Question:

I am to have it repeated next year and supplement my calcium in the meantime.

Don’t forget the Magnesium, and other elements. If I can get away w/o HRT, I’d like to, but if it helps with preventing RA osteoporosis maybe I should consider it.  Anyone got any experience with it?

If you want to consider non-medicinal ways to help bone density, then consider exercise – weight bearing, and dietary – I think I saw a report about onions increasing bone density on the www.nature.com website. — Dr G Chiu http://www.geocities.com/HotSprings/Villa/7472

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One warning about Fosomax–it caused a flare up in my OA in thumbs.  I had to wear a wrist brace on one hand and thumb on the other and go to therapy after taking it.  It happened once after I had been on Fosomax about a month.  My internist and Rheumotologist both said no that wasn’t the cause. I had stopped it–then I started back.  Exactly two weeks to the day, both thumbs were swollen and red and sore again.  Later I read somewhere that in some cases, Fosomax and affect the joints.  Just be aware.  Hope it works wonders for you. Gwen

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I am just entering menopause and have RA.

So the bone density study you got reflects the following things at this point: 1. Your genetic potential for peak bone mass and genetic contribution to osteoporosis – a big amount 2. Whether you achieved your inborn peak bone mass potential – which depends on whether you were healthy as a child and young adult, whether you ingested adequate amounts of calcium and vitamin D during your growing childhood and adolescent years, whether you were on meds such as prednisone, inhaled steroids, etc which caused increased bone loss, whether you had a reasonably average age of your first period and regular periods thereafter. 3. The effect of RA on bone – RA itself, even without steroids, is associated with decreased bone density and osteopenia. If you do nothing and proceed into menopause, you will lose bone very rapidly over the next 6 months to 1 year and more slowly therafter due to withdrawal of estrogen.. Whether you can afford to lose bone depends on how much bone you have, what the numbers are, and what other factors besides estrogen lack will be contributing to bone loss.  These include, steroids, thyroid excess, cigarettes, alcohol consumption, possibly a high protein diet, posslbe colas, other meds such as cyclosporin, anticonvulsants, heparin. My parents have severe osteoporosis.

Genetics will out.  About 70% of peak bone mass is genetics. I had a bone scan done this year to help determine if I need HRT. My back is fine but I’m a little thin in the left hip.

What are the numbers?  Did they look at a wrist as well?  I always find the wrist is a helpful study (except in severe RA where there is a lot of deformity. (This is where I have had RA flairs) It was an enigma to my health care provider who "forgot" I have RA because I am in a current remission.

Many women without RA will turn out to have unrecognized osteoporosis when a scan is done as they are entering menopause. I am to have it repeated next year and supplement my calcium in the meantime.

Not only do you need calcium but you need vitamin D to absorb it – at least 400IU per day. If I can get away w/o HRT, I’d like to, but if it helps with preventing RA osteoporosis maybe I should consider it.  

If you don’t take HRT, you will lose more bone and rapidly as your estrogen levels disappear. Whether you can afford to lose more bone is the decision you and your doc will have to make. If not, you need some kind of antiresoprtive which could be estrogen, or raloxiphene (Evista) or Fosamax, or Didronel or Calcitonin. The other thing you will need to consider is whether you want any of the other real or theoretical benefits of estrogen – helps with hot flashes, dryness of vaginal tissue, lowering of blood lipids, possible prevention of heart disease, possible prevention of Alzheimers and whether you want to risk an increased chance of breast cancer. It’s a tough decision.  Good luck. DrSusan Anyone got any experience with it? – Hide quoted text — Show quoted text – Thanks in advance. Jeri Z

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Hi, I am just entering menopause and have RA. My parents have severe osteoporosis. I had a bone scan done this year to help determine if I need HRT. My back is fine but I’m a little thin in the left hip. (This is where I have had RA flairs) It was an enigma to my health care provider who "forgot" I have RA because I am in a current remission. I am to have it repeated next year and supplement my calcium in the meantime. If I can get away w/o HRT, I’d like to, but if it helps with preventing RA osteoporosis maybe I should consider it.  Anyone got any experience with it? Thanks in advance. Jeri Z The Zezulas

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Jeri, I was just going to post about this subject because I just started Fosamax for osteoporosis. I’ve had RA for 24+ years and am in a surgically induced menopause (I’m 46 years old).  I take HRT (Climara patch).  My GYN said the patch will help my bones, without hurting the liver, since it is a patch and not a pill.  But since I’ve had RA for so long and have been on steroids off and on for many, many years, my bone density test showed decreased bone mass in my hips and femurs.  Hence, I started taking Fosamax along with 1200 mg of Calcium and 400 IU of Vitamin D. The way I found out I needed the bone density done is that I broke the 5th metacarpsal bone in my left foot just by tripping over some mulch in my garden.  My RD felt it was broken too easily and ordered the bone density.  So I’m thinking that I’ve had bone loss prior to my surgery (which was March, 1999). It’s JMO, but I would go with the HRT especially since your Bone Density has already showed some decrease in bone mass.  And maybe start on the Fosamax.  I’m taking 5 mg which is the lower of the two dosages.  It is a pain in the B— to take, many restrictions with the dosing, but if it helps my bones, it’s worth it.  I’m told if taken properly, in 3 months, I should see some improvement in bone density. I fear falling and breaking my hip. Whatever you decide to do, good luck and let me know. Donna

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