My osteoporosis tale

Published 8.30.2016
This probably should have been the first entry in the series, but I finished the book review first and so went with that. What follows is a brief description of my personal experience with osteoporosis, which is why the topic interests me. As always, it is important to realize that I am not any sort of medical professional. Absolutely nothing written here should be construed as medical advice.

I was diagnosed with osteoporosis in May 2011. I'd begun going through early menopause in a different state, and neither my general practitioner nor my ob-gyn there thought to order a bone mineral density (BMD) scan at that point. Thus, the first time I had a scan was three years later, when my new doctor (who was extremely dismissive of the level of care I received in my previous home) immediately ordered one during our first meeting. The results came back osteoporosis, and I was prescribed generic alendronate sodium, which is identical to the brand name drug, Fosamax.

As for exercise, my doctor told me to walk 3 hrs a week, with weights on my back if possible. I was already walking 3.5 hrs a week and doing light free weights, so I added a backpack with 10 pounds. I had recently started walking on an incline because I read that was better for building bone. Certainly the first day I inclined the treadmill I felt it more in my hips. The walking with a backpack didn't last long though, because it wasn't comfortable so I never made it a habit.

Six months later, I was back at the doctors for another annual physical exam (the shortened time frame is because it had taken me quite awhile to get around to having the BMD scan done) complaining of gastrointestinal (GI) distress. The cause of the GI distress turned out to be (mostly) lactose intolerance, as
I've discussed previously. The only importance to restating this tidbit is that my dairy consumption declined precipitously after realizing what milk was doing to me. I still eat "hard" cheeses (those aged long enough to minimize the amount of lactose in them), but much less than I had been pre-diagnosis. To me, the risk of the gastro-distress is enough to keep my cheese intake low. I suffered through only a few months of an irritated bowel. I can't imagine how some people deal with it for years.

I've written about my temporarily irritable bowel previously, so I will just briefly note here that all the tests my doctor ordered came back negative (I was also tested for celiac's at this point). Per the test results, lactose should have no effect on my gut— and yet it does. The reason I tried eliminating dairy (and initially it was all dairy) was because my doctor suggested I do so.

Eliminating all or most dairy, of course, alters the source of calcium (Ca) in the diet, so I was told to take Ca supplements that included vitamin D, and I dutifully did so for four years as I continued to take the drug. After four years of "Fosamax" and Ca supplements, plus two more BMD scans, the results were… that my bone density had not changed at all. My spine bone mineral density has improved, but not by a statistically significant amount. In August 2015, I had been referred to a specialist, and I wish I'd gone to one earlier, because unlike the primary care provider, she was open to taking a break from the drugs— though she would not describe their effects as I do. She would say the alendronate kept the disease "stable."

Because I’m small, active, young (relatively) and healthy, the specialist and I agreed that I would go off the drugs for at least a year. She also was fine (if a bit dubious) about my getting Ca from food rather than supplements. She had not read the BMJ series of review articles that found no benefit to Ca supplementation, but so long as I get 1000 mg of Ca a day I can skip the supplement. I revamped my diet to get enough Ca from beans, greens, seeds, nuts and cheese, pretty much in that order.

However, as of my physical on May 5, 2016, my vitamin D blood level decreased by about 50%, so I began to take a 2000 IU dose of D3 each day. There was no change in the Ca measure. At the same time, I decided to start taking a B12 supplement again. I've read that B12 is related to bone health (something I hope to explore in this series to learn more about it), and in order to eat the plants I need to get Ca, I’m eating less meat. The B12 pill is also small and easy to take, so I don't mind taking it.

I have to admit that I very much enjoyed telling people that I was taking NOTHING (no drugs, no supplements) at age 53— a status that seems to be very uncommon. However, that's a just a vanity and not a reason to ignore the doctor's advice. I’m also regularly eating natto for its vitamin K2 content. K2 is supposed to help with Ca shifting— perhaps keeping the Ca in my bones rather than in my arteries. Vitamin K2 will be a future topic.

As I wrote in the previously, this summer I joined a gym, and I’ve been going 5 days a week, I take yoga and pilates classes I’m also lifting 2-3 times a week heavier free weights than I have at home. I can say that while the poses aren’t held for as long as Fishman would want, the practice is much more intense than what I did it at home. And my core is definitely getting a bit stronger, which can’t be bad for my back. I've also gone back to walking uphill on the treadmill for at least 30 minutes a day, though still not with weights on my back.

Just today I was reminded of this study that found that daily jumping could increase BMD, albeit in pre-menopausal women.

RESULTS: At 8 weeks, unadjusted percentage change in hip BMD was significantly different among groups (F = 5.4, p = .0236). Specifically, compared with controls, the Jump 20 women had significantly greater gains in hip BMD and the Jump 10 women had marginally greater improvements. Following 16 weeks of jumping, differences between the Jump 10 and the Jump 20 groups compared with controls were significant (F = 4.2, p = .0444), especially after adjusting for the covariates (F = 7.3, p = .0092).

These women “jumped like fleas” per the New Your Times article that jogged my memory. However, this doctor says just jumping up and down 100 times (after working up to it, you don’t start off doing 100 jumps, you do what you can at first) can make a difference. Ultimately you work up to multiple sets of 100 jumps. This is something I can add to my gym time. Rather than just standing around between weight sets, I can jump. I actually like this idea quite a bit, which is always key if it's going to become a habit.

In June, I upped my Vitamin D intake to 4000 IU after realizing that Vitamin D might be more important for bone (and perhaps overall health) than I realized. And although I try to get outside in the sun each day, realistically, supplements are necessary if I’m going to get the level up. That's all I'm going to say about vitamin D at the moment, it will be a future topic.

After upping my intake to 4000 IUs, what I noticed is that my finger nails are much stronger— and others noticed as well. I have never had strong fingernails. I could never grow them very long because they would break. The fact that they do not now is a new data point, and one that suggests to (non-medical practitioner) me that it’s not a bad thing that I upped my vitamin D intake. I won’t have another blood test until October, but it will be interesting to see where my serum levels are at that time.

And that's brief rendition of my osteoporosis saga. I will discuss my Ca focused dietary choices in more detail in future writings. But I wanted to close with what I think is an essential point: Everything I've tried to do (or will try) has been with the goal of complementing or perhaps augmenting the treatment ordered by my doctors. I'm not looking to replace medical science or the specialists who care for me. My quest has introduced me to a lot of interesting data, and that's what I want to share here. Everything here is anecdotal, but it's not intended as some "n=1" experiment. I'm looking for things that won't hinder any treatment but could assist it.


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