Compression Fracture in Postpartum Osteoporosis

Dear Editor, I read with interest your article titled, “Compression fracture in postpartum osteoporosis”.[1] I am a lactation consultant and I experienced a similar medical situation. I would like your readers to know that weaning is not necessarily indicated in the case of postpartum osteoporosis. Weaning was advised, but I was adamant to find a way to avoid it. Many medications suitable for treatment of osteoporosis can be taken while nursing. I wonder if nursing may actually facilitates increased calcium absorption and building of bone. There could be hormonal reasons that this is true. In my case I gained the most bone while continuing to nurse. This is my brief case history. In 2000, at age 40, and five months after having my 5th child, I experienced compression fractures of T12, L1 and L3 when moving a piece of furniture. I was subsequently diagnosed with severe osteoporosis. I was seen and treated by several physicians including emergency room, my family practice physician, two endocrinologists and a naturopath. I was limited with pain medications due to my history of vomiting from any narcotics. Initially Toradol was helpful for pain and then I was able to use a transcutaneous electrical nerve stimulation (TENS) unity with alternating Tylenol and 800 mg Ibuprofen. The pain persisted for several months, but subsided greatly with taking an oral contraceptive containing estrogen, but this reduced milk supply. My condition was treated with a variety of therapies both traditional medicine and some alternative. I had improvement in milk supply and remained with milder tolerable pain by switching to natural hormone therapy. I continued to breastfeed my daughter for almost 5 years during which time I gained about 5.5% per year in bone density for a total of over 20% increase in spinal bone mass in the first 5 years. I was able to also use Miacalcin nasal, Cal/ Mag 2001 supplements, Vitamin D some other natural supplements including something for pituitary function and thyroid, as well as weight bearing exercise. Later I added use of magnet therapy and strontium. I did a trial of Forteo after about 5 years for about 6 months that I discontinued due to nausea. After menopause I switched to synthetic hormone replacement therapy which is important to prevent back pain for me on ongoing for now.