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How Long For Body To "Reset"?
Hi, everyone! I am new to this forum and this is my first post although i have been reading through the various threads in the Osteoporosis group for a few weeks now and learnt a whole lot
Some background - I am in my mid-60s with no prior fragility fractures. I was diagnosed with osteoporosis with TScore of -2.7 for femur neck in mid-2022 and my doctor put me on Prolia which i (regrettably) accepted without any prior research. While on Prolia, i started reading up on the condition and the various meds. After my 3rd injection, it became clear to me that i should not have started on Prolia (which supposedly should only be prescribed if other less potent meds do not work). If anything, i read that the right sequence should have been to start with an anabolic and then follow it with an anti-resorptive. So when the time came for my 4th Prolia injection, i opted out and started on a weekly dose of Alendronate to mitigate against the dreaded rebound effect of Prolia. I have since taken 4 doses of Alendronate and other than a mild gastric and some pain near the side of my knee (which could also be due to overenthusiastic squats), it has been ok
My question is, how long will it be before my body can "reset" so that i can, if i decide to do so, commence taking an anabolic like Forteo or Tymlos from a clean slate without the disadvantages of having traces of Prolia or Alendronate still in me? Right now, it seems like a balancing act - i have to continue to take Alendronate to mitigate the rebound effect (for how long?) - but the more doses of Alendronate i take, the longer it will linger inside and affect the effectiveness of any anabolic med i take later
Any comments/insights are welcome. My prayers for everyone's good health and well being
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Reclast is the recommended bisphosphonate following Prolia. It will remain in the bones and blunt the effect of the anabolics, but not completely. The latest I've read is 1 1/2 to 2 years. With the caution that more study is needed. It seems to me that combination therapy following Prolia would be more protective, maybe zolendronate and abloparatide. I haven't found any research yet.
Luckily you haven't been on Prolia for a very long time. And you've made a good decision.
You might consider finding an (other) endocrinologist.
It is surprising to me that anyone is prescribed Prolia. If you aren't cautioned about the drug, is that because the prescribing physician just doesn't know. Or, is there is something I don't know.
Bone markers could be helpful.
Thank you for your prayers.
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2 ReactionsI have been told that the anabolics aren't usually used for bone loss as mild as yours, which is barely over the line between osteopenia and osteoporosis.
Yes, Reclast is often recommended as the relay drug following Prolia. And i believe Dr McCormick is of the opinion that once you have taken 3 or more shots of Prolia, Reclast would be required as Alendronate would not be potent enough to mitigate the rebound effect
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1 ReactionDr McCormick did mention in a video that for TScores between -2.8 to -3.0, he might not even prescribe drugs
Since he is a chiropractor, he is not licensed to prescribe any medications.
I am terrified at the thought of putting in a year's dose of drug into my body through infusion. Also, for Reclast to be effective as a relay drug, the correct timing would have to be determined with the help of bone turnover markers which my doctor is not willing or unable to order. For these reasons, i decided on Alendronate instead. If it's true that Reclast stays in the body for only 2 years, that's a huge plus. I have read that Alendronate can remain for years, even decades after
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2 ReactionsToday i took my 5th weekly dose of Alendronate. The pain at the side of my left knee which i thought could have been due to over-exercise just came back about 3-4 hours after my dose. I am in a bit of a quandary. If i stop Alendronate now, there's a big risk of Prolia rebound and I am really not keen on trying Reclast. Which may leave me with only Actonel and from what i have read, it may be less effective than Alendronate as a relay drug. If anyone has taken Actonel after Prolia, please share your experience
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2 Reactionsformisc,
I am anxious about Reclast, too, but I am doing it anyway. Probably in June. I have had an easy time on Evenity which may be giving me a false since of security.
My friend has been on Reclast for a couple of years and reports no problems.
🤞🏻
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1 ReactionHow does this fit in?
“ Combined treatment with teriparatide 40 μg and denosumab increases spine and hip BMD more than standard combination therapy. This large and rapid increase in bone mass suggest that this high dose regimen might provide a method of restoring skeletal integrity in patients with osteoporosis."
surefire,
I've read the bisphosponates are so adherent that you don't lose it until you lose the bone it is attached to when remodeling recurs.
I see this an unfortunate reality more than a fear. I think that most of us will end up taking a bisphosponate at some juncture.
Actonel (risidronate) is said to be the least adherent. Zolendronate the most. You can take the zolendronate, Zometa, in lower doses than is in the Reclast injections. But it requires an MD who ( well, I leave this blank.) The lower doses are less likely to cause the intense adverse effect (Acute Phase Response) suffered by some 22%. Windyshores , who has the world's best doctor, arranged for her to start with a one mg dose to test her reaction.
You would be advantaged by the use of CTx.
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