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What Causes Osteoporosis?

Posted on Mon, 17 Oct 2016

Question: I was diadnosed with osteoporosis. I am 86 years old. My physician prescribed PROLIA INJECTIONS. i HAVE READ A LOT ABOUT IT AND WONDERED IF I SHOULD TAKE IT BECAUSE OD THE SERIOUS SIDE EFFECTS IT CAN CAUSE. THANK YOU FOR YOUR HELP

I have no XXXXXXX number. I have e-mail I already gave you. = YYYY@YYYY

I am waiting for your reply.

Answered by Dr. Dr.Arnab (2 hours later)

Brief Answer:
it's the benefit outweighing the risk factors..

Detailed Answer:
Hello XXXX, welcome to HCM,
I've gone through your query and understand your concern..

Now, first of all, I'd appreciate that you've already read about it, which makes it easier for me to explain also..

Please let me know your last serum Calcium, Magnesium level in the first place and since when are you taking Calcium, Vit-D3 supplementation ?

Are you on any other medications for any other health concern ?

Were they started on prophylactic basis or to build up calcium, magnesium and potassium level specifically for Prolia therapy only ?

Also it's important to have your Renal Function test prior to initiation of Prolia, as once started, it needs to be titrated accordingly..

The primary contraindication in this regard is mainly Hypocalcemia, hypomagnesaemia, chronic kidney disease and any allergic reaction to the Denosumab (that's why it's strictly advised to be administered by registered medical personnel only)..

The biggest advantage in osteoporotic patients is the Once in six monthly dosage which actually outweighs several other risk factors in this regards (it's the benefit outweighing the risk factors)..

Now since your Doctor has advised it already, I do believe that he/she must've taken all these variable factors under considerations..So if that's the scenario, then let me assure you to go ahead with it..

Please let me know if there's any further queries, I'll be glad to clarify..

Take Care
Kind Regards

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Dr.Arnab (21 hours later)

I would like to follow up on the PROLIA issue. My further question is "Is it worth going through all the terrible complications that PROLIA would cause at my age (86 years old)" Thank you for your opinion re this question.

Answered by Dr. Dr.Arnab (2 hours later)

Brief Answer:
It depends from person to person..

Detailed Answer:
Hello XXXX, Welcome back,
Thanks for following up,

It's a very justified query you've put up and I'm really humbled that you've asked this..

See it depends from person to person based on -

1. the type of Osteoporosis, severity of the affected bones (the bone mineral density, number of affected bones, pain related symptoms will give the exact idea regarding this)..

2. failure of other conventional regimens (bisphosphonates etc.)..

3. the treating physician's clinical experience on this particular regime (PROLIA in this scenario)..

4. associated co-morbidities of the affected person, and how much it's affecting the quality of life on day to day basis..

5. willingness of the affected person (you have complete right to refuse if you feel it's not the suitable choice for you)..

With all these being said, it's also worth to note that Prolia, being a newer generation of medication in this field, has yet to establish any long term data regarding benefit vs risk (researches and trials are ongoing, and hopefully we'll get some proven published large-scale meta-analysis data within next few years)..so to speak..

I sincerely understood what your asking here, and hopefully now I've also clarified it to that extent (quite frankly, at this age your much better judge of it now, so please decide accordingly)..

I remain at your disposal for any further clarification in this aspect..

Take Care
Kind Regards

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Dr.Arnab (47 hours later)

Thank you so much for your reply to my questions regarding PROLIA. You have been so kind and helpful and understanding my concerns. I am still undecided about taking the drug. Now for the first time PROLIA is advertising on TV. You really adressed all my concerns. My own physicians have not been as helpful as you have. Once again, than you!

I forgot to tell you that when diagnosed with osteoporosis by my neurologist - he suggested taking Vitamin D-3 (4,000 daily), calcium 600 mg(as citrate), magnesium 300 mg (as citrate) which I take daily. Strangely. it was my neurologist who diagnosed me with osteoporosis and referred me to the endocrinologist for a bone density test and started me on the above supplements. I went to him because I was concerned with other physicians diagnosing my discomfort as peripheral neuropathy. He examined me for that and told me I did not have that condition, but that I had osteoporosis. God Bless Him! A great physician, like you,

Answered by Dr. Dr.Arnab (1 hour later)

Brief Answer:
it's a pleasure to be of help..

Detailed Answer:
Hello XXXX, Welcome back,
Thanks for following up,

Your most welcome and it's my pleasure to guide you through this..

Yes your right, as quite clearly your Neurologist seems to have more clinical exposure.. frankly speaking, almost all of our body systems are inter-related and all symptoms and signs have some relevance behind their presentation, any good physician/specialist with critical thought process, enough clinical exposure and practical caliber can suspect them early and vice-versa (as goes the saying, "eyes can't see what the mind doesn't know ")..

You take your time, go through those articles again, if possible then get back to your Neurologist once to discuss with him also regarding Prolia, then decide accordingly..

Meanwhile please continue the Vit D3 as well as calcium and magnesium supplementation and get repeated levels (serum Calcium, Magnessium, Potassium, Vit-D3 as well as BUN and Creatinine) checked up after every 3-6 months to decide upon further dose titration and/ continuity..

For future reference you can always get in touch with me, below is my Direct follow-up link through which you can contact me directly anytime anywhere, I'll be happy to help -

http://www.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=71041

Take Care
Kind Regards

Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.

Above answer was peer-reviewed by : Dr. Arnab Banerjee