Low bone mineral density in men on OST

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TeeJay
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Low bone mineral density in men on OST

Post by TeeJay » Mon Dec 23, 2019 1:02 am

This is the other significant problem associated with low-T induced by substitution therapy. This study included men on methadone, morphine and buprenorphine replacement therapies. Only shortcoming in the study was the number of participants on buprenorphine is significantly less than for the other two medications.

https://link.springer.com/article/10.10 ... 015-0732-9

Low BMD usually surfaces in the form of lumbar / lower spine pain.

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Re: Low bone mineral density in men on OST

Post by suboxdoc » Mon Dec 23, 2019 11:18 pm

Good catch TeeJay. I can only access the abstract, at least for now, and I see the low number (6%) of buprenorphine patients. I think about the studies of testosterone levels in patients on 'opioid maintenance therapy' that showed significant decreases in testosterone in patients on methadone, and non-significant trends in buprenorphine patients. I think there is agreement that the low mineral density is causally related to low testosterone, but correct me if I'm wrong.

The abstract clumps together ALL of the study subects, combining methadone patients, where the effect would be much greater, with a smaller number of buprenorphine patients (where the effect would be smaller). So I can't conclude much from the study about bone mineral density in relation to buprenorphine. The buprenorphine group could even have a higher bone density and still have the results in the abstract.

I'll try to find the study and see if they broke down the groups. I think we'll eventually find that buprenorphine has no significant impact on health when taken for a decade or two. But 40 years on any opioid is going to impact other health systems. Men are likely more impacted by decades on buprenorphine than are women, given the testosterone connections.

Thanks for sharing an interesting study. Everyone should know that bone mineral density can be measured, often covered by health insurance. The biggest impact to mineral density is probably genetics. But there are medications that help reduce the loss of bone density, making hip fractures less likely when you're 70. For those over age 50 who have parents with hip or compression fractures, consider having your bone density checked. You may save yourself a lot of misery.

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Re: Low bone mineral density in men on OST

Post by BlueLight » Tue Dec 24, 2019 1:36 pm

This was another benefit of getting on TRT for me. I’ve had two scans done, and while I didn’t need TRT for osteoporosis, it has helped my bone density. Of course the testosterone gave me the energy I needed to get into the gym and lift weights, which is very helpful with bone density issues.

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Re: Low bone mineral density in men on OST

Post by TeeJay » Thu Dec 26, 2019 12:20 am

Do you get HcG as well?

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Re: Low bone mineral density in men on OST

Post by BlueLight » Thu Dec 26, 2019 1:36 am

TeeJay wrote:
Thu Dec 26, 2019 12:20 am
Do you get HcG as well?
I have it, but use it sparingly. It spikes my estrogen and causes cystic back acne something fierce if I’m not careful with it.

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Re: Low bone mineral density in men on OST

Post by LukeAU » Mon Feb 24, 2020 2:16 am

BlueLight wrote:
Thu Dec 26, 2019 1:36 am
TeeJay wrote:
Thu Dec 26, 2019 12:20 am
Do you get HcG as well?
I have it, but use it sparingly. It spikes my estrogen and causes cystic back acne something fierce if I’m not careful with it.
Don't have any aromatase inhibitors for the oestrogen spike?

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