visit) in which I'm curious why ordered before Dr. reviewed 2nd x-ray for the fracture?
At this year's exam, Dr. stated the -1.0 could be reversed. (I have to admit, reason I did not take Calcium initially is my mother is 90 years old, and apparently has good bone health, she fell a few times between ages 85-90 and has never suffered a fracture. I know people are different, but I counted on family history for my bone health also. My maternal grandmother lived to age 90.) Thanks for information. Diane
Hi Diane, thanks for the clarification. I do see why the doctor/nurse suggested the Actonel-due to the previous fracture-but your t-score is still great! You are on the cusp of normal bone density and osteopenia (thinning bone stage before osteoporosis). Hopefully your family genetics will help you to remain fracture free, but you and all of us still need to take calcium and D; do weight-bearing exercise for many other health reasons including our bones.
If you still don't want to take this prescribed med, you need to sit down and discuss this with your Dr. He/she may be most worried about the previous fracture and so mentioned the Actonel, but frankly, and this is just my opinion, your scores are really good. If you hadn't had a fracture, I don't believe you'd need to consider taking an osteo med at this time. But you must confirm this with your Dr. since he/she is the only one who has your full medical history.
See what you can find out when you talk to your Dr. and then make a decision that you can live with. Consider the Drs opinion and voice your's as well. See if this approach doesn't turn into a treatment course you are both happy with, by comparing the risk versus the benefits "for you."
Good luck...
I certainly agree about the Calcium/D, I should have been taking it all along for complete body health and I will continue 1200/400 dosage, but I still question the Actonel. Actually, the GYN's nurse called again to tell me I do not have a compression fracture, but, Dr. still orders Actonel for the -1.6 score on 2nd x-ray--up from the -1.0.
I did discuss with my trusted PCP who agrees with the Calcium/D regimen for now and when time, take a bone density for any improvement, or if not, move to Actonel etc. and continue with my walking exercise; am now considering the 'Curves' exercise program. (PCP thinks bone loss is serious at -3.0 thus appears there is some leeway here). Thanks so much for your comments, you are very knowledgable.
I'm grateful for advice from all, I value doctors' recommendations, and with the Grace of God, will make the best informed decision. Appreciative,
Diane
Hi Diane, my pleasure... See how you do with your supplement/exercise routine and then you can re-evaluate the treatment later, or when you get your next dxa. Curves is a great idea! Glad you don't have a fracture. It's good to keep seeing both the pcp and ortho. If you haven't had your vitamin D levels checked, you may want to do that since the new RDA on D3 is 1,000 IUs a day and 1,200 mgs of calcium total from all sources; food and supplement added together.
World Health Org.'s Definition of T-scores (See paragraph on Understanding Bone Density Test Results) from the National Osteoporosis Foundation:
Normal Bone: Any score at or above -1.0
Osteopenia: Any score between -1.0 and -2.5
Osteoporosis: Any score at or below -2.5
You can also find this information at the bottom of your DXA report.
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Hi Diane, I forgot to ask what your t-scores are? When you say the beginning stage of bone loss, do you mean a score between -1.0 and -2.5 (osteopenia)? If so, then I agree you need to discuss this with your Dr. If your score is below -2.5 (osteoporosis) then you still need to discuss this, but your Dr.'s reasoning may be different. Of course, only you and your Dr. can decide what to do; just be sure it's something you agree with, and think will help.
Good luck...