Osteopenia and hypercalciuria at 6 months PP and 28 years old?
Hello, I am feeling so sad and powerless over my health right now, so I am turning to Reddit to see if anyone has had something similar or if anyone has suggestions of someone I could talk to.
At 4ish months postpartum, breastfeeding, and 28 years old, I had a fragility fracture of the sacrum that took about about 3 weeks to actually figure out but confirmed through MRI (The amount of people who told me "of course your back hurts, you have a baby." ugh). I have a suspected fracture in my right hip as well, but can’t get an MRI until May 15 because I live in a rural place and the healthcare is subpar at best. I’m about 8ish weeks out from when the fracture pain began and am 6 months postpartum now.
-CBC with Diff, PTHrP, AM cortisol, phosphorus serum, vitamin D, magnesium, TSH all came back normal
-Comprehensive metabolic panel came back pretty much all normal except for very slightly elevated BUN and creatinine which is expected because I eat a high protein diet and also take 5 mg creatinine daily
-Tested for celiac and I have the genes to develop it at some point, but no antibodies that indicate I am actively celiac are present and my doctor wasn’t concerned since my other tests came back normal
-24 hr urine creatinine slightly elevated but again due to high protein diet and creatine supplementation which I did take during my test (didn’t realize they were testing that otherwise I probs wouldn’t have)
-PTH slightly low, but also to be expected because I am breastfeeding
The red flags:
DEXA scan revealed osteopenia with z-scores of lumbar spine at -1.9, left hip -1.2, and left femoral neck -1
24 hour urine calcium was 556 mg, so diagnosed with hypercalciuria. My doctor said she had never seen such a high result before.
I have no known metabolic disorders or bone density issues in my family history. Began taking 700 mg calcium daily near the end of my 2nd trimester and have continued to postpartum (I stopped taking it a few days before my 24 hour urine test to get a baseline but am back on it under my doctors recommendation) also take 125 mcg vitamin D daily. Between supplementation and dietary consumption, I consume about 1200-1400 mg calcium daily. I am still breastfeeding at 6 months postpartum.
I have been weight training 3-4x a week on average (sometime up to 6x/week) since 2020 minus a 6 week break postpartum. I was also running pre-pregnancy and pretty much stopped at 25 weeks due to the pressure on my pelvis, but did daily brisk walks and continued weight training throughout. I was doing barbell back squats 4 days before I delivered my baby. I also did a very slow return to running postpartum under the advice of a coach AND a physical therapist and pretty sure my sacrum fractured while running. I just bring this up because people ask me if I went into running too quickly a lot.
I'm just feeling really frustrated because I feel like I did a lot of work to prevent low bone density and I am pretty into health and fitness. This injury and knowing that my body is rapidly losing calcium through urine is making me really stressed out. I'm also really enjoying breastfeeding but am worried that could be worsening my condition. My doctor says she believes its some metabolic disorder, so she didn't advise me to stop breastfeeding. My doctor has referred me to an endocrinologist who's earliest appointment time is literally 3 months from now and I'm just really worried about my condition worsening over that time.
If anyone has gone through something similar, has any advice, other threads I could post this to, or ideas of additional tests I could get done please let me know. It's hard to feel powerless over my health and I'm a pretty active person but feel afraid to do anything in the event I have another fragility fracture. Taking care of an infant with a fractured sacrum is literal torture.
Thanks y'all