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Osteoporosis

Taking Actonel while taking 2000mg of calcium

07/05/2006

Question:

I had a thyroidectomy and am currently taking a daily dosage of 2000 mg of calcium. Recently, I had a bone density scan indicating a problem with osteoporosis or osteopenia. My doctor suggested that I take Actonel. Would there be a problem as I am already taking a high dosage of calcium with Vitamin D? I am going to have a tooth implant in the near future. Will that present a problem with ONJ? Thanks.

Answer:

Since I do not know your age or your entire medical history, I can only recommend points to consider -

Be sure your thyroid function is normal.  Thyroid replacement that is too high can cause bone loss.

Most clinicians recommend only 1200 - 1500 mg/day of calcium.  Were your parathyroid glands removed as well?  That can affect bone metabolism.  Discuss these issues with your physician/endocrinologist.

Most clinicians recommend considering osteoporosis treatment when your T-score is -2.0

I would recommend completing your significant dental procedures prior to starting a bisphosphonate.  Most cases of ONJ have occurred in patients who had cancer and were being treated with intravenous bisphosphonates.  It has been extremely rare in healthy patients, but completing your dental work first would be prudent.

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