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[Peacegirl]

I ask because when someone was criticising me for taking hrt the other day, and I mentioned aching skeletal frame/bones she said 'why don't you just make sure you get enough calcium?

I am still struggling with getting post-meno HRT right, so am now thinking about coming off it all at some point as all I seem to get are side-effects. I do still want to make sure I protect my bones though so will calcium and vit d do the trick?

[Taz2]

Hi Peacegirl - how rude of someone to criticise you for taking HRT!

Have your calcium and vitamin D levels been shown to be low?

Taz x

[Peacegirl]

I'd ask your gp to check your levels of vit d and calcium to get a baseline and take it from there.

S x

Hi thanks, no it's all fine, Ive been tested but bone aching is one of my symptoms and I am deemed at risk (genetically) of osteoporosis but started taking hrt early. I now want to stop as I just feel awful nearly all the time (won't go into the boring details as even I'm bored with it now)

So what I read about calcium/vit d as prevention (not as treatment) isn't correct then

Hasty - sorry to hear you have osteoporosis - how do you manage it now?

[dazned]

Maybe the best thing is to discuss your concerns with your gp. There's not much point in protecting your bones of the rest of your life is miserable,IMHO 
Are there any other HRT options you could try for example,or have you exhausted them all ?
Hope you can find an answer soon.

[Peacegirl]

PG - Adcal tabs oh and Evorel conti patches.
I've stepped up weight bearing excercise but it's a problem given I have MS and my balance is awful.
The OP was only found after I broke my fibula following a trivial stumble on a carpeted floor.

PG if you really son't want to use HRT for goodness sake up your calcium intake in your diet and your weight bearing exercise. Hope all goes well for you.

Ahh ok, yes I hear that op often only gets found out by accident through a trivial fall of some sort. It must be hard coping with that and ms?
I've googled and googled away but can't find anything which compares calcium, vit d etc with estrogen got bone protection. Thanks got the advice re weight- bearing. I could probably do more!

Darned, thanks, yes have discussed with gp/ meno expert etc etc but getting the hrt right these past two years and all that goes with thst is beginning to exasperate me. I mean hrt is great for do many and has been for me up to a point. But mu question still remains 'why take estrogen if calcium can do the same job?'. I've been google scholar searching to try and learn more.

[Dancinggirl]

I've abandoned HRT because side effects were too much. I'm 61 now.
I have aching joints and a bulging disk in my lower spine etc. - I'm an ex dancer so expected joint problems.
Brisk walking eases my aches really well. I try not to sit for too long.
I have taken omega 3 for years - really good for joints and heart etc.
I do take vit d, calcium and magnesium tablets daily, just in case, as my digestive system is causing problems these days, so my diet and food absorption is not so good these days.
Have you had a dexa scan? This will show whether you do have bone loss.
Keep moving. DG x

[Peacegirl]

I've abandoned HRT because side effects were too much. I'm 61 now.
I have aching joints and a bulging disk in my lower spine etc. - I'm an ex dancer so expected joint problems.
Brisk walking eases my aches really well. I try not to sit for too long.
I have taken omega 3 for years - really good for joints and heart etc.
I do take vit d, calcium and magnesium tablets daily, just in case, as my digestive system is causing problems these days, so my diet and food absorption is not so good these days.
Have you had a dexa scan? This will show whether you do have bone loss.
Keep moving. DG x

Yes keep moving even when you feel shit lol! I'm not particularly worried about my joints/bones it was just when someone asks why I didn't just take calcium etc instead of hrt, I realised I don't know why do wondered if you can get the same bone protection via good diet, exercise and supplements.

[greenECLECtus28]

I don't think upping calcium and Vit D would do the trick as as I understand it your body will just remove any excess and you possibly may potentially cause more issues by overdosing, my mum had Osteoporosis and she was given a drug called Fosamax if I remember correctly but she was only given this drug after she had a scan to confirm she had osteoporosis. Normally the advice is what's been given before which is a good diet making sure you get the recommended daily intake of calcium and vitamin D and if possible do as much excersise as you can as weight bearing is good for bones. If you are at risk or you feel you may be at risk you can have a bone density test to check your GP can organise this 

Take care

[Hurdity]

Bone loss increases with age but with women particularly fast after the menopause due to oestrogen decline and therefore only oestrogen can help prevent this rapid decline. Sufficient calcium and vitamin D are also needed but won't work in isolation although one bit of information says that in elderly women (not sure of the age) the supplements alone can help.

I haven't looked for anything academic - just information on this website and NHS website which I will reproduce below for anyone who want to read - apologies if this is what you've done already as this is what is most easily available.

As sparkle says you only might need to take supplements rather than ensuring you get sufficient in your diet if you have known absorption problems and specifically I think taking ?proton-pump inhibitors, as well as some specfic diseases of the gut?

Here's the info:

About osteoporosis:

https://www.menopausematters.co.uk/osteoporosis.php

The most important long-term effect of reduced estrogen involves the effects on the skeleton. With age and reduced estrogen levels, particularly when the menopause occurs before the age of 45, there is an increased risk of progressive loss of bone strength leading to bone thinning and fragility (osteoporosis).

Treating osteoporosis:

https://www.menopausematters.co.uk/osteoporosistreatment.php

This section of the website lists other treatments for osteoporosis - especially important for those who cannot take HRT due to age or medical reasons - but I've just extracted the bit about HRT.

HRT reduces the breakdown of bone while being taken and has been shown to conserve bone mass and reduce the risk of fracture. It is particularly appropriate for bone protection in women who have an early or premature menopause, when it is generally recommended to continue HRT until the average age of the menopause. For older women who may have, or are thought to be at risk of osteoporosis, HRT would be helpful if they also suffered from menopausal symptoms since none of the other treatments for osteoporosis control menopausal symptoms. If HRT is stopped, bone loss then resumes so if HRT has been taken for bone protection, either bone density measurement or other treatment should then be considered.

Calcium and Vitamin D should be considered along with any treatment for osteoporosis. Supplements are recommended in frail, elderly who have other risk factors for osteoporosis as a preventive treatment (since high doses of calcium and vitamin D have been shown to reduce bone loss in elderly postmenopausal women), in addition to treatment for osteoporosis if aged over 70 years and in addition to treatment for osteoporosis if aged under 70 years and diet is insufficient. When calcium and vitamin D supplements are taken in addition to a weekly bisphosphonate therapy, the supplements should not be taken on the day of the bisphosphonate.

Benefits of HRT

https://www.menopausematters.co.uk/benefit.php

Osteoporosis

Systemic HRT has also been shown to be beneficial for treatment and prevention of osteoporosis for women who have, or are thought to be at risk of osteoporosis. Many studies have shown some improvements and prevention in decrease in bone density with HRT and the Women's Health Initiative study showed a significant decrease in osteoporotic fracture with HRT use. Since several other very effective treatments for osteoporosis are now available, HRT is not currently viewed as the first line treatment for osteoporosis but is useful if a woman has osteoporosis, or is thought to be at risk, and also has menopausal symptoms, and is the recommended preventive treatment for women with an early or premature menopause. If HRT is taken for osteoporosis treatment or prevention, then long term (5 to 10 years) treatment may be advised and then either bone density measurement or using other bone protective treatment should be considered. The dose of HRT for bone protection should be that containing the minimum bone protective dose of estrogen :

Estradiol tablet - 1-2mg daily
Conjugated equine estrogen tablet - 0.3-0.6mg daily
Estradiol patch - 50mcg daily
Estradiol gel - 1-5g daily
Estradiol implant - 50mg 6 monthly

Other possible benefits of HRT include reduction in risk of cancer of the colon (demonstrated by the Women's Health Initiative study [ref 7]), and reduced risk of Alzheimer type dementia, cataract formation and macular degeneration with improved dentition and skin healing. These possible benefits are not currently regarded as indications for HRT.

On NHS website:

Are calcium pills and good at preventing fractures – some research:

https://www.nhs.uk/news/medication/are-calcium-pills-any-good-at-preventing-bone-fractures/

Conclusion
These two studies pour cold water on the idea that most healthy people aged over 50 need to eat more calcium than they currently do, or that they need to take calcium supplements. They found that, for most people, increased calcium has little effect on bone strength or chances of breaking a bone.

However, the research is based on available studies, of which there were only two small randomised controlled trials with a combined total of 262 people that looked at calcium intake and risk of fracture.

The cohort studies found are not able to show cause and effect as they are subject to confounding, so the combination of these limitations reduces the strength of the results found in this systematic review.

The UK government currently recommends getting 700mg of calcium daily – and says a healthy, varied diet is likely to provide this for most people.

Good sources of dietary calcium include dairy products such as milk, cheese and yoghurt; oily fish such as sardines and anchovies; or nuts and seeds such as almonds and sesame seeds. To get higher levels of calcium, recommended by some organisations, calcium supplements may be needed.

The results of this study suggest most people are unlikely to benefit from taking additional calcium.

We know from previous studies that calcium supplements can have side effects in some people, including constipation and kidney stones. Calcium supplements have also been linked to an increased chance of having a heart attack. You are unlikely to get these side effects from eating a normal amount of calcium as part of a healthy diet.

It's important to remember that most of these studies were looking at generally healthy older people, not people who had a medical reason for taking calcium supplements.

Menopause and bone health

http://www.nhs.uk/Livewell/healthy-bones/Pages/menopause-and-your-bone-health.aspx

Hope this helps - there will be heaps of scientific papers out there.....

Hurdity x

PS I don't know who to do that multiple quote thing that Dana does with quotes from outside sources - which is why I do them in green!

[Peacegirl]

Thank you so much hurdity for all this info! It's exactly what I was looking for x

[Hurdity]

You're welcome - I love looking things up when I have the time!

There is a huge wealth of information about menopause on this website if you follow the tabs on the green banner - as well as NHS website

Hurdity x

[babyjane]

This is useful to know  .  I have not used HRT and that was my choice, I have a DEXA scan every three years and so far ok.  If there are consequences I will deal with them.  Mother didn't have osteoporosis and she didn't use HRT.  I don't think everyone gets it. 

Anyway it's the calcium thing that struck me.  I was put on calcium supplements some time ago and I ended up in hospital as they thought I had Diabetes Insipidus (not to be confused with diabetes mellitus). Turned out I actually had hypercalcaemia due to the supplements and I was taken off them.  I make sure my diet contains calcium rich foods and take a D3 supplement suggested by my specialist as my levels tend to be borderline low.

We can't know the future, that bus might be along tomorrow (quote my lovely husband) and it might not ever be an issue.  One day at a time will do me fine 

[dazned]

As you say BJ  not everyone gets/has problems with their bones of heart. I think that I've posted before somewhere if that was the case millions and millions of women NOT on HRT would dropping like flies with crumbling bones and heart attacks,we'd be knee deep in the poor souls.
I appreciate if there's a family trait it could be an issue for some though.

[CLKD]

My 'elderly' Mum (what classes as elderly anyway) hans't needed HRT etc., she walked/cycled all her Life and now gardens gently. 

Certainly I wasn't advised to take HRT when I had DEXA scans to check for bone density, was told that I needed to add more dairy to my diet and do lots of brisk, weight bearing exercise which of course, is what my Gt.Gran, Gt Aunts, Grans, Aunts, Mum had done from the time they could walk.  Lots of stodgy foods with lots of dairy - Gt Uncle was a herdsman so cream/milk were to hand, no yoghurt of course - plenty of fresh air and sunshine as the kids played out 'cos the houses lacked good light levels .........