Suggest treatment for low bone mineral density with compression fracture
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Hello Doctor, I am a 48yr old Caucasian male who has suffered a compression fracture at T9 and T7 revealed by a chest x-ray . Prior to the fracture, I had a bone density scan with the following results (T score lumbar spine=-1.5, hip=-1.8). I also had a variety of blood test showing low testosterone and low vit. D (sorry I don’t know the exact test results). In 2004, I had a chest x-ray which noted (mild degenerative changes in thoracic spine – characterized by spondylosis. Also increased dorsal kyphosis). In 2007, I had a Brain Scan to check function of pituitary gland – result normal – scan ordered due to low sperm and testosterone levels. My family doctor has put me on 2000mg of Vit D and 1,200 calcium supplements. I am wondering how serious is my condition and whether there are other treatments I should be exploring? What questions do you recommend I ask my doctor? XXXXXXX
Posted Sun, 16 Feb 2014 in Thyroid Problem and Hormonal Problems
Answered by Dr. Minal Mohit 6 hours later
Brief Answer: You must be on teriparatide. Detailed Answer: Dear sir, Hi! as you have low BMD, bone mineral density, with compression fracture , you must start with ink teriparatide 20 mcg subcutaneous every day. besides low testosterone requires further evaluation of thyroid as well as adrenals. so ask your doctor to find out TSH & FT4 , serum cortisol, LH, FSH and GH also. pituitary scan is not sufficient , anatomically pituitary may be normal but it may not be working so you must work up the hormones. Regards!