1. < Osteoporosis & Bone Health

Undecided choice of drugs for Osteoporosis

Posted by peace44 @peace44, Oct 10, 2023

I am 80 years old women and have borderline osteoporosis which affects my entire body. My doctor wants me to take Prolia and the Rheumatologist wants me to take Reclast. I’m unhappy with both choices as the side effects are great and I do not tolerate new drugs well. I am very undecided and am considering doing not taking annty drugs for this condition. I have never had a fracture and I’m very active Any opinions or advice.

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mayblin | @mayblin | Mar 3 10:41am
In reply to @destinnana "My T score went from 2.0 in 2022 to 2.7 in 2024 in my left hip...." + (show)
@destinnana

My T score went from 2.0 in 2022 to 2.7 in 2024 in my left hip. Spine results went from 1.0 in 2022 to 1.6 in 2024. I am trying to learn what all this means. It’s a process. I was told should I have a fall, I could fracture something. I am taking this seriously and doing everything I can to change things without taking Fosomax. The possible side effects are very concerning to me.

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Other than looking at your T score, you could also look at your bmd value. On average, a healthy person loses 0.25% up to 1% of bone mass per year after bone maturation. For post menopausal women, this loss would accelerate to 1.8% to 2.3% in the spine and 1 - 1.4% in the hip due to the loss of estrogen. You could use this benchmark to compare your annualized rate of bone loss and to see if you had unforeseen faster bone loss.

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guinivere | @guinivere | Mar 3 7:48pm
In reply to @peace44 "Thanks for your information. My close friend became color blind using Fosomax and she advised against..." + (show)
@peace44

Thanks for your information. My close friend became color blind using Fosomax and she advised against it. It took a year for her to see colors again. She is now on Prolia without any side effects. I’m skeptical of all Osteo drugs as I’m 80 years old. I’m still very undecided.

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Some time ago, I tried to get a telehealth appointment with Dr Paul Miller in Lakewood, CO, but he is no longer working with out of state patients. I would really like to contact Dr McCormick for this but I am under the imprssion that hen does nottake insurance & the lists of tests he would require is huge! No way could afford getting them even tho I have insurance!

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1 reply
windyshores | @windyshores | Mar 3 9:18pm
In reply to @guinivere "Some time ago, I tried to get a telehealth appointment with Dr Paul Miller in Lakewood,..." + (show)
@guinivere

Some time ago, I tried to get a telehealth appointment with Dr Paul Miller in Lakewood, CO, but he is no longer working with out of state patients. I would really like to contact Dr McCormick for this but I am under the imprssion that hen does nottake insurance & the lists of tests he would require is huge! No way could afford getting them even tho I have insurance!

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He costs $300 for the first appointment and $85 for follow up on the phone (15 minutes). You do not really have to do all those tests or provide all those records in my experience. Talk to the office and ask what tests are a priority. Then ask your PCP to order them (or maybe you have an endocrinologist who will). Do you have a good endocrinologist? You may be all set. You can read McCormick's books and watch Dr. Ben Leder's video on YouTube if that helps.

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1 reply
gently | @gently | Mar 4 8:16am
In reply to @janflute "Thank you so much for your reply. I will study it, there is so much information...." + (show)
@janflute

Thank you so much for your reply. I will study it, there is so much information. I also love Forteo and wish that I could stay on it forever. Dr. Mannstadt at MA General wants me to have a one time Reclast infusion once I stop Forteo. I am worried about the side effects. I took Fosomax from 2003-2008 with no side effects. I am not familiar with Risitonate.

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Mannstadt must have an opinion about extended Forteo, even if he'd be reluctant to prescribe it that way. He likely knows the most about mineral metabolism with pth. What about a one time reclast infusion while remaining on Forteo. Janflute, you are giving me ideas.
What will he have you do after the reclast?

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3 replies
windyshores | @windyshores | Mar 4 8:21am
In reply to @gently "Mannstadt must have an opinion about extended Forteo, even if he'd be reluctant to prescribe it..." + (show)
@gently

Mannstadt must have an opinion about extended Forteo, even if he'd be reluctant to prescribe it that way. He likely knows the most about mineral metabolism with pth. What about a one time reclast infusion while remaining on Forteo. Janflute, you are giving me ideas.
What will he have you do after the reclast?

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Doc will probably use monitoring after a Reclast infusion to determine if and when drug holidays can happen, from what I gather. MGH does not seem to do CTX and P1NP so I am curious what monitoring entails.

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mayblin | @mayblin | Mar 4 11:50am
In reply to @gently "Mannstadt must have an opinion about extended Forteo, even if he'd be reluctant to prescribe it..." + (show)
@gently

Mannstadt must have an opinion about extended Forteo, even if he'd be reluctant to prescribe it that way. He likely knows the most about mineral metabolism with pth. What about a one time reclast infusion while remaining on Forteo. Janflute, you are giving me ideas.
What will he have you do after the reclast?

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Adding a bisphosphonate to forteo may not be a good idea. Years ago, a small study used alendronate with forteo, results were worse than forteo alone. Considering Reclast is a lot stronger than allendronate, adding it to forteo may further dampen forteo’s effect.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2853981/
It’s intersting that prolia combined with forteo has a better outcome than forteo alone as Leder etc. demonstrated.

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susanjane77 | @susanjane77 | Mar 4 4:08pm
In reply to @janflute "Thank you so much for your reply. I will study it, there is so much information...." + (show)
@janflute

Thank you so much for your reply. I will study it, there is so much information. I also love Forteo and wish that I could stay on it forever. Dr. Mannstadt at MA General wants me to have a one time Reclast infusion once I stop Forteo. I am worried about the side effects. I took Fosomax from 2003-2008 with no side effects. I am not familiar with Risitonate.

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I have had Reclast infusions over several years with no side effects. I wish the same to you.

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janflute | @janflute | Mar 4 5:11pm

Thank you so very much for sharing this information about no side effects. I am supposed to get one in July.

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1 reply
guinivere | @guinivere | Mar 5 1:24am
In reply to @windyshores "I just read a study on the difference between taking a bone builder before Prolia and..." + (show)
@windyshores

I just read a study on the difference between taking a bone builder before Prolia and bisphosphonates or after. The difference was shocking: in some cases the latter had half the effectiveness. It is much much better to take Eventity, Tymlos or Forteo before a bisphosphonate or Prolia!

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Maybe a dumb question, but aren't Eventity, Tymlos & Forteo all biophosphonates?

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1 reply
guinivere | @guinivere | Mar 5 1:32am
In reply to @windyshores "He costs $300 for the first appointment and $85 for follow up on the phone (15..." + (show)
@windyshores

He costs $300 for the first appointment and $85 for follow up on the phone (15 minutes). You do not really have to do all those tests or provide all those records in my experience. Talk to the office and ask what tests are a priority. Then ask your PCP to order them (or maybe you have an endocrinologist who will). Do you have a good endocrinologist? You may be all set. You can read McCormick's books and watch Dr. Ben Leder's video on YouTube if that helps.

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Thanks so much for this! I will be seeing an endocrinologist at UWis in a month. All I know abbout her is her name, Clara Connor. I have both McCormick books & am really marking them up!
Will check out Dr Ben Leder's video on UTube.

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