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Osteoporosis

Calcium Absorption Tests

10/06/2003

Question:

I am a 55 year old female, discontinued hormone replacement therapy 20 months ago, have scoliosis(not severe enough to wear a brace) and spondylolisthesis L5, plus my mother had osteoporosis(very low calcium intake). Recently I had my first dexa scan. Spine T-score was -2.0 and hip was 0.0.

My physician sent a letter with the results stating "If you would like to start Fosomax or Actonel to help reverse these changes, please call your pharmacy number." Not any guidance either way.

I would like to know why the large discrepancy between the hip and spine scores? I`m suspicious about the difference in these scores. Is a spine like mine more prone to osteoporisis? Can the structural problems of my spine result in an inaccurate T-score? Is medication necessary now or can I wait until my next dexascan (in 2 years?)before deciding.

I had been taking 1200-1500 mg of calcium daily but my physician suggested I take more because of nocturnal leg cramps. When asked, she said I cannot take too much calcium. I have just kept it to 1500 though. Not sure about taking more calcium than that. Are there any tests to determine if my body is absorbing calcium properly?

Would appreciate any advice you can offer. I had a terrible time with hormone replacement therapy and stuck with Premphase for 2 1/2 years before just throwing it away on my own. Much happier off of it. Resuming hormone replacement therapy is not an option.

Thanks for your time. It is greatly appreciated.

Answer:

It is not uncommon for the spine to be worse than the hip with regard to density. Scoliosis sometimes invalidates the spine reading depending on the severity. Your calcium intake sounds adequate. Remember to take only 500 mg at a time and be sure you are getting 400 IU of vitamin D somewhere, either in your multivitamin or in your calcium supplement. Without the details of your report and your scoliosis it is not possible to advise you further. You may benefit from consulting an expert in bone densitometry.

For more information:

Go to the Osteoporosis health topic, where you can:

Response by:

Margery   Gass, MD Margery Gass, MD
Formely, Professor, Clinical Obstetrics & Gynecology
College of Medicine
University of Cincinnati