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[Sarai]

Stellajane my main anxiety about bisphosphonates is jaw necrosis and though it may be rare it's not as rare as we are led to believe. Dentists will tell you this. And even if one person gets it that's a real person whose life is ruined.
Anyway that's my reason.

[CLKD]

My Dental Surgeon: the one who did my implants very successfully : and who I love, a little bit  - never suggested necrosis. 

[He did however suggest that no-one should have teeth removed and implants fitted on the SAME DAY because the body sees them as foreign bodies and might well reject the whole procedure.  Teeth should be removed and the gums allowed to heal B4 any further procedure, bone density has to be measured ....... ]

See your Dental Surgeon Sarai ?

[Sarai]

Hasty, yes I do a lady of 56 took alendronic acid for 4 years, she had no other drugs whatsoever and has jaw erosion and has to be seem at the hospital. The hospital and dentist blame the AA.

[Sarai]

CLKD do you take bisphosphonates? If not my point is not relevant to your situation and implants.
All dentists must ask patients what medication they have and those on bisphosphonates should be off them at least 3 months before extraction. They are also asked to sign a disclaimer that they won't sue if it does not heal.

[CLKD]

eh..... no, sorry, a bit of a meander 

[Noheroicsplease]

Hi, some interesting views here. I was diagnosed with osteopenia (though on the cusp) when my periods were infrequent but still happening. My mother has osteoporosis and my sister who is two years older than me. When my periods stopped for 11 months, and I sought medical advice, mostly to tackle the sleep issues and low mood, I was advised by two doctors and one leading meno consultant to try HRT for osteopenia, given the impact of early menopause on bones etc. Talk of osteo medications came after that, if HRT wasn't successful.

I use oestrogel pump and have had the mirena coil fitted for minimum, non-systemic progesterone.

It was a huge decision for me too. Despite the meno issues I was having, I wouldn't have started HRT if it hadn't been for the advice re: osteoporosis

At no point did anyone suggest that I turn to osteo medications first.

[Noheroicsplease]

Sorry, only just saw there were two pages of posts.

necrosis is very real - my mother has tooth issues and this was a very serious concern for her, and her dentist, when she started taking meds for osteo.

[Dana]

Just thought I would let you all know that I had my checkup today, after having my last bone density scan, and it's very good news. I have been on Fosamax (Alendronic Acid) for two years and there has been a density increase of 1.1% of the L2 and L4 vertebral bodies and a whopping 7% of the femoral neck. I am still less than what is "normal" for someone my age so it is recommended I continue with the Fosamax for at least the next two years until I have my next scan.

The decrease I experienced at my scan done two years ago was despite being on Estradot 50mcg patch and taking calcium supplements, eating dairy and exercising, so you can't always assume that those "standard" recommendations are going to work for everyone.

Regarding the issues of jaw necrosis etc, I specifically asked her about that and she said it is very rare and it mainly happens when it is injected, not with the once a week medications that most people take. This is exactly what my own research had already told me, so please don't believe the scaremongering that often goes on with some medications. We all know about the HRT scaremongering, which is also highly exaggerated.

Her opinion is that you have a much greater risk of your health being severely impacted by osteoporosis than you do from any side effects of the medication. I have no intentions of ending up like my father with a broken hip, so my choice is to continue with the medication. Everyone needs to make their own choices, but osteoporosis and osteopenia don't come with any symptoms, so it's impossible to know if you have it until you break or fracture something. Don't take that risk because the older you get the less likely you are to bounce back from a fracture.

Obviously medication shouldn't be the first option with osteopenia, but when you already have fractures of the spine, I would suggest you have already bypassed osteopenia, and I think you need something more than just HRT. However, that's just my opinion.

[Hurdity]

Great news that your bones density has increased Dana

I haven't read all of this thread but someone I know sent me this link today to some research just published about bisphosphonates which is relevant to the discussion - haven't had time to read it myself.

http://www3.imperial.ac.uk/newsandeventspggrp/imperialcollege/newssummary/news_28-2-2017-13-6-7

Hurdity x

[CLKD]

Shouldn't you at least read it prior to posting Hurdity?  It might be rubbish.

[Noheroicsplease]

That's great news, Dana.

Maybe I'll explore this at some point. I need another scan in the next few months. Will be interesting to see if all my exercise, food, calcium, and estrogel has made a difference.

But I have borderline osteopenia. Does it make a difference that I don't yet have osteoporosis?

[Hurdity]

Shouldn't you at least read it prior to posting Hurdity?  It might be rubbish.

Ahem CLKD - don't tell me what I should and should not post!!!!!!!!!!! I think I can judge for myself what is rubbish or not. OK - reasons for posting - 1) I glanced at it and seemed it would be interesting 2) research by imperial college not wacky american website  nor anything "whizzy whazzy" 3) I trust the judgement of the person who sent it to me - she wouldn;t send me anything "rubbish".  I saw it was relevant....

OK?"!! 

Hurdity x

[Dana]

That's great news, Dana.

Maybe I'll explore this at some point. I need another scan in the next few months. Will be interesting to see if all my exercise, food, calcium, and estrogel has made a difference.

But I have borderline osteopenia. Does it make a difference that I don't yet have osteoporosis?

I think that if following the recommended precautions are working ie HRT, exercise etc, then that's great, but if it's not doing enough to help, medication is definitely the way to go. The risks of medication are minimal, but the risks of no medication are great.

I feel that it's best to start any necessary treatment while still in the osteopenia stage, if your doctor feels that the decrease in density warrants it. However the treatment standards may vary from country to country.

Here in Australia doctors aren't supposed to prescribe medication unless there has already been a fracture. My GP is very critical of that stance, and she and many other doctors will prescribe anyway if they feel it is necessary. All they have to do is basically tick a box to say the patient has confirmed they have had a fracture.

In my case she technically didn't tell a lie because I cracked a rib about 15 years ago. It probably had nothing to do with my bone density though. I had an extremely bad dose of the flu and the constant coughing fractured a rib. She had already ticked the box before I told her that though...lol

Anyway, the government is helping to address the problem because they have dramatically reduced the cost of the medication. I used to pay about $36 a month, but now I only pay about $8 a month.

[Dana]

The osteo meds aren't for taking indefinitely only for a period of years, but the HRT should continue to be taken.

I asked my GP about that and she said the recommendation used to be 10 years, but it has now been reduced to 5 years. It will be very dependant on age and deterioration though. Someone of my age (58) would probably stay on them for the 5 years and then be monitored with scans and have medication reinstated if necessary.

[Noheroicsplease]

But you are lucky that you can tolerate Alendronic Acid, Dana. My sister and a friend had a terrible time on it, with the side effects, and both doctors I've seen were diplomatic, but clear, that osteo treatments aren't great