Osteopenia

[michelem]

So, here's a little background:

I am allergic to dairy (causes awful skin rashes) and osteoporosis runs in my family (my great-aunt fractured her bones from rolling over in bed). I was diagnosed with osteopenia at around age 26. I am now getting close to the big 4-0. I am very nutrition-conscious (very much into whole, organic foods; RARELY eat anything processed (not even energy bars with all their saturated fat); skinless boneless chicken once per week, otherwise fish, brown rice protein powder, egg whites, or lentils for protein; take 10g fish oil per day (combo of fish oil pills, salmon, and sardines); once in a while a tablespoon of flax, 1500 mg calcium/750 mg magnesium daily, vitamin b-complex daily, vitamin c and e several times per week, and just about two months ago started taking 2000 IU of vitamin d per day. Why so much vitamin d? Well, it turns out that my avid avoidance of the sun (I wear titanium dioxide/zinc oxide sunscreen whenever I'm anywhere near the sun and wear SPF treated clothing as well - long sleeve SPF jerseys and cycling tights even in the heat of summer) has created a SEVERE vitamin d deficiency - my level was EIGHT and the low end of normal is around 30. My doc said that as my vitamin d levels increse my bone pain should decrease - yay!

As far as exercise goes, I cycle (of course), jog, do power yoga, and resistance exercises with resistance bands. Recently I joined a gym (yuck) and have been going three mornings a week and using the weights. I have been very active all my life, from competitive ice skating to high school cross-country team.

So, where is all of this going? I just had another DEXA scan done a few weeks ago and my bone levels have diminished to the point that I am on the very brink of osteporosis. I am so discouraged. My doc seems to think it is due to the vitamin d deficiency.

I've been doing some research and see that vitamin k2 has been used in mega doses of 45 milligrams per day and that the benefit has been equal to or better than Fosomax and some of the other prescription medications that I'd like to avoid. However, I am having a hard time finding vitamin k2 in doses higher than 400 micrograms, let alone 45 milligrams!!!

Here is one of the studies I've read: http://www.thorne.com/altmedrev/.fulltext/10/1/24.pdf

Anyway, does anyone else have good suggestions?

Oh, and my cholesterol is high too. Go figure. And, yes, I eat organic rye, barley, oats, wheat hot cereal at least 5 mornings per week for breakfast, lots and lots of veggies, very very little oil and only olive oil on the rare occasions that I use it.

Of course, my husband goes out and eats a double cheeseburger with fries and a milkshake the night before his cholesterol test and passes with flying colors. Grrrrrr . . . .

[kat_h]

Why do you avoid the sun so much?

[VeloVT]

Michelle,

Is my memory correct that you had a post some time ago (6 mos - year ago) about amenorrhea? (It's entirely possible that I' have you mixed up with someone else, so go easy on me if I have!). Do you struggle with eating disorder issues or just have trouble keeping weight on? All of these concerns (irregular periods, very low BMI, bone density issues) can be interrelated, so maybe that's worth exploring with your physician?

There was a special section in the NY TImes a few days ago about health as we age. One of the articles was about healthy bones... it mentioned that bone density is in fact not necessarily the only/best indicator of risk/heath, it's just the easiest one to measure... you might find that article interesting, maybe worth checking out to see if it's on the website?

I worry about bone density too. I have never had eating disorders and my BMI bounces between about 19-21, so I've never been "underweight" either... but I've been on Depo Provera for going on 6 years now, starting when I was 23 (when I should have still been adding bone density). I had a scan done when I was 25 -- the measurement at my hip was like, in the 99th percentile of what I "should" have had, but the spine measurement was borderline osteopenic... Doctors didn't seem to be concerned with this at the time, but I wonder... The medication works really well for me for a variety of reasons, and I don't really see an alternative that is equally appealing (though I did just switch to the new low-dose version), but I sympathise with your concern.

I wish you the best of luck.

[snapdragen]

Wow michele, that's a whole lot of supplements. How much real food do you eat daily - your post makes it sound like it's not much. Maybe a talk with a nutritionist would help?

[mimitabby]

gee, with all the Vit D you're taking, i'm surprised to hear that you're still getting worse. But it has only been 2 months.

dysmennorhea would certainly be compounding your problems. Jump rope! lift weights! good luck.
I get to go back to the Dr in November for a bone progress report....

[VeloVT]

BTW, I have an acquaintance who had health issues related to vitamin D deficiency from super-vigilant sun-protection -- it definitely happens... it's so hard to know what to do sometimes...

[makbike]

Have you had your thyroid levels checked recently?

[Zen]

The reason you can't find vitamin K in higher doses is probably because of the possibility of vitamin K toxicity

[Crankin]

I have had osteopenia since I had my first scan in my early 40s. I, too, can't really drink milk, my parents never served it, and now it really does bother my stomach. My grandmother died 4 inches shorter than she started and my mom (who died young from another problem) had several fractures in her early sixties, even though she exercised. I did years of pounding aerobics and sporadic weight training before I started cycling. I eat healthy, but not as restricted as you do! I finally had to start taking Evista. Fosomax made me really ill (all of the side effects you hear about on the ad), when I tried it almost ten years ago. I have been taking it for a little over a year and I am due to have another scan in September. I hope something has changed. I take 1200 mg of calcium, with Vitamin D and I would say I get a good amount from the sun, although I wear a lot of sun block. I've been weight training 2 days a week and doing yoga, but I find it hard to fit it all in and do the amount of riding I want to do.
I would be leery of Vitamin K. It's not water soluble and easily builds up to toxic levels.

[KnottedYet]

MicheleM - please get checked for celiac disease. It is a simple antibody blood test. Celiac would explain your high cholesterol, non-responsive osteopenia, dairy intolerance, etc. It is a genetic disease. And your daily wheat/oats/barley/rye cereal is the deadly foursome of celiac.

[michelem]

Thanks so much for all the kind responses. I avoid the sun per dermatologist's orders . . . I've had pre-cancers removed and I've seen how disfiguring skin cancer has been for my poor hubby.

Liza, Yes, that was me, but my period has been regular again for the past nine months or so. I've put on some weight too so that now I am in more of the "normal" range for my height. I don't understand all that went into it as all the testing in the world (including celiac, thyroid, hormone levels, etc.) came back normal, and I don't think my eating or activity level has changed all that much . . . maybe it's just the age thing . . . whatever it is I finally don't have stick arms that I'm afraid to show anymore! I've had low body weight since childhood (always at the low end of the percentile chart) and it's been frustrating at times.

As far as food intake, I have consulted with nutritionists and am told I get plenty of calories. Last time I saw one was last year, but maybe it would be worth another consult.

Thanks for the warning on the vitamin k toxicity. My understanding is that k2 does not build up in the liver like k1 does, but maybe I'm mistaken. I've got another md appt. set for June and hopefully I'll find out more then.

KnottedYet - I was tested for celiac several years ago, but at the time I had been following a self-imposed hiatus from gluten/wheat for a while (trying to see if it might help my eczema -- it didn't). The test came back negative, but do you think that's because I had already been avoiding the offending substances? Do you think I should get tested again? Is it something a person can contract later in life even if they haven't had it before?

Thanks again for all the great responses. I really appreciate your time and attention.

[KnottedYet]

KnottedYet - I was tested for celiac several years ago, but at the time I had been following a self-imposed hiatus from gluten/wheat for a while (trying to see if it might help my eczema -- it didn't). The test came back negative, but do you think that's because I had already been avoiding the offending substances? Do you think I should get tested again? Is it something a person can contract later in life even if they haven't had it before?

Yup. If you aren't eating gluten, you won't be producing antibodies to gluten and your test will be negative.

Celiac is genetic. You always have the potential, but it shows up (or gets triggered) at any point in life. In my family, it shows up more often in adulthood. It's just family lore that at a certain age, you have to stop eating grains.

The genetic test is a couple thousand dollars. The blood antibody test is a whole lot cheaper, and usually covered by insurance. But you have to be eating gluten to be producing gluten antibodies.

I've avoided gluten (wheat, oats, barley, rye) for 7 years. If I had the blood test right now, it would be negative. But give me a taste of stir-fry made with soy sauce made with wheat (yes, there is wheat in a lot of soy sauces!) and I'll end up pretty unhappy.

It's up to you if you want to repeat the test or not. If you were gluten-free for a week or so when you had the last test, you probably had cleared your system of detectible gluten responses at that point, if you had a gluten problem. If you had been gluten free for only a couple days, it might not have mattered and it's likely the test was accurate.

Either you produce antibodies or you don't, but the offending substance (wheat, oats, barley, or rye products) has to be in your system and offending you at the time of the test.

[Tokie]

Hi Michelem - I've had osteoporosis since age 43.(small frame,blue eyes,mom has it too) when I was diagnosed, no-one could believe it. I was a good weight(109 and 5 1) paddled outrigger canoes, lifted in the gym 2X a week, and did a bit of running. Oh well! My osteoporosis is now only osteopenia, which is normal for a (now) 53 yr old.2 bike accidents this year caused only cuts,bruises,and one ligament injury - no bone fxs! My MD who checks my breasts is encouraging my internist to consider Evista instead of the fosamax, as it helps with osteoporosis and reduces my chances of developing breast cancer. We'll see! I am just so glad to not have problems my mother had (spinal compression fractures) or the repeated broken toes my friend got before going on fosamax. And perhaps just a little sun exposure might do you some good? good luck! Tokie

[mimitabby]

Just keep taking those megadoses of Vitamin D.
the fact is, to absorb Vit D from the sun, you have to have your skin uncovered (not just your head) and washing is going to clean it right off.
Our modern lifestyle is not conducent of getting Vit D from the sun. Pretty sad, eh?
I guess my stepmother was doing something right, laying down on the beach all day to get a tan!

[Tuckervill]

If you live in the PNW or a big city with the cavernous streets, you should worry about vitamin D. Here in the south, most of us don't have to worry about that end of the spectrum. The only way to avoid sun exposure is to stay inside your house all day every day. Even in the car, we are exposed to sun. I got a suntan on my left arm from driving from home in NW Arkansas to Austin, TX, in March. The tinted window was UP the whole time. So, there are lots of factors to consider about whether you should supplement or not.

There's also the study that says vitamin D supplementation may be immunosuppressant.

http://www.sciencedaily.com/releases...0125223302.htm

I think all things in moderation, including exposure to the sun.

Karen