A friend has osteopenia (low bone density) said to be the result of a drug she’s been taking for several years but will soon stop. I’m hopeful this will resolve once she’s off the drug, and furthermore gets specific treatment. In fact I had borderline osteoporosis years ago due to a different drug which resolved once I took much less of it (I also did Fosamax for quite a while).
Is my hopefulness reasonable?
What I read about osteopenia and osteoporosis sounds like it is quite difficult to reverse, but the references I found all describe disease caused by the changing body, not by some external drug side effect that might be stopped. In other words, I understood they were addressing causes that are difficult to reverse, whereas I’m interested in when the cause is completely reversible.
My full-blown osteoporosis (lumbar T-score of -3.5) was reversed, once we found the right treatment. My free and total testosterone were inconsistent (I’m male), so it took my doctors awhile to decide to supplement.
My endocrinologist says my reversal is unprecedented but, as you say, mine was a case of my body working against me. I think there’s reason for hope for your friend, once they stop taking the drug.
Once full osteoporosis develops, it’s harder, because the trabecular network of bone starts to break down, so even if the body starts to generate bone again, it may not reform the light and resilient structure of healthy bone. This isn’t nearly as much a concern with osteopenia.
It may also depend on how the drug causes it. Does it reduce the body’s absorption of calcium and/or vitamin D, effectively making them identical to someone with deficiencies? Or does it have another mechanism?
I don’t know the answer to your question, but I’m curious as to which drug was involved.
Gabapentin (and several related drugs) is getting some press about causing this side effect. I’m not using it, but it IS one common treatment for one condition I have.
For me it was Prednisone. For her, I don’t remember the name of the drug, but it is a drug intended to make recurrence of cancer less likely, and it’s normally only taken for several years. She’s nearing the end of the normal treatment period but perhaps they’ll stop the drug sooner on the basis that it is having such a significant side effect.
Not happy here. It made me jittery and weirdly aggressive, most uncharacteristic of me. I’ve been on as high as 200 mg/day for just a day or two, for medical procedures requiring iodine radiopaque dye which I have a bad reaction to. I guess they know what they’re doing, but it’s a bad feeling.
Ah, prednisone! The medicine that cures everything as it causes everything.
Most drug induced osteopenia isn’t real reversible tho there’s some success with certain drugs that put bone back. But don’t assume one can reverse the process of bone loss readily or easily.
But note that Fosamax and related bone-building drugs sometimes produce their own horror stories. (I’ll leave googling it to the intrepid motivated reader.)
But even aside from the horror stories, there are reports that bisphosphonates (Fosamax and related drugs) just don’t work well. They may help re-build bone, but the re-built bone is said to be brittle and easily fractured. (This, too, is readily googleable.)
Speaking of the osteoporosis drugs: An orthopedist told me quite recently that if I’d been taking them, he’d have advised me to stop until my busted foot had completely healed.
Which is counterintuitive. but I have to trust that he knows what he’s talking about in this situation.
Luckily, I’m NOT on any of those drugs - one of the few benefits of being so overweight is a reduced risk of osteoporosis.