osteopenia - osteoporosis due to lack of androgens

[Axl]

Bad news...
I just heared I have osteopenia. This is a stage between healthy bone tissue and osteoporosis. My score was -1,1. A score between -1 and -2,5 is osteoponia and a score less than -2,5 is osteoporosis.

The worrying part is that osteoponia-scores are average standard deviations compared to a healthy (female?) of 30 years of age... This means that at my age (33), I now have the bones of a 60-year old male...at this speed I will have osteoporosis at 45... (Actually, the same is true for my testosterone levels: I have the Testosterone-levels of a 60year old male, even with 250 mgs of T enanthate every 10 days...I have been hypogonadal all my life)

http://www.health.harvard.edu/newswe...weak_bones.htm

My questions:
1. Does anybody have experience in what I can do to prevent this condition from getting worse? I have found a lot of information on the prevention of osteoporosis (mainly focused on women), but no info whatsoever on osteopenia and hypogonadal males.
2. I'm seeing my doc next month. What questions can I ask or what suggestions can I make to adapt my current treatment scheme?

Regards,
Axl

[pmgamer18]

Originally Posted by Axl

Bad news...
I just heared I have osteopenia. This is a stage between healthy bone tissue and osteoporosis. My score was -1,1. A score between -1 and -2,5 is osteoponia and a score less than -2,5 is osteoporosis.

The worrying part is that osteoponia-scores are average standard deviations compared to a healthy (female?) of 30 years of age... This means that at my age (33), I now have the bones of a 60-year old male...at this speed I will have osteoporosis at 45... (Actually, the same is true for my testosterone levels: I have the Testosterone-levels of a 60year old male, even with 250 mgs of T enanthate every 10 days...I have been hypogonadal all my life)

http://www.health.harvard.edu/newswe...weak_bones.htm

My questions:
1. Does anybody have experience in what I can do to prevent this condition from getting worse? I have found a lot of information on the prevention of osteoporosis (mainly focused on women), but no info whatsoever on osteopenia and hypogonadal males.
2. I'm seeing my doc next month. What questions can I ask or what suggestions can I make to adapt my current treatment scheme?

Regards,
Axl

We have a guy a lawyer that sneezed and broke 3 ribs this is how he found out he has low T. Going on TRT his bone tests after a yr. are back up and he is 63. Form what I know all he did was go on TRT and keep his E2 down.

[cpeil2]

Adequate levels of estrogen and progesterone (yes, in men) are also important for maintaining bone health. With moderate osteopenia, it may be early for you to be thinking about it, but there are a couple of new agents (e.g. recombinant parathyroid hormone) that actually reverse bone loss. Hgh will also reverse bone loss.

[HeadDoc]

here's a good review on the topics. Look for a good supplement package with calcium and D3. Dhea and TRT are also useful as noted.

http://www.lef.org/protocols/prtcl-085.shtml

[cpeil2]

How did your doc document the bone loss. The most reliable tests are a DEXA scan and/or urinary N-telopeptide. The urinary test is fairly well-known in Europe, but American physicians tend not to know much about it.

[Axl]

Originally Posted by cpeil2

How did your doc document the bone loss. The most reliable tests are a DEXA scan and/or urinary N-telopeptide. The urinary test is fairly well-known in Europe, but American physicians tend not to know much about it.

I had a DEXAscan done. My T-score was -1,1. (T-score is the number of standard deviation a person is above or below the bone density of an average 30-yr old).

Actually my dentist noticed it before when I had my teeth RX-ed. He noticed that I had osteopenia in my jawbone. Immediately, I knew I had to ask my doc for a DEXA-scan...

[Axl]

Originally Posted by cpeil2

Adequate levels of estrogen and progesterone (yes, in men) are also important for maintaining bone health. With moderate osteopenia, it may be early for you to be thinking about it, but there are a couple of new agents (e.g. recombinant parathyroid hormone) that actually reverse bone loss. Hgh will also reverse bone loss.

I know I'm "lowish" on IGF-1 and HGH. I had it once tested with an ITT (insuline tolerance test). I was too low (out of reference range), but not low enough to get reimbursed medical care. As for the parathyroid hormone: what hormones should be checked to asses this? TSH, T3,..?

[cpeil2]

Originally Posted by Axl

I know I'm "lowish" on IGF-1 and HGH. I had it once tested with an ITT (insuline tolerance test). I was too low (out of reference range), but not low enough to get reimbursed medical care. As for the parathyroid hormone: what hormones should be checked to asses this? TSH, T3,..?

Don't know about further testing. The recombinant parathyroid hormone has been around for three or four years - the trade name in the US is FORTEO. I think they only use it for severe osteoporosis. It costs big (around $12K for a year's worth) and it's given by infusion.

I saw something else recently, an oral medication that reverses bones mineral loss, but can't remember the name of it. It was brand new.


The bisphosphonates (drugs like FOSAMAX) can retard bone loss, maybe halt it's progression, but they don't help with reversing bone loss once it occurs.

With moderate osteopenia like yours, I don't think you would find a doc who wanted to start any kind of treatment. As Headdoc recommended, you need a calcium supplement and extra vit D - a double dose. And of course, you have to do whatever you can to maintain healthy levels of T, E and progesterone.

For monitoring, the urinary n-telopeptide is better than the DEXA scan. It will reveal changes in the rate of bone turnover much faster than than the DEXA scan can.

I found all of this stuff out when I took one of those ultrasound screening tests, the kind they give in church basements for twenty or thirty bucks. It showed I had a T score of -1.1. I then had a DEXA scan, which showed that I had a T score of 2!! Go figure.

[jboldman]

it would be nice to know what your test levels are and dhea. supplemental dhea can raise your estrogen enough to impact your bone loss.

jb

[cpeil2]

Originally Posted by jboldman

it would be nice to know what your test levels are and dhea. supplemental dhea can raise your estrogen enough to impact your bone loss.

jb

And what a simple solution!

[Axl]

Originally Posted by jboldman

it would be nice to know what your test levels are and dhea. supplemental dhea can raise your estrogen enough to impact your bone loss.

jb

My DHEA-S tests have always been around 350 ng/ml,"too high" according to my doc. (ref range 120 - 520).

My test levels before TRT were always arond 220 ng/dl (ref range 317-800). I have been on TRT for 1 year now , and my T levels (day prior to my next shot) went up from 260 ng/dl over 410 ng/dl to 557 ng/dl over the past year. I'm 33 yrs.

I get 250 mgs testosterone enanthate every 10 days plus 0,25 mgs Adex every 3 days. My E2 is nicely in check around 25 ng/dl (10-50).

Should the DHEA raise mt total estrogen or my estradiol? If it's the latter, I could just stop taking Adex. But I suppose I would ba at risk for gynecomastia...

[Axl]

bump

[jboldman]

did you start taking arimidex because of increased estrogen levels? I would get my estrogen levels checked. do have reason to think that you are gyno prone?

jb

[Axl]

Originally Posted by jboldman

did you start taking arimidex because of increased estrogen levels? I would get my estrogen levels checked. do have reason to think that you are gyno prone?

jb

Do I have a reason to think I'm gyno prone??? Yes I have: I was diagnosed by various doctors, who told me I had "pseudo-gynecomastia"...That was before I started TRT.

Personally, I think the "pseudo" is a bit ridiculous: either you have tits or you don't...No body has "pseudo-tits"...

I started taking Adex because my E2 was a bit too high . Now it is in the reference range.

[cpeil2]

Originally Posted by Axl

Personally, I think the "pseudo" is a bit ridiculous: either you have tits or you don't...No body has "pseudo-tits"...

"Pseudo" meaning you accumulate pectoral fat, but have no nodules or nipple swelling?