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What Do The Following Bone Scan Results Indicate?

Posted on Tue, 14 Feb 2017

Question: I just got my bone scan results and discovered my ostiopenia from 2011 (2.1 Tscre) was now a 2.5 in my spine> I am 59 active (walk daily, hike etc), healthy but small frame. I just stopped talking celexa as I heard it can cause osteoporosis and started running again hoping t curb this. I take all the right vitamins. Can you give me any more advice about how I can strengthen my bones. Should I start taking estrogen again? I am a little scared of side effects of other drugs for osteoporosis....

Answered by Dr. Mirjeta Guni (28 minutes later)

Brief Answer:
About osteoporosis treatment:

Detailed Answer:
Hello and thank you for asking!

I have gone carefully through your concern!

As you described, you ideally follow the recommendations suggested to prevent the osteoporosis (calcium and VitD supplements, physical activity, stop drinking alcohol ect) at your age but the T score is high and at this point medications are needed.

Rather to start bisphosphonates or HRT (hormone replacement therapy: estrogen) i would suggest bisphosphonates as a first line of treatment.
We recommend HRT when Bisphosphonates are contrandicated, are not tolerated or if there is a lack of response.

Having into consideration the side effects of HRT (increased risks of uterine cancer, breast cancer, stroke, heart attacks, blood clots, and even mental decline) you should not be afraid of side effects of Bisphosphonates.

Even if you decide to start HRT, it will most likely be used in the lowest possible dose for the shortest amount of time and the effect is not sure.

So if you were a patient in my clinic i would strongly recommend to start Bisphosphonates as a first line therapy.

Hope the information is helpful.

Kind regards,
Dr.Mirjeta

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Mirjeta Guni (2 hours later)

Thank you, Dr. Mirjeta, for your reply and recommendations. I have made an appointment with my OBGYN next week to discuss this and will probably start a bisphosphonate (I just researched them on line). It sounds like the oral treatment is a 3-5 year time frame. Is that correct? Or will I always need meds for this condition?
I am an RN, I have always been soo healthy and active I cried when I got this diagnosis... nurses are the worst patients...lol
Appreciate your help,
XXXX

Answered by Dr. Mirjeta Guni (2 hours later)

Brief Answer:
No reason to worry;

Detailed Answer:
Hello XXXXXXX
It's a pleasure to inform you ragarding to osteoporosis treatment.
Yes, usually at least 3 years treatment is needed.
There is considerable controversy regarding the optimal duration of therapy and the length of the holiday between therapies, both of which should be based on individual assessments of risk and benefits.
It is a very common pathology at the females of your age, so there is no reason why to think negatively. It's important to treat in time and follow the above suggestions as you alredy did.

Wish you all the best
Regards,
Dr.Mirjeta

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Mirjeta Guni (32 minutes later)

Thank you. You have made me fell better about this. I so appreciate it!

Answered by Dr. Mirjeta Guni (1 hour later)

Brief Answer:
It's my pleasure!

Detailed Answer:

I am always at your disposal for any other question whenever you need!

Regards,
Dr.Mirjeta

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