1. < Osteoporosis & Bone Health

Sudden drop of BMD while on Prolia.

Posted by connectalant @connectalant, Aug 24, 2023

Diagnosed with osteoporosis 20 years ago. I have been Prolia for 7 years. Latest DexaScan showed 11% decrease in hip BMD. Blood tests ruled out parathyroid adenoma. Have others had a similar experience/

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tetris | @tetris | Aug 26, 2023

Was your latest DXA scan done on the same machine as the previous one?
If no, maybe that's the reason for the decrease?
If yes, ask for your DXA results to be reviewed again, in case you were not properly positioned on the machine, etc.?

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1 reply
connectalant | @connectalant | Aug 26, 2023
In reply to @tetris "Was your latest DXA scan done on the same machine as the previous one? If no,..." + (show)
@tetris

Was your latest DXA scan done on the same machine as the previous one?
If no, maybe that's the reason for the decrease?
If yes, ask for your DXA results to be reviewed again, in case you were not properly positioned on the machine, etc.?

Jump to this post

Yes, same machine. Plan to ask for a retake, although change is unlikely.

Thank you for your suggestion.

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pami | @pami | Aug 27, 2023
In reply to @rjd "I have not seen anyone taking Prolia with DEXA scores that are in osteopenia territory. Are..." + (show)
@rjd

I have not seen anyone taking Prolia with DEXA scores that are in osteopenia territory. Are you taking it due to lumbar osteroporosis?

Note my previous posting mistake. My scan score improved by 18.5% after two Prolia injections. Sorry for the confusion. I was focused on the 'suddenness' of the change.

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Is the 18.5% overall? If so, how much did your lower lumbar improve? Thank you!

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1 reply
rjd | @rjd | Aug 27, 2023
In reply to @pami "Is the 18.5% overall? If so, how much did your lower lumbar improve? Thank you!" + (show)
@pami

Is the 18.5% overall? If so, how much did your lower lumbar improve? Thank you!

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The improvement was at the hip. My spine numbers were and remained in the normal range.

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1 reply
pami | @pami | Aug 27, 2023
In reply to @rjd "The improvement was at the hip. My spine numbers were and remained in the normal range." + (show)
@rjd

The improvement was at the hip. My spine numbers were and remained in the normal range.

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Thank you!

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connectalant | @connectalant | Mar 13 2:06pm
In reply to @windyshores "@connectalant be careful getting off Prolia. You might want to read McCormick's book "Great Bones" on..." + (show)
@windyshores

@connectalant be careful getting off Prolia. You might want to read McCormick's book "Great Bones" on this. If you do Reclast too early it won't work, and if you do it too late you might lose more bone density, according to him. He suggests using blood tests to determine best timing.

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I am a six year user of Prolia. My DexaScan recently showed a 10% drop in BMD over the past 2 years. Confirmed on a retest. Another scan at a very reputable clinic showed no decline over a 5 year period. I realize different machines produce different readings, but the BMD and T-scores are significantly different. With the 10% drop shown, I am now faced with a decision on a successor medication to Prolia. Tymlos or Forteo have been recommended, but I am concerned with the rebound effect of Prolia if I change to either of these drugs.

Any thoughts?

REPLY
3 replies
connectalant | @connectalant | Mar 13 2:11pm
In reply to @connectalant "I am a six year user of Prolia. My DexaScan recently showed a 10% drop in..." + (show)
@connectalant

I am a six year user of Prolia. My DexaScan recently showed a 10% drop in BMD over the past 2 years. Confirmed on a retest. Another scan at a very reputable clinic showed no decline over a 5 year period. I realize different machines produce different readings, but the BMD and T-scores are significantly different. With the 10% drop shown, I am now faced with a decision on a successor medication to Prolia. Tymlos or Forteo have been recommended, but I am concerned with the rebound effect of Prolia if I change to either of these drugs.

Any thoughts?

Jump to this post

I have used the same machine for many years.

REPLY
connectalant | @connectalant | Mar 13 2:13pm
In reply to @connectalant "I am a six year user of Prolia. My DexaScan recently showed a 10% drop in..." + (show)
@connectalant

I am a six year user of Prolia. My DexaScan recently showed a 10% drop in BMD over the past 2 years. Confirmed on a retest. Another scan at a very reputable clinic showed no decline over a 5 year period. I realize different machines produce different readings, but the BMD and T-scores are significantly different. With the 10% drop shown, I am now faced with a decision on a successor medication to Prolia. Tymlos or Forteo have been recommended, but I am concerned with the rebound effect of Prolia if I change to either of these drugs.

Any thoughts?

Jump to this post

Sorry to keep adding the info, but the drop in BMD was only in my hip.

REPLY
windyshores | @windyshores | Mar 13 2:39pm
In reply to @connectalant "I am a six year user of Prolia. My DexaScan recently showed a 10% drop in..." + (show)
@connectalant

I am a six year user of Prolia. My DexaScan recently showed a 10% drop in BMD over the past 2 years. Confirmed on a retest. Another scan at a very reputable clinic showed no decline over a 5 year period. I realize different machines produce different readings, but the BMD and T-scores are significantly different. With the 10% drop shown, I am now faced with a decision on a successor medication to Prolia. Tymlos or Forteo have been recommended, but I am concerned with the rebound effect of Prolia if I change to either of these drugs.

Any thoughts?

Jump to this post

@connectalant I posted in another thread on how switching to Tymlos of Forteo if you have been on Prolia more than 1-2 years is not a good idea, based on Great Bones" by Keith McCormick (page 569) and the excellent YouTube by Dr. Ben Leder on Combining and Sequential Approaches to Osteoporosis (minute 35 as I remember). Not only is this switch not effective, according to them, but it can make things worse. These resources and my own doctors say that Reclast is the only med that can avoid the rebound, or possibly to a lesser extent, Fosamax. Or you could stay on Prolia for longer-?

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2 replies
connectalant | @connectalant | Mar 13 2:43pm

I am in same situation (see today's post). What was your resolution?

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