Weird...40 years old, healthy active man with Osteoperosis

[Gumby26]

Anyone heard of a situation like mine, or have any suggestions/ideas? I'v dealing with my doctors, but I have an HMO so they are logistically very slow and in the meantime, my anxyity levels are through the roof.

I'm a 40 year old man. 6'0, 165 lbs and healthy. While I've had a desk job for a couple years, I'm stil careful about what I eat and exercise regularly (which includes mostly moderate weight lifting and walking/jogging). I do not smoke, I do drink a lot of caffeine @ about 6 servings a day and in the past year I've been drinking a bit much @ about 4-5 drinks 4-5 times per week. Prior to the past year I rarely drank at all. I'm mildly anemic and have been so for many years, iron is normal and reasons are unknown, but the numbers have been stable for over a decade.

Now the weird part. I did a healthscan type screening just because to get a baseline and some peace of mine. It was a discount deal through my employer so why not/. I no symptoms of anything really.

During this echo based screening, they found I had a fast heart rate (appc 80's resting) but the rest was good. They did a bone density check using a small heal machine which showed I was at risk for bone loss problems.

I followed up with my HMO primary doctor who said no way I should have any bone or heart problems based on my personal, family, and medical history, as well as my current physical condition (I'm lean and muscular with no real limitations to speak of).

So I get a full CBC and a DEXA screening....guess what? Yep, bad news.

The CDC showed too much TSH at at 6.5 and 6.7 on two tests, and my free T4 was at 0.71 and 0.67 on two tests – sounds like cut & dry Hypothyroidism.

The DEXA showed numbers from –1.4 to –2.6 (I can’t recall which numbers went with which measuring points). They told me that’s severe osteopenea and the beginning stages of osteoporosis.

So can un-medicated hypothyroidism cause osteoporosis? Is there another medical condition that could cause both? I could see Hyper causing the OP, by Hypo? Oddly enough, as I look through the symptoms of hypo vs. hyper I think I fit more the hyper. I don’t have weight gain; I do have a fast metabolism, etc. Also, I have never had a broken bone anywhere.

Any educated guesses or suggestions would help. I do a lot of my own research just because that’s how I am, but right now my stuff seems conflicting and I’m unable to make sense of it. If it made sense, it would be easier to cope with. But the confusion feeds into the anxiety.

Thank you in advance.

[Gumby26]

Calcium and Testosterone came back normal.

[Gumby26]

***FYI...drinking more than 7 per week, and low BMI are risk factors***

yea, that's why I put the brakes on the drinking as soon as I found out. But even then, I had only been drinking the past 8-10 months or so and I'm not sure that's long enough to cause this significant of a problem? In any case I don't want to exacerbate it, so I've cut back to a beer with dinner, and will likely bring that down to once or twice a week shortly. Fortunately I'm not easily susceptible to physical addictions so with motivation it's pretty easy for me to cut this stuff back. I find coffee is tougher for me than alcohol; I love a morning latte :)  

Not much I can do about the BMI, even when I was following body building routines of lifting and caloric intake, despite being muscular, I was always thin. I also always weighed significantly less than I appeared, so I wonder if this thin/light bones thing has been with me all my life and just getting worse as I afe? Who knows. I just need to get a handle on it.

[Gumby26]

Other than mild anemia that's been stable without meds for at least 15 years, I have no other known medical problems, no meds, and no obvious symptoms of anything wrong. I also have no family history of anything similar. If you saw me you'd think I was an above average healthy 40-year-old. If not for the basic screening I participated in through my employer who provide us with a discounted echo body scan screening, I would never have know (until I broke a hip in 10 years or something).

My primary doctor has ordered a calcium serum, PTH, testosterone level check (at my suggestion thanks to CelestC’s info posted above), and put in a referral for me to see an endocrinologist as he suspects it must be some sort of hormonal imbalance. But I'd still appreciate any input.

I suspect hyperparathyroidism will probably be ruled out as my echocardiogram of the carotid showed no calcium build up at all (good news for the hear/stroke risk I suppose).

Very odd situation. I’ve never broken a bone and left weights several times a week, watch what I eat, take vitamins, don’t smoke, no drugs, etc.

Thanks again for your input, I appreciate it.

[dai3symae]

.....I have had osteopenia for several years and have subclinical hypo.  I take actonel weekly and have maintained the same numbers on my DEXA scan since 2003.  There is also a new once-a-year drug called reclast (it's an infusion) that is due to be available in June to treat osteopenia (currently it's used for osteoporosis).

FYI...drinking more than 7 per week, and low BMI are risk factors

[dai3symae]

Did you ever take predisone for an extended period of time?  It can effect your bone density.

dai3symae

[CelestC]

By the way - if you are having bone loss, it always seems like a good idea to take Calcium.  Make sure you don't have a malfunctioning parathyroid - because excess calcium from pills etc. can give you a heart attack or stroke along with organ damage and kidney stones.  Be very careful.  Checking calcium is easy and fairly cheap.  

And if you have a parathyroid problem, do NOT take vitamin D.  If you have low vitamin D in your blood and high calcium, do not try to enter more vitamin D into your diet.  If you do, you put yourself at substantial risk for a stroke.  

[CelestC]

You have a fast heart rate and bone loss correct?  

Although hypothyroidism can cause man things, in order for the hypo to cause bone loss it has to be going on for years.  Ironically enough, meds for hypo can actually cause bone loss.  If you are going to start a medication for the thyroid, read all the fine print carefully.  My mom suffered from bone loss every year until they took her off her thyroid medicine and started something else.  All other meds stayed the same, and she gained bone mass for the first time in over a decade.

I don't know if you know about parathyroids.  They hang out in your neck, the size of a grain of rice and moniter the amount of calcium in your blood.  They can cause all sorts of problems.  The website www.parathyroid.com is written by the world's foremost expert on parathyroids and is easy to read.  

It's important to find out if you have high calcium in your blood. That calcium comes from somewhere - your bones!  

I am like you on the hypothyroidism.  I have found that my symptons fall into the hyperthyroidism category.   My NP, when I was first diagnosed, told me that if she didn't know better she would say that I have Graves Disease.

Check out the website for parathyroids and ask your doctor's office for any calcium tests results, if they are elevated then a check of the parathyroid is in order. The good news is that if you do have problems with the osteoporosis due to the parathyroid, it can be reversed.  It is the only kind of bone loss that can be completely turned around.

By the way, a heart rate in the 80's is nothing.  Due to the problems in my neck my heart rate goes up to 150 even when just resting. :)

[Gumby26]

Sorry for all the spelling errors, I forgot to mention that my white cell count was normal. In fact, its on the lower side of the normal range.

Also, since learning this a few weeks ago, I've cut coffee to 2-3 cups a day, no sodas, and alcohol is about 1 beer a day, maybe 2, and no hard alcohol. I also started taking Caltrate 600+D Plus and placed more emphasis on total body and spine weight bearing exercises such as sqauts.

Here's some numbers for you doctor types.

WBC'S AUTO 5.6  
RBC, AUTO 4.26
HGB 12.8
HCT, AUTO 36.6
MCV 85.9  
MCH 30.1
MCHC 35.0  
RDW, BLOOD 14.5  
PLATELETS, AUTOMATED COUNT 204
MPV 9.2