Do you recommend osteoporosis medication in postmenopausal females on anastrozole with very low Vitamin D (4.5)?
After replacing Vitamin D, what will be your first treatment of choice? Labs including ALP and calcium levels are normal. T scores are -3 or above. The patient has a history of fibula fracture after a fall. Her daughters also have very low Vitamin D.
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Will you treat a postmenopausal female on anastrozole with very low vitamin D for osteoporosis or consider it possible osteomalacia due to very low Vitamin D?
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1 Answer
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Rheumatology · U of AZ Phoenix Dept of Orthopaedics
Answered on
A vitamin D level of 4 is very low and should be corrected before any osteoporosis therapy is considered. Severe low D is associated with decreased Ca absorption and sometimes low serum Ca. Giving an anti-resorptive could result in hypocalcemia. Sometimes D levels that low are associated with musculoskeletal pain and weakness.
Once the D is corrected then women on aromatase inhibitors should be evaluated to reduce bone loss associated with total lack of estrogen. If the use of the aromatase inhi...
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