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Bone density test,orthopedic,evista,cold feet,deep vein thrombosis

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Practicing since : 2002
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I am 71 year old female with a small frame. Weight: 108 Height 5ft 2in. I have had a bone density test that says my bones are orthopenic. I was told to take Evista since I have achlasia and fosamax or any of the others would bother my upper g.i. system. I have cold feet even in the summer at times and since XXXXXXX vein thrombosis is a potential hazzard of Evista, I am worried. I also worry about stroke. Any advice?. Thank you
Tue, 22 May 2012 in Osteoporosis
Answered by Dr. Robert Galamaga 2 hours later
Hello and thank you for your query.

Your question is a very good one. I will try to provide you with some information and reassurance to help you make an informed decision.

Your bone density has demonstrated osteopenia which is a thinning of the bones which we regard as a precursor to osteoporosis which is a more severe thinning of the bones. With osteopenia you have an increased risk of fractures which include hip fractures and also fractures of the spine (compression fractures). Fosamax can cause problems with the GI system particularly if you have achalasia - the pill can irritate the esophagus and cause major issues along those lines.

While there are risks of medications such as Evista which you have mentioned, these are small. What we cannot ignore here is the potential benefit of maintaining and strengthening your bone density.

Another option is Reclast which is actually given once yearly. Depending on your insurance you may be eligible for this medication as well. It is not necessarily superior to Evista but may be more convenient.

I realize this is a challenging decision but I feel the evidence of a benefit for you in taking Evista or Reclast outweigh the small potential risks considering that you are 71 and have many good years of life left to enjoy.

I hope my response has been both adequate and informative. If you have additional questions related to this concern, I am available to address them.


Dr. Galamaga
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