Can my mother take calcium supplements for osteoporosis?

Question

Hello doctor,

My mom is 71 and was diagnosed with severe osteoporosis last month after she fractured her spine just from coughing too hard. Her DEXA scan showed T-scores of -3.8 in the lumbar spine and -3.2 in the hip, which the doctor said is really concerning.

She has been on Anastrozole for breast cancer treatment for the past six years, and I think that is what caused her osteoporosis to get so bad. She also takes Omeprazole daily for acid reflux, which apparently affects calcium absorption. Her vitamin D level was only 14, and calcium was 8.6.

The oncologist wants to continue the Anastrozole for at least two more years, but the orthopedic doctor says her bones can not handle it. Tried to start her on Risedronate, but she got terrible esophagus pain and could not swallow for days. She has already had breast cancer, and now this osteoporosis is causing so much pain that she can barely get out of bed some mornings.

Are there injectable options that might work better? Also, can she take calcium supplements with her other medications, or will they interact?

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I can understand your concern.

I wish your mother continued health and wellness. Basically, of course, since she is taking this hormonal therapy, it makes her bones a bit weak and increases her risk of osteoporosis. At this stage, we need to give her a monthly injection of Denosumab. This will make a big difference; it will increase her bone strength, significantly reduce fractures and the pain she feels, improve her DEXA (dual-energy X-ray absorptiometry) score, and treat many of the osteoporosis issues.

This injection is taken once a month and does not require any monitoring of the kidneys or her renal functions. And of course, we also give calcium and vitamin D with it. Regarding your mother, we prefer that she take painkillers; she cannot live with pain, as the pain is preventing her from eating. She must take painkillers.

If she has pain in a specific area in the spine or the hip, we can give her localized radiotherapy. But if the pain is widespread throughout the body, we can start with non-steroidal anti-inflammatory drugs, then move to weak opioids, and we can even use strong opioids. So, we must manage her pain properly.

The second point is about food. At this stage, she needs to eat small meals; she cannot eat large meals all at once. We should focus on soups, juices, and ensuring she is always well-hydrated.

Hormonal therapy is completely fine, but we should give Denosumab along with calcium and vitamin D, and she should take painkillers. Regarding the esophagus pain, if she has esophagitis, we can give her Motilium or other medications that regulate the GI (gastrointestinal) tract and improve motility. I wish your mother continued health and wellness.

Treatment plan:

Hormonal therapy.
Denosumab monthly injection.
Painkillers.

Regarding follow-up: Seven days.

I hope this information will help you.

Kindly follow up if you have any further concerns.

Thank you.