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Is 3% annual gain in bone density a realistic goal?

Posted by rogerscott8562 @rogerscott8562, Feb 3, 2024

Age 80, male. Able to exercise, yoga, bike, hike, etc. All DEXA scores rated Osteoporosis. Spine T score -3.5.
Probable cause many years of steroids for lung diseases. Cut Wixela dosage to 250/50 once per day from 2 per day. Result: only moderate increase in lung symptoms. I prefer that to breaking my hip or a vertebrae.
My draft plan is approach bone density normal in six years with Vitamin D, calcium, protein, exercise, and some osteo medicine. I am taking Alendronate, 10mg/day.

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formisc | @formisc | Feb 5, 2024
In reply to @rogerscott8562 "In reading the Alendronate statement, I see that for men the average first year gain in..." + (show)
Profile picture for rogerscott8562 @rogerscott8562

In reading the Alendronate statement, I see that for men the average first year gain in BMD at the spine is 5.3%, If assumed the same for a second year, I could get to Osteopenia status in two years. But 2 years of high chance of fracture is daunting. The side effects of the alternatives, Evenity, Forteo, and Tymlos are also daunting. Thanks to those who directed me to look at those options. I will talk about those options and a plan with my doctor.

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If i am not wrong, the % gain is based on the actual bone density value in g/cm2. So with 2 years of 5.3% gain per annum, the expected bone density would be:

Pre-treatment BMD in g/cm2 x 1.053 x 1.053

The new bone density would then translate to a new T-Score which has to be below 2.5 to fall within the osteopaenia range

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sophie | @sophies | Feb 17 7:49am
In reply to @windyshores "With a spine score of -3.5 I hope you can do Tymlos, which is good for..." + (show)
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With a spine score of -3.5 I hope you can do Tymlos, which is good for the spine (I had a 20% gain) or Evenity. The longer you do an anti-resorptive like alendronate, the more the effectiveness of bone builders like Tymlos and Evenity is affected negatively. The problem is that insurance likes the cheaper drugs first, so your doctor will have to authorize a bone builder.

After a bone builder you can do Reclast or alendronate to "lock in" gains.

So no, with your score, a 3% gain is probably not enough. Ask your doctor! (I hope you have an endocrinologist who treats a lot of osteoporosis.)

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@windyshores
Hi...would you please elaborate on you 20% gain , how long you stayed on Tymlos, what you took and for how long AFTER Tymlos? Did you do any special diet or exercise with the drugs, have any negative side affects, and please share your age. I am 75 and trying to decide if I want to walk down this path. Thank you!

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ldwl | @ldwl | Feb 17 8:39am

Hi to the group. Dilin here for the first time. I have taken Evenity shots for the past 12 months, and just received the first Prolia shot follow up last week. For the last 9 months of Evenity, I suffered with extreme night sweats. I mean my gown was very wet and my chest was puddled with water. I am 72. Can anyone relate to this as a side effect? The information with the medication does not list night sweats.

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oopsiedaisy | @oopsiedaisy | Feb 17 11:23am
In reply to @ldwl "Hi to the group. Dilin here for the first time. I have taken Evenity shots for..." + (show)
Profile picture for ldwl @ldwl

Hi to the group. Dilin here for the first time. I have taken Evenity shots for the past 12 months, and just received the first Prolia shot follow up last week. For the last 9 months of Evenity, I suffered with extreme night sweats. I mean my gown was very wet and my chest was puddled with water. I am 72. Can anyone relate to this as a side effect? The information with the medication does not list night sweats.

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@ldwl Hello and welcome. I run hot at night and often wake up sweating. I've had 10 shots of Evenity so far. I am menopausal and have been for 9 years and am on bHRT so I don't think it's hot flashes. I never get hot during the day so probably not hot flashes.

I'll be curious to see if this continues after I come off Evenity in a couple of months. Have you noticed a difference since you stopped the Evenity or are you still getting them?

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ldwl | @ldwl | Feb 17 3:31pm
In reply to @oopsiedaisy "@ldwl Hello and welcome. I run hot at night and often wake up sweating. I've had..." + (show)
Profile picture for oopsiedaisy @oopsiedaisy

@ldwl Hello and welcome. I run hot at night and often wake up sweating. I've had 10 shots of Evenity so far. I am menopausal and have been for 9 years and am on bHRT so I don't think it's hot flashes. I never get hot during the day so probably not hot flashes.

I'll be curious to see if this continues after I come off Evenity in a couple of months. Have you noticed a difference since you stopped the Evenity or are you still getting them?

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@oopsiedaisy
Thank you for your reply and welcome. I came off Evenity and one month later started Prolia for maintenance. I understood this was the norm. I had the sweating 3 nights following the day of my Prolia injection. However, at this time 3 more days have passed and no night sweats. I will keep you posted if they return. I certainly am hoping they do not.

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