Another 10% bone loss - so talk to me about osteoporosis treatments

 Yes, my parathyroid IS enlarged, but it is 100% related to my calcium malabsorption - that I know for sure.   I just had a chat with Dr. Kemmeter about it, and he told me it will likely always stay enlarged now, and that even if I got my D and calcium absorption to effective levels, my PTH will always remain high, because of that enlargement.

Strange.  Did he explain how calcium would be at normal levels if PTH was high?  Or would they not be?

I'd assume that calcium would never be normal if PTH stayed high?

What was your last PTH/calcium?  Do you test ionized calcium now too?  Since you had mentioned that your albumin numbers tend to be a little slacky in the past, I'd think the ionized or free calcium would be more reliable.

Whatever happened to the endo you traveled to see?  Was it in Chicago or something?

So weird to not respond to the vit D supplementation though.  It's still in the 30s? 

Do you test both 25 OH and 1,25 OH?

 Kayla:

At my last set of labs (I just had 14 vials drawn at 7 a.m. this morning, so will know more soon) my serum calcium was in the normal ranges    It had previously been low, along with zinc, albumin and protein.   All of a sudden, they all popped into the normal ranges - which who knows what corrected what.    However, my PTH remains quite elevated (I think 157 was my last value) and my D was a 31.    Yeah - both D 25 OH and 1,25 OH were drawn.   This is not at all uncommon - you can have normal serum ca++ and abnormal PTH/D., because serum ca++ is like the last thing to drop.  (If I'm getting all of this correctly).    Ionized calcium, from what I recall, was normal.   What was all off, however, were my bone markers....and again, I just had all of those tested this morning.    My bone specific alk phos was off, and whatever else they drew.  Don't have my last labs in front of me, because they are sitting in my car.    I'm anxiously awaiting this new set!

The Chicago endo doc (from Northwestern University) admitted I was pushing his knowledge of calcium metabolism, and recommended me to the Detroit vitamin D specialist.   This guy also told me that "just at the end of his career someone came along to challenge his knowledge (referring to me), drew a crapload of labs, told me he'd get back to me on a course of action, then completely disappeared.    I emailed him many times, he told me he was in India and that he'd get back to me when he returned to the states, and I left four messages for him at his office. He never returned my calls either.   Maybe he got deported or something, LOL.    He's the one that wonders if I have some type of inherited vitamin D receptor problem.     My mom's D is low, but she has responded to meds.   I know nothing about my paternal side, though, because my grandma died at age 58, and they didn't do much testing of D back in those days.   Interesting, my maternal grandma died of breast cancer at only age 43, my paternal grandma died at 58 of a very rapidly advancing lung cancer.   Who KNOWS what deficient vitamin D may have played in those deaths???

 Was removal of parathyroid glands discussed?

Julie and others,

I have been on Forteo for almost two years, which is the limit allowed. The first year on it I had  increase in bone mass.

Now my calcium blood were about midrange when I started on it. I know many of you are scared of
Bisphosphonates. But with me there is a family history, steroid use long term is what the endo chewed me out for BIG TIME ! But there were other medical issues that required steroids. Endo also explained injectibles are the best for WL pts.

I just had labs drawn on Weds and do not have the results yet, but I had upped my calcium and D3 as they were trending down 3 months ago. I am also due for my next Dexa scan in early Nov. I will post my results when I get them .

The endo I have been seeing is great. He gets it with WLS and believes in being aggressive . Scores last year were dual femurs -2.6 which is a 2.2 improvement and AP spine was was -1.7 from a previous score of 1.4... I asked why one was improved and not the other and he he said it takes time, that it usually improved in the femurs before the spine from what he has seen.

So that is where I am. I now when my knee replacement was done, he said he had seen better bones on people my age before and inquired to my routine. Ortho seemed impressed, but surprised as well !
I also had bone grafts when I had my dental implants done. They have remained stable which I was scared to death about. But so far so good in that department and I can chew anything now ! WOO HOO.

Right woman Chad got me onto Vitacost's Bone Booster Complex.  It took my extremely elevated PTH and bought it back to low to normal limits within 8 weeks.....I kid you not! 

I think you should try this.  I take four tablets three times a day though if I were you I'd take four four times a day.  I would also look into doing weight training.  The resistence from weight lifting (not ***** areobics but the horrible sweaty smelly stuff) will cause ossification of depleted bone and force new formation.  Your bones essentially get stronger in response to the additonal workload placed upon them.  Start small BTW and build up until you are able to really challenge your frame.

Supplement Facts Serving Size: 6 Capsules Servings per Container: 40

	Amount Per Serving	% Daily Value
Protein (from MCHA)	1.5 g	3%**
Vitamin C (ascorbic acid)	200 mg	333%
Vitamin D3 (as cholecalciferol)	1000 IU	250%
Vitamin K	175 mcg	219%
Vitamin K1 (as phylloquinone)	100 mcg	*
Vitamin K2 (as menaquinone)(MK-7)	75 mcg	*
Folic Acid (as folacin)	400 mcg	100%
Vitamin B12 (methylcobalamin)	100 mcg	1,667%
Calcium (as MCHA)	1000 mg	100%
Magnesium (as magnesium oxide)	600 mg	150%
Phosphorus (as MCHA)	510 mg	51%
Zinc as zinc l-methionine) L-OptiZinc®	10 mg	67%
Copper (as cooper gluconate)	1 mg	50%
Manganese (as manganese citrate)	1 mg	50%
Microcrystalline Hydroxyapatite (MCHA)	4262 mg	*
Glucosamine (d-glucosamine HCl)	300 mg	*
Lycopene	5 mg	*
Boron (as boron citrate)	3 mg	*

 LOL - I'm the one that turned Chad on to that stuff - I take 3,000 mg a day of it.
Yes, it's definitely weight training time for me.   I carpool with another teacher, and we park our cars every freaking day right in front of a gym that I also have a member to....and still, I have ignored it.   We vowed that starting this week we'd bring our workout clothes with us and hit the gym three times a week.   I walked all summer, but I think I need to step it up.

So it hasn't helped?  **** it has been phenomenal for me.

Yes YOU....GYM!  Screw the aerobics bull****  5minute warm up then do a weights circuit aiming to increase your load each week in increments.  Free weights are awesome but make sure you have a clever person on hand to train you in correct posture and technique. 

Tonight I realised I've got biceps that you can see from the other side of the room....i mean my arms are still chicken wings but brawny little wings none the less. That rocks in my book!

 Yeah, this gym has the whole weight machine circuit thing going on, and there is a trainer on staff.   LOL.....brawny little wings.     I need some of those.    Maybe I'll actually even see some physical improvement to add to the bone building - like build some ass or something.

Sorry pet my arse is a flap of skin with a bumhole in it. No change despite 70kg squats on a regular basis.