Severely dropping bone density since RNY

Hi folks!

I am 2 years post-RNY. I am faithful in taking my vitamins, including 2 multis and 1200-1500 g of extra calcium a day (or patches for both). I have a family history of osteo so as I've had Dexa scans over the last year and a half, I've been watching my bone density like a hawk.

My initial bone density in 11/17 was at the high end of excellent. I had my 4th Dexa last week, and while my bone density is still not problematic, it is dropping FAST -- 2.3%, 3.9% & 2.6%. I've also added in extra Zinc and Vit K, which are supposed to help with calcium absorption, but any more suggestions on what may help would be GREATLY appreciated.

I also do weight bearing exercise in the form of walk & running & strength training 2-3 times a week. Still dropping though...argh!

When I asked my surgeon about it last week, he just said to take my vitamins and not to worry until I had "symptoms". I am NOT going to wait to do something until I have a broken hip or vertebrae like my grandmother did! Not sure what else to do.

Thanks for your thoughts!

sounds like you're doing everything that you can do on your end to control it. I'm wondering if it might start leveling off -- just keep monitoring it and see.

I discovered two years after surgery (via a DEXA scan) that I had osteoporosis in my spine and osteopenia in my hip. Like you, osteoporosis runs rampant in my family, and since I didn't have a scan prior to RNY, I have no idea if it was already there or if it was a "side effect" of RNY. At any rate, they started me on a biophosphonate a year ago (my bariatric surgeon said an oral one - like Fosamax - should be OK, but my PCP insisted on an infusion since she was worried that Fosamax would be too hard on my altered stomach. So we went with that - it sounded a bit safer to me, since my mom was on Fosamax for awhile, and it was hell on her stomach (she switched over to infusions)). It doesn't sound like you're at that level yet, though. Just keep doing what you're doing, because that's about all you can do...

Thanks! I was just really pissed with my surgeon (not a new thing!) that he brushed it off so quickly and made no other suggestions related to it. I just refuse to wait until I become immobilized by bone shattering like my grandmother did. If there is something else that I can try, I'd like to.

i think we tend to have denser bones than normal to start as carrying around extra weight is 24/7 weight bearing exercise.

As I have had multiple Dexa too... I did have a drop and then it leveled off. May just be our bodies way of adjusting to new requirements- our bones don't need to be as dense.

Certainly keep watching it. For now that is probably all you can do.

What are your PTH levels? My PTH is off which caused my surgeon to order a bone density scan which shows I have premature osteopenia. They, by some miracle have had success in getting insurance to pay for another bone scan which showed an additional loss of 5% in my hip. My spine is still holding steady. Anyway, they're now tracking closely my PTH numbers and are considering an ultrasound/CT to see if I have a tumor on my Parathyroid.

If your PTH is off, you may be leeching calcium from your bones to compensate for the PTH levels.

Thanks for the info. I need to schedule an appointment with my PCP and have her include in my labs a PTH test.

I wanted to add on to what Stacy said, your PTH test results you want a LOWER number, not a higher number. Higher the number you are leaching more calcium from your bones, lower the number less is leaching.

Unlike our Ferrtin numbers (which you want high) and most other labs which we generally want higher than lower PTH is the one odd one you want lower.

I think you are doing everything right. Its my personal belief that our bodies are still adjusting to all the changes we have thrown at it up to year 3 even if you are vitamin compliant. And again this is just my personal story but I have been vitamin compliant since day one, and the first 3 yrs my labs changed a lot up and down (I track them religiously in excel) and yet in the last 18 months my labs have been steady and I have not changed anything, still on the patches and oral B12.

I recently added in oral magnesium on the recommendation of my Neurologist to help with my migraines, otherwise its just the patches I use and oral B12.

Good luck!

Try taking collagen. I get a powder and put it in my coffee. I order it off of Amazon from a company called Zammex. It really helps with my arthritis and it is supposed to be good for bone and joint health.

Prolia shots saved me..... I had lost 17% in my first year and freaked out. I had a great PCP and she started me on Prolia every 6 months and it has slowed the loss and I have a little bit of an increase. Talk to your surgeon about it and see if it works for you.

I'll check on that. Thanks!