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    35 year old female with osteoporosis -3.5 t-score ADVICE PLEASE :)
    35chris posted:
    I really need some advice...
    I was diagnosed with osteoporosis a few months ago after a dexa scan showed my t-score to be -3.5....with a z-score of -3.0. Both hips and my spine. I'm 35 years old, 5' 8" and 105 lbs.
    The whole reason they did a bone density scan was because I fractured a small bone in my foot (3rd metatarsal). This is the only thing I've ever fractured in my life. I don't smoke, don't drink, and get alot of exercise and am a busy mom.
    I have not had my period in about 6 years...and my horomone tests show that I'm not producing estrogen...probably because of low body fat. I've dealt with eating disorders in the past(for a few years) but not for the last 4 or 5 years.
    The first thing they did after my scan was perscribe me actonel...after doing research, I'm completely against taking any of the biosphate drugs. I have not gone through menopause and breast cancer does run in my family so I also do not want to take estrogen. How I am dealing with this so far is doing alot of resistance exercise even though I'm pretty active anyway....and making sure I get the proper nutrition (which I know I was not getting before)....I'm also taking all the right vitamins and minerals everyday including Oscal Ultra, citracal bone building with genestein, exta magnesium, extra vitamin d-3 (I make sure I supplement at least 2,000 d)...and 1200 calcium as well as boron...I also take a multi-vitamin and vitamin K-2 everyday.
    I'm really scarred and don't know what to do...but at my age being and not going through menopause I feel I might do more harm than good by taking these overperscribed bone drugs.
    I'm wondering if starting birth control might help with estrogen production....I just don't know what to do. I also wonder why z-scores don't matter....because according to my z-scores I'm not far off from someone else of my height, age and weight. Any advice about replacing estrogen in my body without really harmful side effects like breast cancer would be very appreciated.
    bonebabe responded:
    First let me clear up something for you. You have gone through menopause. You are postmenopausal. If you've gone one year without a period, you are postmenopausal. That means that your ovaries are not producing estrogen. That combined with your eating disorder depletes calcium from the bones.

    You should be looking at T-scores instead of Z-scores. You definitely need the calcium and Vitamin D. You also need an osteo med. You are waaaaay too young to have to deal with fractures. Because you've had one fracture that alone puts you at double the risk for another. Fractures impact quality of life. With osteoporosis, they heal very slowly and often irregularly.

    Birth control pills will help, but you need more. You can do that and something else. I doubt that your bone density will ever be in the normal range, but you can hold off fracturing.

    I would suggest a couple of things. First I'd go online to the National Osteoporosis Foundation website ( ) and order their booklet "Boning Up on Osteoporosos." It's $6.50 and gives you all kinds of reliable information. We use it in teaching our osteo rehab classes. There's also other info available for patients on the site. Play around with it and get informed - especially their official statements about use of the osteo meds.

    Next, I'd research the meds and with your doctor, choose one. You can't escape it and expect to lead a fracture free life. Diet and exercise help, but with scores that low and one fracture under your belt, only meds will do what you want to happen. My personal suggestion for you, with your absorption complications and hesitancies, would be Reclast. That's the annual IV med. It gets very good results in patients. You could do this and birth control pills.

    I'd also get some instruction on proper body mechanics. The booklet gives you some info, but a physical therapist can assess you individually and really help. There are some definite "no, no's" you should be aware of.

    It's good that you're this young and taking charge. You've a lot of years ahead and you want to be independenet and active.
    Adi Cohen, MD, MHS responded:
    All of the factors that you are considering, including nutrition,
    estrogen, calcium, vitamin D and exercise, are important for bone health. Both nutritional issues and amenorrhea (absence of menstrual periods for several months in a row) may be important causes of osteoporosis and/or bone loss. A knowledgeable doctor will be able to advise you as to what measures you should take to protect your bones, taking into consideration your medical history, family history and other important factors that are unique to you.

    The National Osteoporosis Foundation can also supply you with free information about low bone density in younger women, nutrition, and other topics related to bone health. You can request this information by calling 1-800-223-9994 or visiting and clicking on "Patient Info" and "Request Information."

    tomasrobert12 responded:
    Exactly how Crucial Is Vitamin D for your Health

    D vitamin should be employed in the combination with other minerals and vitamins. Once you use Vitamin D Deficiency along with other supplements its advantages may well improve largely. Also if we take only one vitamin we have chance to create vitamin toxicity whilst creating vitamin insufficiency along with other vitamins. For this reason using multivitamin pill rather than only d vitamin dietary supplements is greater because in that way all of our wants for vitamins are satisfied.
    bonebabe replied to tomasrobert12's response:
    Vitamin D is what sends the calcium to the bones. Without it, you're not getting the maximum absorption you need. Multivitamins, as a rule, do not have the daily recommended dose of Vit D. Very few foods have it naturally and people over age 50 and/or don't live close enough to the equator aren't getting enough from the sun. Best to take a supplement.

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