Patient: I am 35 years old, after I gave birth to a child at the age of 30 and breastfeeding for 1 year, I often had back pain at that time, went to the hospital to check the bone density loss of 20%, said heavy calcium deficiency, prescribed calcium tablets and strong bone capsules, took them to feel better, then did not review. Now I have back pain again. I went to the hospital for a double x-ray bone density test, Zsore: -22% Tsore: -22%. The doctor still wants me to take calcium supplements. I have now looked up some information on the internet and the effect of calcium supplementation is not good after the age of 35. I regret that I did not pay attention to it at that time and I am worried that the effect of simple calcium supplementation is not good and delayed. What should I do? My periods have not been normal. I had an endocrine test and my estrogen level was low and my lactogen level was high, so I had to take Mafron to get my periods normal, but they often took a few months to come when I stopped taking it. I suspect that this is the cause of my calcium deficiency. Is my condition serious? Can I just follow the doctor’s advice and take some calcium tablets and vitamin D? I am in Wuhan, if I want to see a doctor, which hospital and which doctor is better, can you suggest? I’m really anxious now, I’m so young, what can I do when I’m old? I saw some cases of fractures and immobility on the internet, and I am scared! Please help me! Liu Limin, Department of Orthopedics, Xuanwu Hospital, Capital Medical University
Patient: I went back and found the list of previous examinations. In September 06, L1-6%,L2-4%,L3-9%,L4-15%, this time L2-16%,L3-16%,L4-22%. Three years of time, so much less, how to do ah, really regret not pay attention at that time. I’m 35 now, can I still make my bone density rise?
Liu Limin, Department of Orthopedics, Beijing Xuanwu Hospital.
According to your description, you can consider the diagnosis of osteoporosis (a systemic bone disease with reduced bone mass, degraded bone structure, and reduced bone strength), but determining the diagnosis depends on the local hospital based on your X-ray and/or bone density test, blood alkaline phosphatase, and blood calcium. Treatment of osteoporosis is an old topic: non-pharmacological treatment: reasonable diet, daily calcium supplementation of 1200mg, vitamin D 400-800U, and regular and appropriate physical exercise. Drug treatment: 1. Anti-bone resorption drugs a. Alendronate (Fosamax), etc. b. Salmon calcitonin (mikacalciferol), etc. c. Raloxifene, etc. 2. Bone formation promoting drugs: Osteotriol (rocalciferol), etc. We recommend that you visit your local osteoporosis clinic for specific selection and joint application, and insist on long-term treatment.
Patient: Thank you for your answer, you have given me confidence and I feel much better! I will definitely go to the regular hospital for treatment. If I have any questions, I will come back to you for advice.
Patient: I went to the hospital and the doctor told me to take calcium supplements, 2 tablets of Diclo, 600mg per day, vitamin D was not added separately, it was in Diclo, only 200 units, one tablet of Fosamax per week, no other medicine was used. In addition, the examination of the lumbar spine has osteophytes. Is this enough, and should I also use bone-forming drugs and calcitonin? How long does it take to take the medication? How long does it take for a review? How do I know how effective the treatment is and whether I should adjust the medication?
Liu Limin, Department of Orthopedics, Xuanwu Hospital, Beijing.
It can be taken for 2-3 months first. Treatment of osteoporosis is a relatively long process, which can be relieved by long-term medication, more calcium-containing foods, and half-yearly bone density review to alleviate bone loss and the accompanying pain and discomfort.