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Any osteoporosis sufferers here? Tell me how it (doesn't) affect you (please!)
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Despite having weathered a few fairly heavy ski crashes with no ill effects, in the last 12 m I've had a femoral neck stress reaction (right side); a femoral shaft stress reaction (left side); and most recently a trauma-induced fifth metatarsal fracture (rolled my ankle whilst running).

My Doc suggested a bone density scan earlier in the year. The 5th MT fracture convinced me it was worth it. I had a DXA scan today. My T score was -2.5, which means, apparently, that I am just into the osteoporosis category.

A quick google discloses that maybe, just maybe, having eschewed running and weights for most of the last 25 years in favour of cycling may not have been the smartest thing to have done. Lots of indicators that the absence of weight bearing activity doesn't do much to keep your bones dense.

To be honest, I'm pretty shaken up by this news. I'm a 47 yr old male; don't smoke, don't drink to excess (much); no chronic conditions, and until this, of what I thought was good health.

I'm being referred to another specialist - a skeletal and rheumatoid one - who I will probably not see until after Christmas.

I've got a head full of questions - no surprise there. How fragile am I? How fragile am I going to get? Is this condition reversible, or nothing more than manageable? Should I forego any further ambitions to compete in middle/long course tri to avoid further stress reactions/fractures? Should I forego Oly distance events?

I know that weight bearing is the best way to strength bones, but I don't know yet whether the risk from running (which is, I bet, short term) is >> the benefits (which are presumably quite long term).

So if there's anyone out there who has osteoporosis, and who has managed to keep doing triathlons at the same time, I'd love to hear from you.

TIA.
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Re: Any osteoporosis sufferers here? Tell me how it (doesn't) affect you (please!) [Greg66] [ In reply to ]
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2 years ago (when I was 29) I crashed my mountain bike and snapped the ball off my femur. 6 months after that I broke my wrist. That prompted a check into bone density revealing osteopenia .
I ride primarily, but also run ~10miles / week with my wife. (She's the runner in the family!). I have a long history of weight training and other weight bearing activities. So, this finding was a surprise.

My primary care suggested a few supplements, MK-7. Strontium, D. I ended up finding them in the Jarrow Bone-Up formula.
Additionally, we decided that bisphosphonates (fosamax, boniva, etc) were not appropriate for me as osteoclast inhibitors.
Instead we did a course of Forteo (which carriers its own risks, namely bone cancer) for 1 year. At 1 year post my numbers were moving in the correct direction. We discontinued the Forteo and I continnued with the supplements and weight bearing activity.

Interestingly, Running is not a reliable activator of bone formation. The forces are too low and too repetitive for significant growth. Hence all the stress fractures associated with it.
At an ACSM conference, a research had mentioned that 10 maximal jumps per day were significantly better at causing bone growth. Better yet were sports with abnormal loading (such as soccer) where forces are constantly changing direction.

This reason alone is why I recommend weight lifting to endurance athletes. You can argue all day whether it increases performance, but the fact of the matter is that its worthwhile for bone health regardless.

The above poster is a physiologist employed by PEARL iZUMi. However, statements are not made on behalf of nor reflective of PEARL iZUMI in any manner... unless they're good, then they count.
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Re: Any osteoporosis sufferers here? Tell me how it (doesn't) affect you (please!) [Greg66] [ In reply to ]
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I'm 69, and was diagnosed with osteoporosis almost two years ago. I had a bone density test because I also have a hypothyroid condition. Not sure of the reading, but it was not good. The endocrinologist suggested Prolia, D3 (extra 5k units/day) and calcium (Caltrate) plus cut back on cycling and swimming and start weight training and increase my running. The Prolia has a whole host of side effects, none of which have shown up (yet). He also told me "If I insist on riding, not to crash my bike". However, in September I went down hard on my right hip during a race (Slipped on a painted line in the rain). Lots of soft tissue damage (ugly bruise!!!), but fortunately no bone breaks. BTW it still hurts some when running... Due to insurance restrictions, I can't get another bone density test for a while yet, so I have no clue if the Prolia or the lifting is helping. As an aside, in 2010 I was diagnosed with a bone spur on my left shoulder, that required surgery and a long recovery time - maybe the calcium was migrating from my spine and hips to my shoulder - sort of like male pattern baldness: as you age you hair moves from your head to your eyebrows and ears.

.

Remember Luddites are people too...
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Re: Any osteoporosis sufferers here? Tell me how it (doesn't) affect you (please!) [Greg66] [ In reply to ]
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I'm very sorry to hear your news. I have osteoporosis as a result of an eating disorder.

A couple questions with the running - how quickly did you up the mileage? What sorts of surfaces were you running on? You probably do not have to give up running completely, but rather need to do less of it and on softer surfaces (grass, sand).

Have your vitamin D levels tested (blood) and ask for an NTX study (urine sample, measures calcium excretion).
You need 3 x 500 mg of calcium a day - it can't be absorbed more than 500 mg at a time. Viactiv are good supplements. Twin Labs Bone Support or Tri-Boron are good too. (General note: calcium supplements can be constipating. You've been warned)

One of the best things you can do is to start lifting weights. If you end up limiting your run mileage, do lots of walking - that is also weight-bearing.

PM me if you have more questions.

Proud member of Fishtwitch and the ST Grammar Police
disclaimer: PhD not MD
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Re: Any osteoporosis sufferers here? Tell me how it (doesn't) affect you (please!) [xtrpickels] [ In reply to ]
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Interestingly, Running is not a reliable activator of bone formation. The forces are too low and too repetitive for significant growth.

That's interesting. Seems like walking would be even less a reliable activator of bone formation, yet walking seems to be touted for bone health... obviously it's weight-bearing activity. All the Boniva ads show people walking ;-)

Proud member of Fishtwitch and the ST Grammar Police
disclaimer: PhD not MD
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Re: Any osteoporosis sufferers here? Tell me how it (doesn't) affect you (please!) [tdstegner] [ In reply to ]
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I am *very* relieved to hear that you guys still run. I am still in something of a state of shock over this. The earliest I can get to see the bone specialist is the first week of Jan - not that surprising given the holiday season.

I've been called back for another DXA scan today. Yesterday I had the lumbar spine done, because I was told that the prior stress reactions in my femurs might distort the results from a hip scan. It seems that the specialist has looked at the lumbar spine scan and now wants me in for the hips. Not sure that that's going to result in me being told that I'm in the clear. Doubt it somehow.

I'm having real trouble reconciling myself to the idea that I may be a person who can't run, can't ski, has to totter down stairs for fear of falling, etc. That's just not me. I have to remind myself that this year, as I now see it, I've managed to train for and complete an IM with the fecking condition. Of course, there were some bumps in the road, but nevertheless the goal was achieved.

I guess there's not a lot more I can do right now other than sit and wait until January. Frustration has a new definition...
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Re: Any osteoporosis sufferers here? Tell me how it (doesn't) affect you (please!) [Greg66] [ In reply to ]
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They can scan your wrists too.


The hip scan won't result in your being told that you're in the clear. They get T-scores from various points and assume that those are representative of your skeleton (and the hip, spine, and wrist are the most likely to fracture). My hips are osteopoenic and my spine is osteoporotic (based on the scores). So we extrapolate that my skeleton is kinda weak :P


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I'm having real trouble reconciling myself to the idea that I may be a person who can't run, can't ski, has to totter down stairs for fear of falling, etc. That's just not me.

You will be able to run, in limited quantities.
You will be able to ski, just avoid doing stupid stuff.
There's nothing wrong with being a little more careful on stairs :-)
One of the things that was recommended to me was to do balance work and lift weights. Those are not nearly as satisfying as running but it is something you can do.

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I guess there's not a lot more I can do right now other than sit and wait until January. Frustration has a new definition...
Do you have fractures currently? You can swim and bike and start lifting, no?

Proud member of Fishtwitch and the ST Grammar Police
disclaimer: PhD not MD
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Re: Any osteoporosis sufferers here? Tell me how it (doesn't) affect you (please!) [Greg66] [ In reply to ]
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I am also in the same situation with osteopenia in my hips and osteoporosis in the lumbar vertebrate. Your doctor should do the FRAX asessment for you. It has several questions which estimates your risk of fracture occurring over a 10 year period. While the initial diagnosis scared me, I learned that my risk of fracture was very low.Therefore I am not a candidate for drug therapy. I continue to run, bike and swim without restrictions. I also strength train year round, take vitamins and eat properly. You will always have a risk of breaking a bone due to a bad fall or crash. However, the benefits of staying active far outweigh the risk you take.
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Re: Any osteoporosis sufferers here? Tell me how it (doesn't) affect you (please!) [Greg66] [ In reply to ]
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After a long history of fractures, finally vertebrae fracture, pelvis fracture, left tibia and right fibula within a 5 year period a doctor was convinced to check my bone density (I understand I appear to be a perfectly healthy person, so in my early 30s no doctors suspected issues). My dexa scan came back at -2.7 for both hips, unfortunately they can't get a read on the spine from too much titanium hardware. They sent me to a second location for testing with the same results, it is possible the different machine used a different data base (these data bases are full of people that don't match my age, etc. so it skews the data). The doctors went from not believing I had a bone density issue to insisting I start medication or I would see more fractures. They pushed the common drugs like boneva, etc. I was not comfortable with these as they are not designed for young per-menopausal women and I have had family members have bad reactions. I ended up seeing a specialist that recommended Forteo, which I took and lowered my scores to -2.3. I also ate much healthier during that time and took supplements. Who knows how long this new score will last though. I am by no means a doctor and do not know if that or other drugs would be beneficial to you, just happened to work out for me for now. I have to ramp up my running slowly, and find a balance between speed and distance. I have also added in more strength training and actually increased my body weight. I have to be more conservative, but I can happily say I ran 2 marathons last year (one was a PR) and am training for my next one. I remember being very shaken up at the beginning, but things have gotten so much better. I wish you lots of luck in your journey.
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Re: Any osteoporosis sufferers here? Tell me how it (doesn't) affect you (please!) [jlfein] [ In reply to ]
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Your doctor should do the FRAX asessment for you. It has several questions which estimates your risk of fracture occurring over a 10 year period.


You can find this online - and it estimates the probability of a hip, vertebral, or risk fracture (from a fall, I think), not a stress fracture. Just something to remember... I think our fracture risk is higher if you take into account stress fractures.

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Last edited by: tigerchik: Dec 27, 13 15:27
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Re: Any osteoporosis sufferers here? Tell me how it (doesn't) affect you (please!) [tigerchik] [ In reply to ]
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Many thanks to everyone who has responded, and with whom I have corresponded. A bit of hope was just what I needed.

An update: I saw the bone consultant today.

My DXA scores were:
Lumbar spine: T -2.5, Z -2.2
Hip (total) left: T -1.1, Z -0.8
Hip (total) right: t -1.2, Z -0.9.

The basic message was; "don't worry about it". He put the stress reactions down to overtraining/overuse, and the metatarsal down to bad luck (his words). The key things going forward were to build any sort of training base slowly, eat sensibly and don't drink to excess. One insight he offered which clicked with me was that each time I have had to have running "downtime" whilst recuperating, I have inadvertantly been allowing my bones to detrain. This has been followed by a rapid re-entry into training without sufficient adaptation/rest built in.

He also mentioned that they see quite a few broken 4 and 3rd MTs following a return from a broken 5MT for this reason. Something to watch for.

So overall, v happy. We didn't even get as far as a FRAX test, although I had found one online, completed it and found myself clearly in the green zone.
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Re: Any osteoporosis sufferers here? Tell me how it (doesn't) affect you (please!) [Greg66] [ In reply to ]
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good deal. Avoid soda, too - that's bad for bones - phosphorus or something

Proud member of Fishtwitch and the ST Grammar Police
disclaimer: PhD not MD
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Re: Any osteoporosis sufferers here? Tell me how it (doesn't) affect you (please!) [tigerchik] [ In reply to ]
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tigerchik wrote:
good deal. Avoid soda, too - that's bad for bones - phosphorus or something

yes - of the many things I now regret, living on Diet Coke in my 20s and 30s is one of them.
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Re: Any osteoporosis sufferers here? Tell me how it (doesn't) affect you (please!) [Greg66] [ In reply to ]
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I have osteoporosis, diagnosed by t-score of -2.7 in my lumbar. (I forget the exact #s for my hip and femur, but I think they were around -1.3).

I am a long distance runner, logging weeks of 70+ miles at the peak of my training, and have been training since 2007 (in past years, I've hit weeks of 90+). Knock on all the wood you have around you, but the only broken bone I've ever had in my running career was a 2nd metatarsal fracture about 3 years ago - and that one was a traumatic break, not a SFX. Interestingly, the bone density in my foot has been twice read at +3.5 or greater - granted, that was at the Marine Corps Marathon expo - so may not have been the most accurate reading.

I do have a history of injury, but it's all soft-tissue - plantar fascitis, torn high hamstring tendon, posterior tibial tendonitis.

My primary care doctor and I have agreed NOT to go on Boniva or anything else right now. To her mind, they're still unproven, and might make the situation worse. So we're just sticking with my annual DEXA scan, for now. I've also increased my vitamin D intake, and have added certain back exercises (supermans) to my workout schedule while avoiding anything that promotes too much lumbar flexion.

I'm not cutting back my mileage or stopping running marathons :)
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Re: Any osteoporosis sufferers here? Tell me how it (doesn't) affect you (please!) [darkwave] [ In reply to ]
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You and tigerchik make for heartening reading! I doubt I'd be looking at doing on a regular basis the sorts of mileages you do - at most I'd be looking to do enough to get me through a standalone mary/IM once in a while - maybe every 2-3 years.

I've been reading Keith McCormick's book, although I find it has fairly rapidly moved into areas of medical specialism that are going to take me a couple of passes to get into. Anyone have a view on the utility of what he says (generally or specifically)?

And is anyone using a supplement called osteodenx, made by an outfit called Nikken? My doc was keener to push me towards healthy eating plus moderate Ca and vit D supplements than anything more exotic, but he did mention that one of his patients had gone onto this and seen a significant positive change in bone density (he also made the point that bone density can increase without bone strength necessarily tracking the increase though).
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