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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Treatment For Osteoporosis


My mom had some 6 hairline fractures in 2008 dec she was diagnosed with osteoporosis in 2009 nov

she has had Osteophos 70 for 3 yrs almost - could be 2 and half yrs not sure of exact time frame - weekly dose of one tablet from she stopped in October 2013


her results are as follows

she is now only 46 kgs for her 153 cms
Her bone density

in Nov 2009 AP spine L1-L4 T score -3.6 Z score -1.8 osteoporotic
femoral neck left -2.7 -1.1 osteoporotic
total hip left -2.1 -0.9 osteopenic
total hip bilateral av -2.2 -1.0 osteopenic
femoral neck right -3.2 -1.6 osteoporotic
total hip right -2.2 -1.0 osteopenic

spine total t score - 3.6 and zscore -1.8

now bone density done in November 2013

left hip

DXA results
Neck -2.9 t score -1.1 z score
total -2.0 -0.5


right hip
neck -2.6 t score -0.8 z score
total -1.9 -0.4

lumber spine
DXA results

L1 -3.5 t score -1.6 z score
L2 -3.3 -1.2
L3 -3.3 -1.1
L4 -3.5 -1.3
total - 3.4 -1.3



calcium serum test
calcium 9.6 mg/dl

vitaminD, 25 Hydroxy (elisa) - reult 39.8 nmol/L


so the doctor suggested Forteo (teriparatide)OD SC for 18 months
1 vit D3 tab once weekly for 2 months
calcium tablet


Another doctor feels that - Denosumab

She is hypertensive and has problems of flatulence and stomach ailments

She is not keen for these type of drastic injectable treatments

Kindly advice please as to what she can have as treatment orally preferred otherwise suggest what you feel based on her bone density

Someone suggested osteum k2, arachitol and cholecalciferol
Thu, 22 May 2014
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Orthopaedic Surgeon, Joint Replacement 's  Response
Hi
Thanks for posting your query
After going through your suffering ,severe weakness of bone (osteoporosis) for which calcium tablet alone may not work. The osteoporosis may be confirmed by Bone mineral density (BMD) by dexa scan along with X ray of spine.
For now my advice would be-
1. For Osteoporosis there is few options like- calcitonin nasal spray (Rock bone C nasal spray).
- Once a year injection of zoldronic acid, once a month tablet of alendronate, once a week tablet of osteophos.
- Injection Teriparatide.
You may discuss with your treating doctor and decide what is best for you. Once the pain is reduced you may start exercises to strengthen the back that is back strengthening exercises.
Take balanced diet rich in calcium (1000mg/day) and vitamin D (1000 i.u. /day) along with vitaminB12, B6.Vitamin D is available in weekly dose pattern as well as injection, just talk to your local doctor as the above written medicine are prescription only .
Hope this information suffices.
Take care and I shall be glad to answer any further query.
Regards
Dr. Chugh (http://bit.ly/drmchugh)
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Suggest Treatment For Osteoporosis

Hi Thanks for posting your query After going through your suffering ,severe weakness of bone (osteoporosis) for which calcium tablet alone may not work. The osteoporosis may be confirmed by Bone mineral density (BMD) by dexa scan along with X ray of spine. For now my advice would be- 1. For Osteoporosis there is few options like- calcitonin nasal spray (Rock bone C nasal spray). - Once a year injection of zoldronic acid, once a month tablet of alendronate, once a week tablet of osteophos. - Injection Teriparatide. You may discuss with your treating doctor and decide what is best for you. Once the pain is reduced you may start exercises to strengthen the back that is back strengthening exercises. Take balanced diet rich in calcium (1000mg/day) and vitamin D (1000 i.u. /day) along with vitaminB12, B6.Vitamin D is available in weekly dose pattern as well as injection, just talk to your local doctor as the above written medicine are prescription only . Hope this information suffices. Take care and I shall be glad to answer any further query. Regards Dr. Chugh (http://bit.ly/drmchugh)