Osteoporosis

Greetings!  I had RNY surgery back in Dec 2003.  Was diagnosed with Osteopenia in 2005 and got tested every two years after that; tested positive for Osteoporosis this year!  I have always taken calcium supplements and even started BioIdentical Hormone Replacement Therapy (in 2011) to keep my estrogen levels normal and to prevent bone loss.  I was just advised that taking the HRT via transdermal cream and not pill form does not allow my bones to absorb the estrogen!  So, I was wondering if there are any Endocrinologists in the Lehigh Valley that deal with osteoporosis in bypass patients as for what we need (dosage) is much different from a patient with a normal digestive tract.  

Hi Sue

Can you give your surgeon's office a call and see if they can recommend an Endocrinologists?  Try posting this on the Roux-en-Y Gastric Bypass Surgery Forum (RNY) and hopefully someone will be from your area that may be able to assist you.

Try calling your local office and ask to speak to someone in their bariatric department and see if they can recommend someone for you.  Keep us posted on how you are doing...

Thanks, Kathy - I was planning on contacting the surgeon's office today but thought (while I was thinking about it last night!) that I'd post here to see if I got any replies.  I've had trouble with primary care docs and labwork - what THEY think is normal is not always normal for WLS patients; therefore, if I see and Endo I want to make sure he treats ME for what I need.

You are very wise.....  If they are not educated in WLS they can misdiagnose you.  Don't laugh, but I was in the ER once and they thought I had liver cancer due to the high white blood count.  When I saw my surgeon the next time I shared the episode with him and he laughed and asked me one question.  Did I have any wine that evening and I said yes and he said there you go.  With RNY patients, wine can shoot our white blood count sky high.  Yes, we need to stay within the WLS community.  I think your surgeon will be your best bet.

Keep me posted on how it goes.  I am taking Prolia shots and waiting for my next Dexa scan to see if they are helping.  Good luck to you

Can't help you with the endo, but I have a couple of questions. DO you take calcium citrate? How about dry vitamin D? What's your D level and your PTH?

I too had surgery in 2003, and my surgeon did NOT ever explain to me how calcium, D, and magnesium work together. I was taking huge amounts of calcium, but no D---so I wasn't absorbing much of the calcium, as evidenced by my sky-high PTH.

Yes, I take Calcium and D, among other supplements:

•          Absorbable Calcium (1200mg) PLUS Vitamin D3 (1000 IU); 1 softgel, twice daily

•          Vitamin D3, 5000 IU; 1 softgel, twice daily   I've never heard of dry VitD - what are the advantages?

I also quit taking Prilosec (which robs the bones of calcium) and switched to decaf coffee; I don't drink sodas.  I also drank wine, every night, for years - now I only have an occasional alcoholic beverage.  I have labwork done 2-3 times a year and my results always fall within the "normal" range.  I was diagnosed with hypothyroidism, back in 1983, and was on Synthroid for years, until it stopped working; I now take BioIdentical T3/T4 to support my non-functioning thyroid.  I don't think I've ever had my PTH tested; doesn't appear in my CBC or Chem Panel; is that a test you have to specifically ask for?  

Is the calcium you are taking calcium citrate, though, or is it calcium carbonate or some other kind that we don't absorb well? Our altered anatomy after RNY doesn't allow us to absorb other types of calcium very well. 

The Vit D that you are taking in the soft-gel is likely not getting completely absorbed because it is an oil, and with your RNY you likely still malabsorb some amount of fats.  They have dry Vit D capsules that don't have that issue.

Yes, you may have to specifically ask for your PTH to be tested. The problem is that the serum calcium level tells you nothing other than that IF you aren't getting enough calcium from food and supplements, your body is doing a good job of pulling it from your bones (since your heart needs it).  The PTH level will help you identify whether or not the body is pulling the calcium from your bones.

Lora

I had my surgery in 2001 and I had never heard of "dry Vit D".  That was an eye opener since I too now have osteopenia and will look for the dry vitamin D.  I also tend to be anemic and have had infusions before.  Thanks