Osteoporosis at 17 years old?!?!

This - nailed it. I had a T-score of -2.0 at age 16 as well (mine was due to eating disorder, though). Through good nutrition and some weight lifting, my bone density had completely normalized by age 25. I ran a bit (no more than 20-30mpw), but not much until I was a stable weight with body fat stores.

I'll echo what others have said - find a good endocrinologist. Assuming you are nourishing yourself well, sounds like it could be thyroid-related. Whatever you do, do NOT let a doctor put you on bisphosphonates (Fosamax, etc). 99% of docs know now better than to prescribe those for young people, but every once in awhile, you'll get a doctor who doesn't understand. Forteo, a parathyroid drug that helps increase bone turnover, is actually really promising (without the brittle bones potential of bisphosphonates).

Good luck.

Keepatit wrote:

Why can’t you run though? Running actually helps build stronger bones. I’d continue to run just don’t do the silly high mileage which leads to stress injuries anyways even in athletes with normal bone density. If you need to do workouts then do them. Focus more on quality vs quantity. Have easy days though that are more like 3-4 miles rather than 8-10. Or run everyother day or 3 days on 1 day off and lift that 4th day. Also add a off day once a week and just rest imagining ur bones getting stronger!

I think you should still run if you want to (obv as long as the original sfx is healed) . It will help you.

Sorry, but I disagree with this. Running can help build stronger bones under certain circumstances and at certain levels, but it can also contribute to dramatic and permanent loss in bone density. He should be seeing a specialist, ideally one who treats young athletes for low bone density and related symptoms, as I've discussed above. I'm not saying that he needs to stop running, but he needs to understand that low bone density in a young athlete is a serious condition that may present a complicated etiology and require a sophisticated long-term treatment plan.

Any joint laxity? Ehlers-Danlos?

The OP states the doctor did say he could run 20-30mpw so I think he should. I don’t think that is enough to cause sfx but enough to build some strength and maintain a base .

I’m not sure the severity of the condition but I’m shre a bit of running will be helpful both mentally and physically for him to a degree.

listentothis wrote:

I had a T-score of -2.0 at age 16 as well (mine was due to eating disorder, though). Through good nutrition and some weight lifting, my bone density had completely normalized by age 25. I ran a bit (no more than 20-30mpw), but not much until I was a stable weight with body fat stores.

I'll echo what others have said - find a good endocrinologist. Assuming you are nourishing yourself well, sounds like it could be thyroid-related. Whatever you do, do NOT let a doctor put you on bisphosphonates (Fosamax, etc). 99% of docs know now better than to prescribe those for young people, but every once in awhile, you'll get a doctor who doesn't understand. Forteo, a parathyroid drug that helps increase bone turnover, is actually really promising (without the brittle bones potential of bisphosphonates).

I'm curious if you are male or female.

A few points about Forteo: First, you may encounter some resistance in prescribing or obtaining insurance coverage for Forteo in the treatment of a 17-year-old male (mainly, I think, because it's expensive, and it's often seen as a second line therapy). Second, based on some rat studies, Forteo carries a black-box warning that it should not be taken for more than two years total during the patient's entire lifetime, and in any event becomes less effective over time. (I'm not going to say how long I've taken it.) Third, once the patient stops using it, Forteo's anabolic effects on osteoblast formation and activation typically reverse fairly quickly, so the patient may need to switch to a different drug, which at this time would probably be either a bisphosphonate or denosumab (Prolia), both of which are anticatabolic agents that inhibit osteoclast activity. But I'm not aware of any more promising drugs that are currently on the market. Fourth, I have no idea how any osteoporosis drug therapy might be affected by hyperthyroidism or its treatment.

But this is getting into the weeds. He should be seeing one or more experts, likely but not necessarily including an endocrinologist.

I was in the same place when I ran in college (10 years ago), so I'm going to try my best to properly remember this all. I had a bone scan after 3 stress fractures in 18 months (two were in my femur), and t-scores showing osteoporosis. I was recommend to go see an endocrinologist. After a bunch of testing, which included blood work (all normal calcium & nutrient levels, and hormones, and thyroid), and also doing 24 hour urine collections, they found that my body was not properly processing calcium and other nutrients (forget what it was called). I would take it in, but essentially piss it all back out (not properly absorb it). They put me on a water pill (Hydrochlorothiazide aka HCTZ). If you do end up on this route, and plan to run in college, make sure to register it with your trainers and NCAA as it is a masking agent for steriods/hgh and is a banned substance. I was on that for two years, and I've been good since then.

The first year on it wasn't perfect. I had to take 2 weeks off a couple times for "hot spots" (precursors to stress fractures) as it takes time for the body build back up bone strength. it will be a slow process back, but you will be able to slowly increase your mileage. After a year I was consistently running 70-85 mpw without issue. Also since it is a water pill, it flushes fluid from your system, so you have to piss all the time and staying hydrated is not as easy as it used to be.

I also cut out soda completely from my diet. Some sodas have phosphoric acid in it, which may interfere with calcium absorption / your body uses calcium from your bones to process it out of your body if there is no free calcium in your system. The science is not definitive on it, but after sitting out 4 seasons, it wasn't worth the risk.

Definitely go see an endocrinologist and best of luck.

The first doctor I saw (bone scan) did prescribe me fosamax for osteoporosis, but the endocrinologist told me not to take that until all the additional testing I did with them was complete. As someone else pointed out it's not osteoporosis, but rather low bone density. The bone scan results are the same scores as osteoporosis scores, but my endocrinologist informed me, that I was too young at the time (21) to actually have that yet. I ended up never taking the fosamax.

-large caloric surplus

-get vitamin D, calcium, and Vitamin K

-all nutrient and biomarkers are up-to-par

-regular strength training (especially weighted)

-sleep 9+ hours

-regular visits to the endocrinologist/orthopedist

You can get through this, just take things one step at a time.

Osteoporosis wrote:

What would you recommend I do if heavy cross training isn’t an option? I have a lot of recommendations to lift heavy weights but I’m worried I won’t be in shape if I can’t get intense cardio in.

I can see water running being a challenge since it requires a pool that is deep enough. that's tough in some areas in the summer.

Do you have access to a gym? The elliptical should be safe along with cycling. you can work your way up to being able to so some really intense xtraining on both of those machines and some cyclists believe that riding heavy gears is like doing squats.

120lbs is too skinny for a 5'10 guy. Just like it was suggested, eat mostly animal products (without over-cooking them), and don't waste your time with vitamins that our bodies cannot absorb.

Ended my running career. Buke.

Ask you doc about going on Foreto, it's an injectable that builds bone density, two year program

I'm female. And yes, you are right - Forteo is difficult to get covered. Now I'm curious how long you've been taking it? I tried to get it covered but insurance said no, so I opted against paying $5k a month out of pocket (though apparently a lot of runners do). My endocrinogolist, who works with runners, mentioned that they usually put people on bisphosphonates afterwards, but did not recommend that to me as a runner (and I would have said no anyway).

On Forteo for a total of at least four years over a five-year period. (My doctor is a leading authority on Forteo; I'm not concerned about the rat studies.) I will probably start Prolia soon, unless something else gets fast-tracked through the FDA. (A year or two ago, one very promising drug -- I don't remember its name -- was just about to launch when the company pulled it because of liability concerns relating to a small but apparently statistically significant risk, the details of which I don't recall.)

Osteoporosis wrote:

After getting 4 stress fractures in the last 8 months, missing out on the entire cross country season, I got a bone scan and was diagnosed with osteoporosis with a bone density of -2.0. Osteoporosis seems to be very rare in teenagers, especially males, so I am wondering what I should do to continue training and try to maintain my fitness. I had trained 70mpw the summer going into this year which was the start of my stress fractures. My doctor said I can’t go above 30mpw and wanted me to stay under 20 mpw for the first few months. I was thinking cross train recovery days and run workouts with everyone else. Does anyone have any advice on how to deal with this as I am feeling kind of hopeless right now.

There’s this thing called cross training. If you’re smart and wanna run you should probably try it. You can get a good amount done in it. I was out and couldn’t run for 5 weeks and ran 1:47 as my season opener in the 8 off straight cross training. It’s very possible to come back. Just have to want it more than ever.

The most important piece of advice I can give you is to get the hyperthyroidism under control. The hyperthyroidism is most likely the primary culprit of your low bone density and stress fractures. I am curious as to how your doctors are treating the problem. Also what do you define by "minor hyperthyroidism "? I reccomend you get a blood test asp to see what your levels are. Successfully treating the hyperthyroidism would not only benefit your bone health but will also allow you to be able to train and preform so much better.

You absolutely need to get in the gym 2-3 times per week and lift heavy.

This will be incredibly beneficial for both your bones and running. It will improve your bone density, help to prevent stress fractures by ensuring you have strong glutes and good mechanics and also improve your basic speed (which is a bonus secondary to your health).

I'd recommend seeing a personal trainer or strength and conditioning coach. There are a lot of athletic performance centres around these days that can help set you up with a basic program.

I'm thinking a program that centres around heavy squats and deadlifts will work very well. And no, you won't put on weight. I'd really get stuck into this now while you aren't training as much.

Osteoporosis wrote:

If I make sure to reduce the impact of running, how does high volume training affect me negatively? Does it have something to do with energy levels?

No, it has to do with the amount of load you are forcing on your skeletal structure. In your body's current state, you cannot do such a high volume until you fix some things.

Osteoporosis wrote:

If I can't maintain the same volume with cross training, what is the best way to keep my fitness up so that I can continue to race well? Do all miles have the same impact on my injury (recovery runs vs workouts)?

DON'T. RUN. MORE. DANGIT.

Unless, of course, you want the same results.

Aquajog, bike, elliptical, swim, etc. It will take a while to get used to performing these at the same intensity you tend to run with. Try to match your heart rate in aqua jogs with your heart rate during easy runs, if that's why you're doing the aqua jog. Likewise if you bike, etc.

And, as others have suggested, get stronger to help your body put load on your musculature rather than your skeleton.

You have to take a nonjudgmental look at yourself and figure out how to continue your current performance with different training methods. Less mileage isn't bad. IT doesn't mean your fitness has to go down. It's just different. Look at this as exciting new step in your evolution as a runner!

Avocado's Number wrote:

On Forteo for a total of at least four years over a five-year period. (My doctor is a leading authority on Forteo; I'm not concerned about the rat studies.) I will probably start Prolia soon, unless something else gets fast-tracked through the FDA. (A year or two ago, one very promising drug -- I don't remember its name -- was just about to launch when the company pulled it because of liability concerns relating to a small but apparently statistically significant risk, the details of which I don't recall.)

Interesting - your health insurance will cover it beyond two years? My endocrinologist said the same thing - wasn't worried about rat studies and wished the FDA would lift the two-year ban. After a string of stress fx's I was on it for two years - didn't get a single stress fracture in that time. Came off of it, and within 3 months, got another stress fracture. (I have low BMD, not in the osteopenia range though). Wish I could stay on it.

I don't recall whether insurance covered anything. With my high deductibles and other restrictions on coverage, I seem to end up paying out of my pocket for almost everything.

I really hope that the original poster gives this condition the priority that some of us think it deserves. I'm concerned that some postings on this thread seem to underestimate the difficulties typically encountered in treating very low bone density. Of course, it's possible that the condition in this case will be resolved fairly quickly. But low bone density can be devilishly difficult to treat, especially if it's not addressed early in life. And unlike the original poster, most people don't find out that they have very low bone density until it's too late.