Bone Loss (Also posted in Nutrition Forum)

I did a bone density scan two years ago (six months after my surgery) and I was fine. I just did another one today, and I show significant bone loss. Anybody else out there who's encountered this problem? I take about 2000 mg of calcium supplements a day, with three different types of vitamins to hedge my bets (or so I thought). I am so bummed...

Pam

Hi, Pam! I have many questions... How are your labs regarding calcium, PTH (parathyroid hormone) and vitamin D?   Do you take supplemental D?  If so, is it in Dry form (not an oil filled capsule)?   You want your vitamin D level up over 60-70+.  (High is over 150 so there is plenty of space there). How often do you take calcium and in what doses?  What do you take it with?  What form of calcium? Not sure what the "three different types of vitamins" means regarding calcium. Do you know your scores from your bone density scan? Good luck, Kathy

Kathy, I just had labs done last week and everything was in the normal range. D was 40, which was low normal. I take Optisource chewable multi-vitamins four times a day. Those have 250 mg of calcium each. I also take a Citrical Creamy Bite, with 500 mg, each morning and a dry capsule with another 500 mg of calcium citrate in the evening. All of them also have D and magnesium. For D3, I take a 1000 mg sub-lingual tablet each morning and a 5000 mg dry capsule every other day. I haven't got a copy of the bone density scan yet, but my nurse practioner was concerned enough with the preliminary results to call me at work. She'll send it off to specialists and to an endocrinologist. I have a mass on my thryroid, but it was biopsied last summer and it's benign. Thryroid function tests at that time were normal.  Sorry - I sound like I'm babbling. Have you had problems with bone loss? I know there is medication for osteoporosis, but is it effective for gastric bypass patients? Anyone out there who currently takes something who might know? I appreciate any advice you have to give. Thanks.

I've had some bone density loss but I had a tumor on my parathyroid prior to WLS and that was causing issues so it's hard to chalk it up to the WLS alone.  The tumor has since been removed (along with half a thyroid due to a benign growth - a "while we are in there" situation). I have been working to get my D level up my D was in the 20s for quite a while before the newer levels came out and I was told it had to be higher.  At last check, it was 50ish.  I take about 2000 mg of dry D a day plus what is in my calcium supplements (UpCal D powder).  I'm taking 3000 mg of calcium in 500 mg doses.  Hopefully that will keep things in a decent place.  I get labs in May again for my 3 year post-op.  Should also get another density scan.  I'll take the same as last year! I have heard of treatments for osteo being used by folks who have undergone WLS.  Not sure of the results but I think it is a time-will-tell thing.  But be sure, if you speak to the doctor about this you are informed about necrosis of the jaw from the biphosphonates.  I know someone on another WLS list that has this issue.  Not sure if she was taking the anti-osteo drugs prior to WLS or not but she has lost jaw bone and it's causing lots of problems. Kathy

Thanks, Kathy. I had heard about the possible necrosis of the jaw bone that some of these drugs can cause, too. That certainly makes me a bit leery about taking any of them. I know my nurse practioner wants me to go back and see the endocrinologist I saw last year and see if there are changes in my thyroid that might be causing problems. I'm just glad that I found this website before I had my surgery because my surgeon has never said anything about doing bone density scans - I learned about them from postings on OH. He's a great surgeon, but has provided no nutritional or exercise information after the surgery. I've had to learn how to do things from reading books and from the good people of OH. Good luck on your scan and labs.  Pam

Not to diss a particular vitamin, but the Optisource stuff?   I tossed it.  It has our iron, calcium and D all together in one vitamin all fighting for that little bit of intrinsic factor we have left.  My labs were GREAT until I switched to these vitamins.  Now I have a problem with iron, D and calcium.  My B12 however is through the roof.  Have you seen how much B12 they have?   I also supplement Calcium, but I think the Optisource sh*t needs to be trashed for a good multi.  JMHO

Kathy, So what do you take for a multi-vitamin? My iron has been fine, but I do supplement slightly with 25 mg of Gentle Iron four days a week. Everything else has been good, too, except for the D and calcium. What is your vitamin routine now? Thanks, Pam

Pam I had dexcan last Sept and I have significant bone loss in my spine and hip. I do have osteoporosis. I have no pain or problems from this and I am 58. I always have a backache  since I was 16 and 3 herniated disks so I thought everyone had backaches. My primary gave me a script for once a month Boniva. Well I called my bariatric surgeon to find out if we can take it since its slow acting for one month and his reply was it shouldn't hurt you "if you want to take this". I heard the tone and decided I needed to research this before I took it. I read many studies and forums  I found online that did not show any significant improvement and then I find out its not on the market 5 yrs so there is only 3 yr studies., I am not a guinea pig and I don't take meds that are not studied at least 5 yrs. The more I read the more I thought I can up my D3 to 5000 & more if needed and Calcium(2000) w/Magnesium and skip the Boniva. When I get my next scan we will see. Not to alarm you but everyday I get alerts and updates from Medcape and FDA, its for caregivers and there was a warning last week that patients taking bisphosphonates are expriencing much more pain during treatment and there is no evidence the treatment works and more evidence its a failure. I was happy with my decision not to take it. Also mention was all the other brand not just Boniva so let your fingers do the clicking ands you decide what is best for you. I also have a hypothyroid and I am on Levothroid. This med does a number on bones also but if I am 58 feel better than I did at 38, I can handle osteoporosis.

Mirabelle, Thanks for the information. I'm kind of leery about the drugs they use for osteoporosis, also. I guess that I'll up my D and calcium for now and see how things proceed from here. My nurse practioner wants me to do some kind of urine test for calcium and then go to the endocrinologist to see if my thyroid is part of the problem. Otherwise, like you I feel great. Good luck to you! Pam

Aww...Sorry to hear this...I need to get the bone density test myself and you just reminded me to ask my doc...She was the one *****commended it and forgot to order me one!  I don't know anything about bone loss...but somehow I have a feeling I'll be reading up on this subject too :(   Thanks for the post though...Wish I had something to add...but you are the one who just helped me!  LOL Hugs and good luck Anita