Swollen esophagus/throat

Just for balance here Bebe, I have taken risedronate (Actonel) for 6 months, had no side-effects, have now moved to an injection med. for 2 years and have then to re-start risedronate or alendronate for a further 3 years. I take calcium and Vitamin D3 also.

I eat pretty well without letting it take me over and I exercise regularly but am finding anything other than brisk walking to be a bit of a struggle - but I'm trying to improve this a bit (could/would not sweat in a gym!!).

Faith made a good point by saying ' don't panic' - so hopefully you're not!  Take care - and keep in touch. J

I must differ with your statement that nothing is set in stone when it comes to the bisphosphonates and other osteoporosis drugs. These drugs have a staggeringly long half-life, meaning they do not leave your system for many years. That is what makes them especially risky and unlike most other types of drugs.

Everything is a risk. I have just come off denosumab injections (already been in the other drugs). Had osteoporosis for ten years etc etc. It's all a judgement call. Do what is right for you.

My research tells me that Prolia works by ratcheting down the message that leads to excessive osteoclast-driven bone removal and is active in the body for only six months.  As with any drug there are potentially serious side effects.  With Prolia this includes skin infections, musculoskeletal pain, urinary tract infections, including cellulitis,  among other side effects. I am fortunaye I have no side effects. 

However bisphosphonate drugs such as Fosamax (alendronate), Actonel, and Reclast  (all of which have their own potentially serious side effects) work by layering on the surface of bone and are consumed by the osteoclasts, reducing their activity and remaining in bone for a relatively long time.

If these drugs help to improve bone densiity and there are no side effects,  please explain why you consider them so risky?

I'm unclear which drugs you're referring to that have "no side effects." The "potentially serious," and, occurring often enough to raise concern, actually serious side effects, which you didn't mention, for ALL of these drugs, include osteonecrosis of the jaw and atypical femoral fracture. Also, an improvement in bone density does not necessarily translate into stronger bone. My own understanding is that the mechanism of action for all of the drugs is interference with osteoclast activity, which results in the bone becoming more dense yet more brittle, thus setting the stage for the very fractures they're intended to prevent.

I am aware of osteonecrosis of the jaw but thank you  for reminding me!.. I didn't make myself clear re "no side effects", I meant that I personally have no side effects. 

I think my main concern is whilst I agree that the drugs can interfere with osteoclast activity, what is the alternative?  Will healthy eating, exercise,  vitamins and minerals be a suitable substiutute for bone strengthening drugs?

 If only our doctors weren't led by the drug companies we might get an honest answer to this question. 

I have no idea if diet, exercise, vitamins, etc., actually help to strengthen bone. My guess is that, once the bone is osteoporotic, diet, exercise, etc., may be only marginally helpful (if at all). That said, I try and eat calcium-containing foods, occasionally take a calcium supplement, and exercise a couple times a week, as all of these measures seem to fall into the probably-can't-hurt category.

Sadly, I do not think there is yet any means for reversing osteoporosis that is both effective and reasonably safe. Others on this site consider the risks acceptable. It's a difficult individual decision.

The one somewhat reassuring thought is that osteoporosis does not, in itself, cause fractures in most people who have it, unless their osteoporosis is so severe that they fracture for virtually no reason. Fractures, at least of the hip, are generally caused by falls, and they happen regardless of whether someone is or isn't taking an osteoporosis drug.

I realize that some people have such severe osteoporosis -- as evidenced by a history of fracture -- that taking a medication may be the lesser of two evils. If I felt I was in that situation (not there yet), I might consider Forteo. However, that drug is prescribed for only two years, at which point doctors then pressure patients to "maintain gains" by taking a drug such as Prolia and Reclast. Hopefully, other, safer drugs will come into the pipeline sooner rather than later.

I have two friends (about my age, one at least is a few years older) who were both diagnosed with osteoporosis.  They both successfully through diet and exercise moved themselves into osteopenic range.  One has carried on with her healthy regimen and continues to improve, while the other has slacked off and become osteoporotic again.  It's definitely a lifelong committment.

I am doing the supplements part but not the exercise so much. I can do the pool but not much else so, hopefully, that will be enough. I will not know until next year.

I meant to add, in my post above, that people who sustain a fracture from a fall are as likely NOT to have osteoporosis as to have it. There are no studies, to my knowledge, showing that an increase in BMD from taking medication translates into prevention of fracture from a fall. The benefits, again, to my understanding, are hypothetical, with an increase in BMD being presumed -- not proved -- to prevent fracture. If anyone has a different take on this and/or studies that point to an actual (vs. presumed) benefit, please post. Possibly the meds have more effect in preventing spinal fracture than hip fracture, as the latter more typically occur in a fall. That said, I feel compelled to add (once again) that personally, I don't consider any of the osteo meds to have an acceptable risk level.

We all benefit from your research Allison whether we agree with your stance or not. Sustained research is what we need. The more people who are researching in a scholarly manner the better off we will all be! When all options are backed by scientific analysis then and only then can people make an informed decision.

I also believe that preventing a fall is the best protection we all have which makes me a bit paranoid about falling!

People stating their experiences is also helpful. I had a gut feeling about swallowing AA which seems to have been justified by other people's comments.

A good GP will say they do not know everything or have the time to research so they count on people telling them what they know and from what source.

How long did the  process take for your friends to reverse their osteoperosis and how long did it take for the one to return into the osteoperosis range?

I'll FB them and ask!  I know the younger of the two, who I think is either my age or a year or two older (I'm 68) does things like parkour, which even pre-PMR I would never have been able to consider.  She also does Nordic walking which I'm thinking of trying this spring.  

Thanks for responding. It is not possible for me to reverse my score naturally, so I take the meds with no side effects so far. If I had not suffered from 2 fractures of my vertebrae and the pain that brought,  perhaps I might not have even considered anything "artificial" but I have osteoperosis, despite doing everything the natural way for 60 years. First fracture at 47. Did not start on the meds until I was 60. This is why I am interested in what your friends did. Keep me posted please.

hi Allison, Re. use of bisphosphonates( BPs ) increasing fracture risk, which, as you rightly say, they are suupposed to prevent: This certainly may have been the case when,in the past, they were seen as 'magic pills for all of us poor dears (!) with thin bones and we were prescribed them for decades. The most recent advice (I must post about this later) is IN MOST CASES they should be taken for 3 - 4 years max. This significantly reduces  further the risk of atypical femoral fracture (AFF) - which in any event is quite rare.   J

Hi Kathleen

Yu may be interested to hear that a few months ago  I fell down the stairs (own fault - didn't trip, didn't lose balance - just looked out of window at wrong time!!). I slid gracefully -  my husband contests the use of the word gracefully here - to the bottom of the stairs.  Despite having a spine T score of -4.9 nothing was broken. Perhaps I'm just lucky but it has taught me to be more aware and to CONCENTRATE whilst going down stairs, however it shows that a fall does not necessarily result in a break - thank goodness! 

Very true. My second vertebrae was fractured when I lifted something. I did not fall. People who exercise, normally have better central core muscles, so therefore tent to have better balance and fall less. Since being diagnosed, I am more careful how I lift things.

Exactly.  But on the other hand I've heard that some of the hip fractures in the elderly are not caused by a fall, but the fall is caused by the bone breaking.  Honestly, we all need to learn a lot more about maintaining our bone health at much younger ages.  It would certainly save our health care systems a lot of money if we were all stronger, not to mention the increased well-being of older people.  If I only had known when I was twenty-five what I know now!

I heard from my friend (I don't know the other person well enough to feel comfortable just asking her out of the blue).  This is the woman who has reversed her diagnosis.  She said there were two years between the readings which showed a significant improvement.  She also says she feels the Nordic walking has done her the most good although admitting it is hard to really know.  Feels it is the strong workout when doing it properly.  Also stays away from "refined sugar and flour".  Hope that info helps.  I know I find it encouraging.  From past conversations I gather she does not take major calcium supplements, not more than you or I would be taking anyway, but I think she was the person who alerted me to research Vitamin K2.

Don't be so hard on yourself Anhaga , if you are anything like me the information we have now at our fingertips was just not available when I was 25!

Having a family history of osteoporosis I have always been aware of exercise, diet, etc to hopefully maintain good bone density. In my forties I requested a bone scan to " see how I was doing", doctor refused unless I took HRT. I refused to take it and pure pressure from work, family , ageing parents meant I just forgot about it until my sixties when I thought I'd try again for a scan. The rest is history. Mid seventies -a score of -5.2 (now -4.9). But No breaks - long may it remain so.

Unfortunately swimming is not particularly good for the bones as the water supports your weight, and it is the weight-bearing exercise that is most effective.  I read that walking downstairs is good for the bones (better than walking upstairs, which in turn helps the heart!).  Can you walk at all?  That's supposed to be the best.  I've also heard about people using a vibration plate, but I don't know if they are available at the average gym, or whether they have to be bought for home use....

I think that breaststroke is very good for strengthening  upper and lower back muscles, which in turn help the spine . . Also even walking in the pool is a resistance exercise (against the water) which is good. Agua aerobics is  pretty good to for strength training. 

Front crawl and butterfly not recommended (forward bending of the back??).  The 'feel-good' factor is great . . . . .

Well, that's good to know.  I don't care for swimming myself, so I shouldn't say anything I guess lest I mislead people.  But over and over I read that walking is the very best weight bearing exercise.  It's the bones we need to strengthen, and maybe swimming is mostly stengthening muscles?  Worth a little research will I will do later.....

Many Nuffield gyms have vibration (Power Plate) machines. The personal trainers are only too happy to instruct members in the correct use of them. The only concern I have is that some of the younger, less experienced,  personal trainers don't appear to know the difference between osteoporosis and osteoarthritis!

They are expensive to buy,  but if they help with bone strength......What price strong bones?

What I remember reading is that if people for whatever reason are unable to walk, or unable to walk enough, a vibration plate can be a reasonablyeffective subsititute.

Mary D is right. Don't be too hard on yourself. Its a, "If we knew then what me know now" situation. In my city, we are usually only scanned every 5 years, but I am being checked after 3 because my risk of falling is expected to be greater than most. This is why I persevere with the exercises. Hope to reduce the risk as much as possible. I have been listening to an American Dr who specialises in OP and low bone density and I have learned a lot of things I understood to be facts, are myths. Once I have fully studied everything he has said, I will write what I have learned. Sofar, I have found out that taking extra calcium does not help. We can only use upto a certain amount each day and the rest is excreted. So, taking more than the recomended amount, gives us no extra benefit. But it doesnt cause heart attact either. (This was thought to be the case a few years back)

I do step ups from the pool onto the steps that are out of the pool, up to one hundred. I also use dumb bells under the water for arm strength training and noodles using the legs to push down through the water to the bottom using one leg at a time. Walking is hard in the pool as you have to push through the water. I think the water is excellent because it is safe from falling.

I have other exercises I do too and you can get around the weight bearing aspect. By keeping moving in the pool it helps every part of your body.

I cannot walk far and the pool is excellent in many ways. You can get around the weight bearing exercises concern by using dumb bells and noodles and the steps which I do.

Walking can be dangerous as I know a lady who suffered a small bone fracture in the foot and the risk of falling is high for some people. 

I prefer the pool to everything because of the safety concern and the enjoyment factor.

We have a new large warm water pool designed for rehab and exercises and disabled people. 

 

Read below my response to Juno as my response to you has been moderated but I never mentioned anything specific by way of an ad!

So what I've learned is that swimming is good for the muscles, which of course helps protect the spine, but it really doesn't do anything for the actual bones, which need to be stressed in order to be stimulated to build themselves.  Walking is good because one is bearing the weight of one's own body.  Repeatedly stepping out of the pool so your weight is placed on your skeleton after being supported by water probably is good exercise.

It would be difficult to have too much calcium as four serves a day is hard enough to get in. At my age I require four serves according to my dietician and to get the fourth one if not the third as well I need a top up of one either each day or every other day.

It is great to share information on here if only it causes us to research more.

Got this off a pretty good website.

Taking into account different foods’ bioavailability of calcium, here are seven notable choices that compete with milk. You’ll find how much of each food it takes to equate to the calcium found in an 8-ounce serving of milk.

Bok choy: This Chinese leafy green vegetable would appear to be most similar to lettuce: it’s tender, light, watery, crisp and would seem to be low in nutrition density. But just 1 cup of cooked boy choy equals the same amount of calcium as an 8-ounce glass of milk.

Kale: The beloved “superfood” green vegetable boasts calcium as just one of many minerals found inside its chewy, dense leaves. In 1 ½ cups of cooked kale, you’ll get the same amount of calcium as an 8-ounce glass of milk.

Turnip greens: Turnips can be used with squash, potatoes and root veggies in winter dishes; don’t throw out their greens! Turnip greens are rich in bioavailable calcium; just 1 cup of cooked greens gives you the calcium of an 8-ounce glass of milk.

Sea vegetables: Sea vegetables seem to do only good for the body. They flush out toxins and heavy metals from our system and supply ample amounts of trace minerals. Pile your lunch bowl with a large heaping of alaria (or wakame) and kelp for a calcium boost; 4 cups of the seaweed equals the calcium of an 8-ounce glass of milk.

Tofu: Tofu isn’t as hot as it used to be with health nuts in the ‘90s, but it does still deserve credit when due. With most tofu varieties, just a ½-cup serving has the same amount of calcium as an 8-ounce glass of milk.

Dried figs: Believe it or not, these dried fruits are an excellent source of dietary calcium. Ten fruits supplies the same amount as an 8-ounce glass of milk.

Sustainable bony fish: You don’t have to be strictly vegan to do dairy-free. If you ever eat fish, check out Alaskan salmon, sardines and mackerel (all sustainable choices) for a serious calcium boost. A 3-ounce serving contains the same amount of calcium as an 8-ounce glass of milk.

Once they found we needed Vitamin K2 to properly metabolize Calcium, the cardio issues appear to have evaporated - but we do need to actually consume that K2!  I only had a scan because I asked for it.  I'm 68 and on prednisone, which can lead to bone thinning, for PMR, so I do think the doctors have been somewhat negligent.  I could have started my bone-building efforts at least after I broke my leg in 2014....

I knew about the fish and its small amount needed. However, I would only have this once or twice a week.

I know people like kale but I do not after trying it a few times. Other greens are okay though.

A cup is still a lot when cooked. I might manage a portion of that. I have that as my greens some nights in the week.

Yoghurt and cheese are good and I only have milk in my tea. 

I think that four serves are still hard to manage every single day for me anyway. I will do the top up and know that dairy is more integral to my diet.

 

Kathleen, there are so many ways to prepare kale .  We eat the fresh tender leaves in salads all summer.  In the fall I just add it to soup.  I can't imagine eating a whole cup of plain cooked kale leaves either!  But I think you'll find that the problem with too much dairy is that it can cause imbalances in some of the other minerals it contains which kind of defeats the purpose if we are consuming it for our health, so that's why it's not a good idea to rely on dairy for most of our calcium intake.  It's okay as a fairly minor part of our diet, it just shouldn't be a major player.  Some people give up daity altogether, but I like my milky tea, yoghurt, cheese and kefir too much!  But no glasses of milk for me.  Blah!  

People are now anti dairy, anti wheat, anti gluten, but my view is that unless you have an issue with it, none of them are bad! A balanced diet is best in my opinion.

I will stick with dairy as the main source of my calcium and know some is included in tinned fish and some greens but I know me and I would never have enough without dairy and a top up supplement when needed. And there are other goodies in yoghurt and cheese and even milk.

 

I know.  If we listened to everyone there wouldn't be anything left to eat!  I'm just concerned that people think dairy is the best form for us to get calcium.  Unfortunately the countries with the highest dairy consumption, like Finland, also have the highest rate of osteoporosis, but I sometimes wonder if it's because of a lack of vitamin D.  I mean - Finland!  Long sunless winters!  So who knows?  I may disagree with you about how to get calcium, but I do agree that we should all do what is best for us, and variety is best.  

Even in sunny Queensland, Australia, everyone has a vitamin D deficiency so what is going on in the environment?

I probably did have until my specialist checked it. I grew up in Queensland and was there til nearly 60 and loved the beach all my life.

I suspect we lack things now that we never used to. My father's family were all dairy farmers and they ate very basic, plain food, and lived well into their nineties.

My father could work hard into his eighties.

Perhaps I was not very clear. I meant, taking too many calcium tablets rather than taking too much dairy, kale, oily fish etc. It would be very difficuilt. Too time consuming as we would never leave the table!!!!!!!

Yes. I think most people take too little. My husband is dairy intolerant as are two of our children and it is very hard for them to get enough. My husband has calcium enriched soy and none of them would come at a cup of cooked kale or other similar green.

Grandchildren are shockers to get to eat greens but they will eat cheese, yoghurt, etc.

Our teenage grandson cannot be convinced to bank extra calcium which has been proven recently to be possible.

Studies have shown that most people especially the young ones are not having enough calcium which seems a tragedy in this day and age.

A surplus of calcium would be preferable to what is happening now. 

In Australia, we have beautiful fresh fruit and vegetables, amazing actually, yet people do not always take advantage of this.

I think it is the wisdom of age that dictates what could be happening but who listens!

 

Luckily, you husband has less risk just because, he is a man. I have heard, that teenage girls today, have much lower calcium levels, on average, than our generation had as teenagers. This is a very worring situation for their future. We tent to take things for granted. During the war, a piece of fruit was something treasured and valued. An abundance today, we see as no value. I saw a joke once. Teenagers, move out of the family home and get a job in politics, because this is the only time in your life, you will know everything.

My husband has the bones of a 30 year old. I think genetics plays a huge role in our health and everything about us. 

You are right about now that things are readily available they are not valued.

 

Jeepers Kathleen that's very impressive! Despite my musings about some types of swimming for exercise ( which my rheummy told me about )  all I do at present is brisk walking. However, I have plans . . . .