Has anyone been diagnosed with osteoporosis after being on prednisone? If so what has the doctor prescribed?
Unfortunately I had osteopenia before starting prednisone and have been on Fosamax weekly for years and Vitamin D monthly.
Thanks Jan. Have you had any issues taking Fosamax and the Prednisone together? Has the Fosamax helped with your bones?
No problems with Fosamax and prednisone to my knowledge and my bones are not getting worse but only had 3 days of prednisone so far so time will tell
I have osteopenia and am on Prolia. It's an injection given twice a year. I improved with the Prolia so my Dr took me off it but when I was diagnosed with PMR my Dr said I had to go back on it. I've been on prednisone 1 yr 4mo and have had no issues.
Funny you should ask that. Well..not really. Just today I had to have a bone density scan. Report says “BMD measured at Femur Total Left is 0.518 g/cm2 with a T-score of -4.0. Patient is considered osteoporotic. With a Z-score of -2.5, patient has very low BMD for their age and sex. Causes of secondary bone loss should be investigated”. I started on 50mg of pred 31.5.17 and stayed on that for 7 weeks due to PMR and GCA. Have managed to reduce to 11mg, inflammation rate down from 53 to 2 so I thought I was going great guns. As this test was only today I have still to see the GP and rheumy to get their take on this. I’m 62 and only 46 kls, (was 49kls pre illness but lost 9 Kls in 5 months pre diagnosis.) I have managed to put on 6 kls but a lot of that is puffiness. I have always been small and have always taken calcium, and bumped it up to the recommended higher dose, plus included vitamin D supplements, plus get out in the sun as often as possible when I started pred. If fact, just came in from a few hours in the pool. Like you I’m interested to hear others reaction or side affects to further medication while taking pred, as this is mentioned on the report ( fosamaz, Actonel, Miacalcin, Evista, and Forteo).
There are unlikely to be problems taking them together - it is standard practice to prescribe alendronic acid (Fosamax) to patients on long term corticosteroids to avoid loss of bone density.
Whether it is a good idea to use them as a preventative/just in case is debatable due to long term issues with bisphosphonates that are just coming to light after being in use for about 15-20 years. I have never taken any and my bone density has barely changed in 7 years on pred just taking calcium and vit D. But monitoring is essential to know your status - some people are already osteopeneic before pred and a dexascan is needed to establish that.
They definitely should not be taken for more than 3 years at a time, 5 years is the absolute maximum.
See my post above - it is good practice to do a dexascan within a short time of starting pred and then standard practice to prescribe one of the bisphosphonates in tandem with the corticosteroids to reduce the risk of loss of bone density. With readings like yours and having been on pred only since May I doubt your very low readings are due entirely to pred. You were at risk anyway with such a low body weight even though you were taking calcium.
I would imagine your doctor will recommend Forteo - it is the only drug that actively builds bone, the others change the turnover to stop bone loss. There are side effects to them all - no drug that doesn't have some - but some people have none. Just like with steroids.
Eileen and others.....thank you for your comments and insight.
I was fine just with Calceos. Couldn't deal with Alendronic Acid.
Yes, on reflection I remember my sister, a nurse, always commenting on my being “small boned”. My mother was the same, tiny little thing she was, 6.5 stone when she got married at 25. Mind you, she lived till she was 99 with only one fracture all her life, her hip. Tripped over the leg of a walker at the hostel at the grand age of 95! So there’s hope for me yet . 💪 Thanks again for your insight Eileen, always valued.
One of the consolations of being a buxom wench! More deformation of your bones as you walk encouraging the formation of new bone tissue!!!!! And even pred-associated weight gain isn't ALL bad - saves wearing a weighted vest...
bjmoen,
Do you know if Prolia is considered a bisphosphonate drug? Years ago when I was was diagnosed as osteopenic, my OB put me on a bisphosphonate monthly dose, and after only three months, I began to have terrible muscle problems in my legs and always felt very flu-like while on it. Needless to say, I stopped taking it.
My rheumatologist has now recommended Prolia to me because my density has gotten slightly worse, but not because of the Pred. because I have only been on it 4 months. This was from my last bone density. I told her I had to think about it because I really don't need any drugs making me worse. I am a daily walker and have been for at least 40 years, but it just goes to show you that sometimes heredity trumps environment.
Prolia is a different mechanism of action to the bisphosphonates.
Per Dr. Sharon Orange (from internet) Proli works differently from the biophosphonates. Prolia is what is called a monoclonal antibody (hint, a medication whose generic name ends in mab is a monoclonal antibody). Prolia inhibits the activation of osteoclasts which break down bone.
Dr rang this morning and wants to see me first thing Monday morning. I’m not sure if I’m apprehensive or happy that he’s onto it so soon. 😌
Yes - know what you mean!
HI again Poupe and Eileen and others,
Firther to my previous posts, and after seeing the GP yesterday, looks like I may be starting Prolia shortly. That will be added to the pred and the aspirin and so after a few months I’ll be able to give you some feedback Poupe on how I’m going mixing that little cocktail. GP also said it’s important I get off the pred asap due to how bad my osteoporosis is already ....not sure how that’s going to go given I wasn’t planning on rushing the reduction. I’m to go to the dentist first to check that I’m not looking at any major root canal therapy or anything that requires drilling into the bone as I’m the told you can’t be on Prolia if you’re having that done, you have to have it done first.Meanwhile he has given me a stronger Calcium/Vitamin D combo to tide me over, then I see the rheumy early Jan and he will lead the treatment, with the suggestion being twice yearly injections of Prolia. ( Eileen, I did ask about Forteo but he hadn’t heard of it and I wonder if it is available in Australia). He suggested increasing my calcium with adding extra dairy to my diet but I told him I was off dairy,carbs, sugar wheat, and salt and trying to eat mostly anti inflammatory food to reduce the inflammation. GP meanwhile ordered more bloods to check for other possibilities of the cause of such severe osteoporosis given i’ve only been on it 6 months, so will wait now with more apprehension for those results. One thing that seems likely that came to light is that in Jan 2016 I was on a high course of steroids for a month for a severe sinus infection that required surgery. Even more interesting and which I wasn’t aware for until yesterday was that a “newly invented” drug I was on for 2 years back 35 years ago for endometriosis was a synthetic steroid. It’s since been replaced as the drug of choice for that condition due to its side effects, including liver problems and osteoporosis ....😒. Whether the previous steroid use coupled with my small frame is the cause, or whether there is something else going on I’ll just have to wait and see, but at the end of the day being told my bones are full of holes and within the next 10years I’m at major risk of a “significant bone fracture” sent me straight to the pantry looking for wine and chocolate....not with a smile on my face either Michdonn. 😔
Don't you have to love them? If you are on Prolia the bone density problem is shifted. A member of the forums (in hibernation currently) has been on Prolia for 3+ years and her bone density is now classified as "normal". She is on lifetime pred at somewhere between 5 and 7.5mg (can't remember) because she has adrenal insufficiency.
If you are small that is immediately a risk factor. This is the main reason we should all have dexascans immediately - people with very low levels almost certainly have a pre-history. And it is unfair to blame pred - but that's what they do immediately if they didn't check.
You're in Australia - have you been a slip, slap, slop lady avoiding the midday sun? Low vit D means any calcium isn't being utilised anyway. What other medications are you on? PPIs lead to low bone density all on their own - but do the doctors have a fit about it? Nooooo.....
Hi Eileen, and thank you for coming in. I’ve never been one that’s needed to take any long term meds, I’ve been quite healthy and fit for an old wee lass, albeit when I do get something it usually requires surgery rather than meds. The endometriosis started at the age of 26 with surgery( partial hysto) then the prolonged medication, and continued on and off throughout my life however after that initial 2plus years of Danazol I opted for laser removal when it flared rather than more meds or a full hysterectomy. Low BP required extra salt at times, ( that was hard to give up) and being small and never gaining weight I ate what I wanted ( so was hard to give up sugar, carbs and wheat). Only had to take the occasional anti’b and never suffered from allergies or recurring colds and flu until the sinus infection last year at 61 which required a double course of anti’bs, double course of steroids then surgery, however I bounced out of that like a trouper and recovered well. I did pick up a staff infection in the cannula site when they blew up a vein in the hospital and then a blood clot in the same area, requiring more anti’bs. The PMR/GCA diagnosis 6 months ago was quite the slap in the face and this on top sent me straight for naughty food and a pity party yesterday but I’m back in grateful land now that it isn’t anything worse. I’m pleased to hear that the bone density can be improved, I have my sisters words echoing in my ears. She was a nurse and was always telling my little frail elderly Mum to “look down when you walk, if you fall and break something that will be the end of you”. I love her but she’s not the cheeriest sole! If I need medical advice she’s great, if I want family sympathy I go to my other sister. 😌