Hoping Eileen is around to help me with this question. I am not taking AA. I have a new GP who is making a fuss because of this. Now, she said that you have to take AA with the calcium and VitD for them to be effective. Is there any truth in this? I felt she was grasping at straws trying to convince me that Alendronic Acid is essential!
My rheumy did the same, I refused, but he took it well and left me to it. He also tried me on MTX and Planquinel (spelling?). Both made me dizzy and sick!
They all try to get you off pred asap, if not sooner!!!
Stick to your guns! It's your body.
Thank you Constance. Did you have a dexascan and if so what were your T Scores?
Dear Sheilamac,
Dexa Scan results and your health history should be your physician's barometer for suggesting you take Allendronate.
At age 50, I had my first baseline Dexa, and began taking calcium supplements with Vit D. My subsequent Dexa at 59 showed osteopenia so I "upped" my Vit D and
Calcium. A Dexa at age 63 showed worsening of the osteopenia. My rheumatologist
requested another Dexa 2.5 years ago upon diagnosing my PMR and the osteopenia
had considerably increased, inching very close to osteoporosis. He strongly
suggested Allendronate orally 70 mg once weekly. He felt that my body was just not
utilizing the calcium and Vit D I was ingesting. I took it for 2 years before having side
affects (burning in my stomach) and stopped it 6 months ago. All the while, I was on
prednisone starting at 20mg, then restarting at 15 mg after a bad flair. All in all the prednisone controlled my PMR quite well.
After I stopped the Allendronat six months ago, a repeat Dexa showed my osteopenia had actually DROPPED to at or below the one taken 8 years ago when I was 59! I am now at 2 mg of Pred. using the DSNS method, which my Rheumatologist was not familiar with but agreed to let me do it. We will revisit my situation in a few months to see if I can successfully get off the Pred. and he and I are both pleased that the Allendronate did protect my bones.
I hope my experience might encourage you but, of course, we're all different, a fact some doctors ( not the good ones, ) have trouble with.
When I had a hip replacement nearly four years ago the surgeon said I had "amazing bone density for your age" which was then 81 )
I was nearing the end of 5 years on Pred. and had previously, eight years before, been on it for three years so you can see I've had as much as most and probably more than many.
Apart from the six weeks on AA that it took my body to revolt I had just taken the Calceos prescribed by my GP.
If you need and bio-phosonate, there are others. The National Osterosporosis site has loads of info.
What is it with medics, that they are hell-bent on dishing out stuff, which are what I call - just in case.............
Yes, if you actually need it.........no if you do not and there are other alternatives.
I also was given Calcium and Vit D. Without any checks being made.
I ran into trouble with pseudo gout, caused by excess calcium - did not need it.
I then ran into trouble with Vit D deficiency, I had never been tested, the units I was given did zilch to rectify the matter.
Also did she tell you...........pred for breakfast and calcium for lunch, as if you take them together, they don't work.....................
No - what a silly woman! You need calcium and vit D at the right levels for the AA to be effective. You shouldn't take pred and calcium together and you should take the calcium/vit D as 2 separate doses - you body struggles to absorb more than about 500mg calcium at a time.
The rheumatology guidelines say that you need a dexacsacan with in the first few months of pred - and if that is in normal range you take calcium and vit D and have a rescan 2 years later. If the first shows osteopenia that is bordering on osteoporosis then MAYBE you need AA (or something, they are almost all bisphosphonates) but Anhaga will give you the lowdown on how to improve bone density without them. The guidelines differentiate between over and under 65, assuming that all over 65s are heading for osteoporosis. However - both Betty and lodger had good bone density at over 70. If your bone density is good and you take AA you run the risk of developing VERY hard bones - which can also cause problems.
I have been on pred for nearly 8 years. After well over 7 years my bone density has barely changed - I have only been on calcium and vit D the entire time.
Yet another "Where DO they get the idea from?" moment. There's been a few in the last few days!!!
I forgot to ask you in my other reply.
Are you a member of PMRGCA Scotland?
Dexascan hips -3.5, spine "normal range". I take vitamins d and k2.
Which IS hip reading even I would discuss with a specialist about taking something.
As others have said, it's the AA which needs the calcium and D, not the other way around! If you have not had what they call fragility fractures, which I think are a game changer, I really believe you can get by and improve your t-score without OP meds. If you feel after due research and consideration that you would like to try the meds route, please consider committing to only two years maximum of treatment. It's becoming more and more apparent that the longer one takes these meds, the more the risk of side effects increases, and the less benefit one sees from the drugs. Whatever you decide, follow the advice Eileen gives about how to take the calcium whilst on pred, and also add several other supplements, notably Vitamin K2 (and maybe a lttle extra magnesium to balance your extra calcium). K2 and magnesium guide calcium into the bones where it belongs, rather than having it settle into organs or onto blood vessel walls where it can cause damage and cardiac issues. The usual advice about good, balanced diet, with lots of leafy greens, and appropriate weightbearing exercise. Just a reminder I went with the natural route and despite being on pred have improved my t-score, within one year, from -2 to -1.6, and they are no longer recommending drugs. I know you are starting with a worse result than I did, but if you are otherwise running no risks other than the pred I'd tend to opt for the non-drug regimen. The only side effect I've experienced from not taking the drugs is overall better health - and an inability to put on weight because of my extra exercise! 
It's so trying isn't it! So basically, she had it the wrong way round. You need the VitD and Calcium to enable the AA to work properly NOT the reverse! I didn't say anything to her at the time because I had already corrected her on not having to come off Prednisolone when taking the synacthen test... I got around it by saying she had to know about loads of conditions and their treatment and I only have to know about PMR. I got away with it but you know how it is... I didn't feel I could contradict her about AA...
I do realise that with a lumbar spine T Score of -3.5, they are going to push me to take Alendronic Acid however, when the results came in late 2014, I took it for about 9 months and then took fright worrying about the side effects I stopped it. Don't know how much that will have done. She is sending me for my repeat Dexascan soon. That will be interesting. I meant to do all sorts of natural things to improve my bone density but I haven't been as good as Ishould have been!
Going to start taking K2 and Magnesium and get my Nordic poles out of the cupboard.... I just hope the horse hasn't bolted!... I know I can stick to my guns re AA but I just hate the stress of arguing with these 'experts'.
I will take advice from Anhaga.
as ever,nthank you so much Eileen x
yes, I am. I used to go to the Support Group in Dundee which was great but then I didn't always have transport and so it fell by the wayside.
OMG Anhaga, I love you!
just what I needed to hear! I am going your route. Thank you so much!
Sheilamac, I'll private message you my essay on my osteoporosis journey.
I like the "even I". 😀 Didn't quite understand the beginning of the sentence though!
Which is a hip reading... is what it should have been. Oh for an edit button!!!!!
Does everyone that has had an insufficiency fracture have to take alendronic acid?
Nobody has to take AA. I just wouldn't dare to advise people one way or another on the matter as I have no medical training. In fact one of my risk factors was a broken leg in 2014, but at the time no one suggested it was anything other than an unlucky break from twisting my leg severely when attempting to navigate a narrow icy path - I never actually fell, so the fracture was caused by the way my leg bent in the wrong direction, and I was told it was a good thing the bone snapped, rather than ligaments and tendons being torn off. The bone was not displaced, and no one said anything about osteoporosis or having a bone scan, although at the time I was well past what I have since learned is the age we all, male and female, in our jurisdiction are recommmended to have a scan. Nevertheless those who decide these things added the fracture to my pred and the DXA scan result to come up with my future fracture risk. My personal opinion is that instead of doling out bisphosphonates as a preventative measure the first line of treatment should be a serious effort to improve bone health through natural means. This should actually be the attitude taken towards a lot of our ailments, I think - not injuries or infectious diseases, of course, but things which we know we can influence, like type 2 diabetes for example.
I'm pleased the AA worked for you, and I think your experience has inadvertently shown that two years was sufficient to improve your bone density to what is most likely your normal level. 