Reclast?

[Crankin]

I just found out my osteopeinia has progressed to to full blown osteoporosis. I've been tracking this for ten years. I can't take Fosomax , or any of the other drugs in that class; huge upper GI issues when I tried. I have been on and off Evista for about 5 years, but every time I have to stop it because I get estrogen-like side effects, which scare the crap out of me. So, I'm at my last resort. I even began running to try and get some impact exercise and weights, too. For some reason, my body does not absorb calcium/vitamin D maybe? I have been taking supplements for 25 years, but I guess my family history and other risk factors (slim, white, mother and grandmother had it) have doomed me, despite 20 years of high impact exercise before I started riding.
I am going to meet with my gyn. next week to set a plan, but has anyone here tried Reclast? I seem to remember someone talking about it. I am allergic to all kinds of things and from what I can see, this might not have any side effects for me.
I guess I better not get in any crashes.

[Zen]

I guess I better not get in any crashes.

That's what my gyno tells me, too.

I have no experience with it.
I'm supposed to be taking Boniva but haven't started yet because of 3 dental implants in progress

[Biciclista]

how much Vit D are you taking? what are your Vit D levels? (there's a test your doctor can do)

work on balance, less falling that way.

[Crankin]

I haven't had the vit. D test, but will ask for it.
I really haven't been in a serious crash in a few years. I had altercation with the road in July (not my fault,though), but it was slow speed and the only result is a scar on my knee. I am already a super cautious (i.e.wimpy) descender, so I'll just keep that up. Yea, my balance isn't great, but I manage to stay upright.

[tulip]

Crankin, I know you are strong and athletic, and this is not aimed at you. I wish you the very best in figuring this out.

But for those of you who need another reason to work on your core (besides being more comfy on a bike and looking great when you go to Rio in February), it's so important for balance. So many people--men and women--have falls largely because they don't have the core strength and balance to hold themselves up.

Pilates, yoga, tai-chi, hiking, rock-climbing, gym rat--pick one or many and get going!

[Crankin]

Well, I might be athletic, but ever since I stopped teaching aerobics, I feel my core has been weak. My class was known for killer abs! Yoga seems to work for me, though. Yea, people who have flat stomachs should remember that it doesn't mean they have a strong core.

[nolemom]

I haven't used Reclast but my mother-in-law just got her second yearly injection. She is very frail (83 lbs) and about to turn 87. Normally she has a bad reaction to almost all medicine. She could not tolerate any of the oral medications. She tolerates the Reclast without any side effects. The doctor does bloodwork before the infusion and administers the medication through an IV about a week later. It seems to work well for her.

[Biciclista]

my mother got that spent a fortune and got no improvement at all (reclast)

[lph]

so Crankin, or anyone else, how did you find out that you had osteopenia? What started you tracking it?

I'm interested after reading here and other places about the need to keep up high-impact exercise, especially since I know I walk and hike much much less now than 10 years ago, and bike much more. I also don't drink milk, but do take a calcium supplement daily. Is this something I should be checking out regularly as I get older?

[ny biker]

Would that be something you would learn from a DXA scan?

[Dianyla]

how much Vit D are you taking? what are your Vit D levels? (there's a test your doctor can do)
Yep, get your D-hydroxy levels tested. Also, consider that the most absorbable form of vitamin D is the animal form (D3 - cholecalciferol) from cod liver and other sources. Plant-based vitamin D (D2 - ergocalciferol) is not as well utilized by the body. I take these D Drops by Carlson's, which come from cod-liver. (I also take cod liver oil for the EFA benefits, but a serving of that usually has less than 1,000IU of D per dose.)

Also keep in mind that the current RDA for vitamin D is quite low and on the verge of being revised. The amounts you can get from normal dietary sources (even enriched with D) are generally not enough to correct a state of deficiency.

Many healthcare providers and nutritionists advocate against taking too much vitamin D (and the other fat soluble vitamins like A & E) because it is fat soluble. The upper tolerated limit of D is suspected to be 10,000IU per day. If you are exposed to bright sunlight in summer, your body does not manufacture more than this amount.

My own physician recommends 4,000-6,000IU in winter time, bumping that up to 8,000-10,000IU if I'm fighting off a cold/flu. In summertime I still take about 2,000IU daily because I work indoors and tend to avoid excessive sun exposure.

[Dianyla]

how much Vit D are you taking? what are your Vit D levels? (there's a test your doctor can do)
Yep, get your D-hydroxy levels tested. Also, consider that the most absorbable form of vitamin D is the animal form (D3 - cholecalciferol) from cod liver and other sources. Plant-based vitamin D (D2 - ergocalciferol) is not as well utilized by the body. I take these D Drops (http://www.evitamins.com/product.asp?pid=14071) by Carlson's, which come from cod-liver. (I also take cod liver oil for the EFA benefits, but a serving of that usually has less than 1,000IU of D per dose.)

Keep in mind that the current RDA for vitamin D is quite low and on the verge of being drastically revised within the next year. The amounts you can get from normal dietary sources (even enriched with D) are generally not enough to avoid or correct a state of deficiency. Most people living above the 40th parallel (NorCal to NY, approximately) are deficient unless they get significant sun exposure all summer long.

Many healthcare providers and nutritionists advocate against taking too much vitamin D (and the other fat soluble vitamins like A & E) because it is fat soluble. The upper tolerated limit of D is suspected to be 10,000IU per day. If you are exposed to bright sunlight in summer, your body does not manufacture more than this amount.

My physician recommends 4,000-6,000IU in winter time, bumping that up to 8,000-10,000IU if I'm fighting off a cold/flu. In summertime I still take about 2,000IU daily because I work indoors and tend to avoid excessive sun exposure.

[Biciclista]

yes, they do a bone scan and based on density in different places you get diagnosed.

3 years ago i had one, and had osteopenia in my back and my hip. last month i had a second one and my back has improved but my hip got worse. I think the back improved because of upper body weight bearing exercises. I am taking more Vit D3 now (but less than Dianyla) so hopefully that will help.

[Crankin]

I started getting the DXA scans at about age 45 because I knew my mom and grandmother had osteoporosis. I have never been a milk drinker. A little as a kid, but my parents didn't push it and it was never served at dinner. I started taking calcium/vitD supplements about 25 years ago, before I got pregnant with my second child. I did lots of high impact aerobics for about ten years, then some semi-impact step classes for about 5 years after that. I've been weight lifting on and off, all along. What scares me is that my bones have been getting worse, despite these interventions and taking Evista for awhile.
Well, I am not going to stop cycling, will up the weights and get back on tack with my running.
I tried the Fosomax in 1998, a little bit before I started cycling. If I hadn't had the horrible reaction, it might have stopped the decline. I don't have to pay for the Reclast; my insurance pays for everything.
I just wonder if some of this is related to the same phenomena that was discovered in male cyclists (a high level of osteoporosis in elite male cyclists) because of my sweat rate and the fact that I already have a genetic predisposition. I do sweat like crazy when I ride. Something is leeching the calcium out of my body!

[Biciclista]

Crankin, two things; one start taking the D3 two, start taking calcium after the rides. Ever notice there's no calcium in sports drinks?
I've even talked to the NUUN company about this. they said only cyclists lose calcium , not the other kinds of athletes that use their product, so they're not going to add calcium. So after any ride that i sweat during, I take extra calcium. that plus taking a lot more D3 than "normal daily requirements". I'll let you know in 2 years (sigh) if it's helping.
ps, i've read some stuff about Fosomax and i'm not really sure the kind of bone it builds is going to make us any better off.

[OakLeaf]

Also, don't take calcium supplements without magnesium (http://ods.od.nih.gov/factsheets/magnesium.asp). It's important for bone health that your intake of calcium and magnesium be in balance.

Personally, if my leg cramps are any indication, I sweat out more magnesium than calcium. I find it hard to believe that the electrolytes in your sweat depend on the sport you're doing, though. I think it's just that cyclists tend to spend a lot more time at their sport than other athletes, and thus sweat out more electrolytes total. (Imagine if it was commonplace for running clubs to not even bother with less than a 2.5-hour run, e.g.) Potassium is plentiful in food and as for sodium, you can just grab the salt shaker. Not so easy to grab the calcium-magnesium shaker...

[Biciclista]

It doesn't make sense to me, either Oakleaf!

[Crankin]

OK, I will be off to the natural foods pharmacy/grocery to get some decent calcium and magnesium. I will wait to start the Vit. D until I get my levels checked. Since I am zealous about sunscreen, I suspect I don't get much naturally.
I never thought about taking the supplements after a ride. I will try it, though my riding is sort of slowing down at this time of year (until I pull out the trainer).

[Biciclista]

why are you hesitating to get Vit D3? you'll discover that they put it in calcium supplements, just not enough.

[Crankin]

I want to find out exactly what my levels are. I don't want to over supplement something that could build up in my body. I know some don't care too much about this, but I have reactions to everything, including vitamins and minerals.
I used to have an asthma attack after getting Vitamin B shots.

[newfsmith]

I'm also osteoporotic and have had one Reclast injection, recommended by the endocrinologist. Like you, my stomach couldn't tolerate Fosamax. The injection itself was a breeze (given in the infusion therapy unit where the nurses are used to putting IV's in very sick chemotherapy patients, so are really good at it). You are warned to arrive for the infusion well hydrated and they want you to drink extra for 2 to 3 days post infusion. None of that was problematic. However, 6 months later, my routine blood work had a spike in my kidney values. My kidney values had never strayed from normal, even when I was in the midst of renal colic with a kidney stone. I gave my next injection (due back in June) a miss, and will make my final decision based on my next round of blood work in January and discussion with MD then.

Like you I have a very strong family history of osteoporosis, every woman on my father's side had at least a "Dowager's hump" and one of my aunt's had a vertebral fracture that left her permanently looking at the floor. My mother has had a sacral fracture that caused nerve damage, leaving her totally incontinent. That has severely impacted her quality of life. However, at this point, I'm inclined to take my chances. It's one thing for Simvastatin to give me slightly high liver values, the liver is good at regenerating. Kidneys are a different story. I'm not sure how much I'm willing to risk damaging my kidneys to reduce my fracture risk. After all, 2 out of 4 of my closest female reatives did not have any significant fractures. I really should have paid more attention in my statistics class.

[Crankin]

Thanks, Jean. I guess I have to take my chances. No one had any fractures, but my grandmother lost like 3 inches and had a hump. My mom had, now that I think of it, may have had fractures, but it was totally related to the meds she took for her liver disease, which accelerated the osteo.stuff. On the other hand, my grandmother lived until 92 and died of something else. My mom was extremely athletic for someone of her generation, but she died at the young age of 67 from her liver disease, which was viral/contracted in utero, from what she told me.
I see my gyn. Friday and will take it from there. I've been having a lot of back and hip issues, which I've been told is a disc, but maybe it's related to this? I am frustrated! I look young for my age, but I think my body is giving out. What good has 30 years of exercise done for me????

[tctrek]

I had osteopenia about 7 years ago. I took Actonel for a little over a year and put all the bone back + added some. Just found out that I have it again only this time they told me to treat it with calcium/Vit D for a couple of months and then test again.

It's sad that you can't tolerate the standard meds, because they really work.

[Crankin]

I saw my gyn. yesterday; I will be seeing an endocrinologist (one I saw for thyroid nodules, so no new doctor, thankfully) and she had her assistant draw blood to test my Vitamin D levels right there in the office. She also gave me a list of calcium rich foods, which included a few things that I didn't know (did you know cumin has a lot of calcium?).
My gyn lost 115 lbs. in 2005. She now is a tri-athlete. I used to see her at the gym, where she compulsively goes everyday at 5:30 AM. Anyway, she just completed a half marathon, so I got a whole earful about that. She keeps telling me she is still "scared" to ride on the road for the most part and how her DH is not active like mine, hence, she goes to the gym and trains early in the AM, so it doesn't interfere with her family life and delivering babies. Although I was the same way at her age, it seems like she has replaced one addiction for another...
Anyway, she gave me a big lecture about not getting down about the osteoporosis because even people who lead super healthy life styles get stuff.

[Biciclista]

Interesting gynecologist you have. She's right. and I think you're young enough to turn it around.

[SLash]

My last bone scan 2 years ago showed me having osteopenia with only 2 points separating me from osteoporosis. I am due to be retested next year and nervous that the results will show osteoporosis.

At my annual physical my doctor tested my Vit D and although technically it was in the normal range (it was 32 ng/ml) he said the ranges need to be adjusted and that he considered my score low.

He prescribed 50,000 i.u. :eek: of Vitamin D every week for 12 weeks. I hate taking it, weird side effects (extreme teeth sensitivity/pain plus headaches) although I like the loss of appetite effect. I just took my 7th pill today, I actually skipped last week because we were on a trip and I didn't want to feel bad. It is his hope/belief that getting my Vitamin D level up will help my absorption of calcium. I hope so too. He will retest my Vitamin D level at the end of the 12th week and if it is still low I get to do it again for 12 more weeks.

[Zen]

Personally, if my leg cramps are any indication, I sweat out more magnesium than calcium. I find it hard to believe that the electrolytes in your sweat depend on the sport you're doing, though. I think it's just that cyclists tend to spend a lot more time at their sport than other athletes, and thus sweat out more electrolytes total.

I don't think the calcium is lost in sweat. Sweat is the end product of cellular respiration, in which calcium is not a factor.
Calcium is a factor in muscle neurons firing. "At rest, neurons contain an overall internal negative charge, called the resting potential. This potential is maintain by the Na+/K+ pump which actively pumps out 3 Na+ for every 2 K+ in"

Discuss.

[OakLeaf]

I know nothing, but Google yields a number of studies on calcium loss in sweat, anything from 20 mg to 92 mg per hour...

[Zen]

My line of thinking (I hesitate to say reasoning) is that a lot of calcium is lost during cycling even if you're not sweating because of the constant firing of muscle neurons. Hence cramping in the legs and nowhere else.

I know I'm drifting here...like Mimi said,most sports drinks don't have calcium yet cyclists always get leg cramps.

Well. That helped me think something through anyway:o

[OakLeaf]

Endurolytes. I have a friend who swears by them, to the extent that she brings a big baggie on all the century rides, and hands them out to her cramping friends. :) After she gave me three of them at the lunch stop on KCBC, my feet stopped cramping...

All Hammer products have some calcium, but then they have Endurolytes (capsules or powder) if you need the balance to swing more toward electrolytes than calories.

[Crankin]

That is an interesting point. I have been having pretty bad leg cramping on my last few rides, of let's say 35-40 miles, as opposed to what might happen previously on a hilly 55-65 mile ride. Somehow, I suspect many of the issues I am having are all related to my lack of absorption of calcium, and perhaps a Vitamin D and magnesium deficiency. I just can't believe that I have become "weaker" all of a sudden. I need to find a doctor or someone who can put all of this together. Well, the endo. will be first and then perhaps a nutritionist and an orthopedic doctor.
If I hadn't been tested for every disease known to mankind two years ago, I would suspect I have celiac or Crohn's, but everything came out negative.

[SLash]

I forgot to mention, the 50,000 i.u. of Vitamin D (Drisdol, Max D3/1.25 mg) is in one pill so it really is a huge dose all at once.