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Osteoporosis
 

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KerryIrons
Joined: 12 Jan 2004
Posts: 3243
Location: Midland, MI

11/19/23 5:45 PM

Osteoporosis

Do you guys remember a study and subsequent discussion from a decade ago about bone loss in endurance cyclists? At the time there were folks recommending that older men get a DEXA scan because of bone loss observed in the professional cycling ranks. The argument is that cycling, regardless of how much and how hard, does not result in weight bearing on the bones and therefore they will lose density over time. The discussion went back and forth without much of a resolution. I ignored the DEXA recommendation (as did my doctor).

After some nagging by my concerned spouse, I got the scan done and guess what? Osteoporosis. My lumbar spine is a -4.6 and my hips are -3.0. Anything less than -2.5 is osteoporosis. Seeing the doctor this week to see what the next steps are, but I'm guessing bisphosphonates for the next 5-10 years and longer if the bone density doesn't come back. I've also incorporated jumping into my daily routine as that is supposed to be the best "bone stress" exercise to maintain/strengthen bones.

If I knew then what I know now I surely would have incorporated more weight bearing exercise into my routine. That said, I do mow the lawn (with a significant hill to climb) every week, and when it rains during the warmer weather we go for 6 mile walks. But clearly whatever I have done, it missed the mark.

Have any of you been dealing with this and what has been your experience.

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Sparky
Joined: 08 Dec 2003
Posts: 19129
Location: PDX

11/19/23 6:31 PM

I forget your age...

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dan emery
Joined: 11 Jan 2004
Posts: 6910
Location: Maine

11/19/23 7:20 PM

I think one theory for bone loss in cyclists is sweat leaching calcium from bones. I donít know if this is the case.

Iíve had osteoporosis (and osteopenia in different spots) for years. I used to do weights, but havenít in quite awhile. I walk a lot (including dog twice a day) and snowshoe in the winter, fwiw. I also mow the lawn, which takes a couple hours.

My case was so complicated that the endocrinologist took it to a seminar. I had hyperparathyroidism and excess cortisol production, both of which can lead to bone loss. A few years ago I had an adrenal gland and a parathyroid gland out.

At this point I take calcium and D and have reclast infusions, and regular scans. I think the infusions have some benefit. I generally get one a year, though I had this year off. I think the situation has somewhat stabilized, weíll see on the next scan. I really donít think about it much, other than trying not to fall. As I said, I walk a lot anyway.

Obviously the causes can be multifactorial. Good luck.


Last edited by dan emery on 11/20/23 4:15 AM; edited 1 time in total

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Sparky
Joined: 08 Dec 2003
Posts: 19129
Location: PDX

11/19/23 7:59 PM

I though it was muscles taking calcium from where nature deems it less needed...


I guess a better question than "what are are you" would be, what age should we be doing this? We are a lot of 60+ cyclists after all.

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LeeW
Joined: 13 Jan 2004
Posts: 457
Location: near Baltimore, MD

11/20/23 1:19 PM

I don't recall the study you mention, but the timing is interesting (to me).

This summer, a friend gave me a gift of a Lifeline screening package that consisted of 5 different scans. I didn't have much experience with the Lifeline group, but I scheduled an appointment and had the scans performed. To my surprise, the one that raised a minor alarm, indicated a borderline Ostopenia condition and they recommended I see my PCP for a gold-standard DEXA scan. That surprised me as I still try and run (closer to a jog at this age;-) 3 to 4 miles about two times per week and also do some shorter day hikes a few times/month, as well as lifting on machines at the gym once or twice a week.

Saw my PCP in September for what we used to call a physical and showed him the prior scan results. He wrote up the prescription for the DEXA scan which I had a couple weeks later. Results came back barely borderline ostopenia with femoral necks reading -1 and -1.1, but L1-L4 showing only -0.6. The DEXA estimated a 10-yr probability 8.1% for osteoporosis.

My PCP wasn't overly concerned, but recommended daily supplementation with 5000 IU of Vitamin D3, weight-bearing exercise, and a retest in 2 years. He expounded that about everyone with osteoporosis started with ostopenia, but not everyone with ostopenia advances to osteoporosis.

I've since added seated squats to my gym routine and also 75-100 jumping jacks on a rubber mat. We'll see what develops.

Kerry, maybe you need to be pounding more hard, icy moguls😉.
BTW, what are your ski plans for the upcoming season?
My ladyfriend and I are going to be at Steamboat in late Jan with a ski club trip and then at Big Sky in late Feb.

lee

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KerryIrons
Joined: 12 Jan 2004
Posts: 3243
Location: Midland, MI

11/21/23 10:40 AM

Age: 74 I have full-blown osteoporosis with lumbar numbers in the -4 range and hip numbers in the -3 range. After I got the DEXA results my doc had a blood panel done and "normal" could not be a more accurate description of the results. Pretty much in the middle of the range for calcium, thyroid, testosterone, creatine, and a host of other numbers. I assume the doc will put me on bisphosphonates after our consult tomorrow.

And yes, I do hit the slopes hard for 20+ days of downhill skiing each year. I'll be in Steamboat January 30 through February 5, and Utah January 17 through 23. Any chance we can connect with any TTF members?

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LeeW
Joined: 13 Jan 2004
Posts: 457
Location: near Baltimore, MD

11/21/23 12:05 PM

Darn. I'll be at Steamboat Jan 20-27. Just missed the window.
I recall hooking up with you for a half dozen runs or more at Alta in Jan 2007. Parkin had to bail out due to an injury.

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Nick Payne
Joined: 10 Jan 2004
Posts: 2630
Location: Canberra, Australia

11/22/23 12:31 AM

I got a good quote about 20 years ago from my physio, who until he retired was Head of Physical Therapies at the Australian Institute of Sport - that's the main high performance academy in this country for Olympic sports. His comment on bone density and ageing and being a cyclist was: "There's no substitute for going to the gym and training with weights".

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KerryIrons
Joined: 12 Jan 2004
Posts: 3243
Location: Midland, MI

11/23/23 9:23 AM

Sorry to miss you Lee. Nothing like a few turns with "old friends."

Had the follow up appointment with the MD and he said he had never seen a case like mine. Old sedentary guys with osteoporosis, sure. Active women with osteoporosis, sure. Active old guys, never. Anyway he's going to test a few more things (parathyroid, etc.) but I'm just waiting for the pharmacy to open so I can get my Fosamax prescription. 5 years (at least) of pill popping and another DEXA scan in 2025. No news until then unless I'm not able to tolerate the bisphosphonate.

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LeeW
Joined: 13 Jan 2004
Posts: 457
Location: near Baltimore, MD

11/26/23 8:05 AM

Kerry, that's always distressing when you go in for a "wellness check" thinking you are in pretty good health and they find something looming. I guess the good news is that you haven't yet broken any bones and now you are aware of it and can take some level of corrective action. Good that your Dr is attempting to investigate what might have caused this unusual condition (blood panel for testosterone & calcium, parathyroid, etc). More weight bearing exercise should help. Did he mention anything about D3 supplementation?

Would be interesting to have a repeat of the DEXA in 6 and 12 months to see the treatments effects, but I suppose there's a period where insurance won't pay for a repeat?.

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RCoapman
Joined: 09 Feb 2005
Posts: 5179
Location: Back in the snowy homeland

11/26/23 9:06 AM

I know a person who has cycled and raced all his life who has osteoporosis. It's a real thing for cyclists. As much as I hate the idea, I'm going to have to start some sort of running (more like shuffling) program to start stressing the bones. Will try to find the balance between impact and damage to joints cuz that's also a thing in the twilight years. I've got a .6mi CX training track in my back field, can use that then the snow isn't deep to not be running on pavement.

Last edited by RCoapman on 11/27/23 6:29 AM; edited 1 time in total

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dfcas
Joined: 11 Jan 2004
Posts: 2821
Location: hillbilly heaven

11/26/23 11:00 AM

I've had a broken bone in my foot for no known reason and the dog pushed off my ribs and broke some of them. It wasnt that hard of a push. So, I assume I have osteoperosis. My doctor is trying to get me scheduled for a scan but medicare doesnt want to pay for it. Hes working on a diagnosis they will accept.

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Bob Dymond
Joined: 08 Apr 2010
Posts: 15
Location: Columbus Ohio

11/27/23 9:54 AM

The Kickbike Option

I have been riding a Kickbike for twenty years. Very few (if any) physical ailments during this time. It's gotten a few laughs and cynicism here in the past, but seems pertinent to the present situation. Might provide a nice, low-impact alternative to running, yet provide the ride that cycling gives you. Here's a clip:

https://youtu.be/Zch1oNB-nGc?si=nxhsQBai2cacDN8W

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KerryIrons
Joined: 12 Jan 2004
Posts: 3243
Location: Midland, MI

11/27/23 9:57 AM

Did a wider panel of tests (parathyroid, complete blood count, liver tests, celiac test, autoimmune checks) and nothing other than a slightly low red blood cell count which the doc says is not meaningful/relevant. Actually I have broken bones, but they have all been due to traumatic injury so they didn't raise a flag. It was my wife nagging about the broken bones that finally got me to schedule the DEXA. I will get another DEXA in a year as that is the protocol once you start bisphosphonates.

Indeed there is lots of research about low bone density in endurance cyclists and swimmers (not so much for runners as the impact triggers bone growth). I have added jumping to my daily routine as a way to get the benefits of impact/weight bearing activities. What I have found suggests that it doesn't take much jumping to be equivalent of walking. I'm doing 4 sets per day of 20 standing jumps, and from what I read that is more beneficial than 4 miles of walking. This will be a long story.

DFCAS: I would think that your doctor could easily get a DEXA scheduled under Medicare. Broken bones from something as "mild" as a your dog pushing on you should be all the doc needs to convince them that you need to be tested for osteoporosis.

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LeeW
Joined: 13 Jan 2004
Posts: 457
Location: near Baltimore, MD

11/28/23 7:15 AM

DFCAS, I'm not up on the "art" of how primary care physicians (PCP) need to manipulate the diagnose to get insurance to pay for something, but I have regular Medicare and haven't (yet?) been billed for any personal payments for the DEXA scan.

Maybe because my PCP had a (more primitive?) ultrasound of the tibial plateau that indicatited potential ostopenia, but my PCP got it through the system.

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dfcas
Joined: 11 Jan 2004
Posts: 2821
Location: hillbilly heaven

11/28/23 7:48 AM

Yes I'll talk to him about it. Hes the bass player in our band:)

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dan emery
Joined: 11 Jan 2004
Posts: 6910
Location: Maine

3/18/24 12:59 PM

data point

Just had a DEXA scan and my hip went from -2.5 in 2021 to -2.2 now. I take Ca and D
and have had a couple Reclast infusions.

Moving in the right direction at least.....

I'm trying to set a record for scans. Recently had contrast scans of head and chest, nuclear stress test, Zioplast heart monitor, DEXA Scan, have contrast CT of aorta coming up (scheduled at least).

Other than the DEXA and aorta (aneurysm) scans, the tests are because I fell twice walking the dog a few weeks ago - so far they show no problem so it remains a mystery,

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Sparky
Joined: 08 Dec 2003
Posts: 19129
Location: PDX

3/18/24 4:03 PM

I guess so far I am lucky. My dilation/aneurysm is the Aortic root. Lucky, unless/until it grows and the valve can't close properly. But not the aortic wall like an ascending aneurysm. 5 years of Echo Cardiograms later with no changes, you gotta wonder. I have quit the gulping air highest heart rate assents, more harm that good in it at this point.

These hearts in these chests been doing double duty for decades with probably higher HRs than is good for us ultimately. But the other benefits that came with it are evident.

When you have friends close in age that take 15-20 seconds to get on their feet outta the lazy boy... And cycling keeps you +10 years more ambulatory/active, it sure seems good.

A friend eating Chile dogs while I was having a cob salad once told me this: Jack said if I subtract all the time riding and exercising from how many years it may add, it will be a bust. Jack was 300ish lb., and we wanted to take a certain small plane out. But our combined weights would have allowed only enough fuel for 20 minute trip within safe guidelines. I was 190lb then. But I think of Jack saying that for some reason. And I have not been 190 since I was 43ish. ;) He went to Costa-Rico to retire soon after. The plane was one he bought and moved down. His house was an island and you needed a boat or plane to get home. Not a boat guy. ;)

It was an Air & Space 18A late 60s gyro-plane. I really wanted to fly in it. The rotor is the not fixed wing. You could land it in 50-60' he told me. Across even smaller runways pretty much. It was a small island. ;)

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