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What would you do? Medication.
Hi, I am interested in lay people opinions given I have received so much conflicting advice from MDs. It’s astounding and I’m sure I am not the only person who is confused and wary about any decision I make.
I am 68 years old and have significant OP – my T score is a -3.5. I was diagnosed in October. I knew I was genetically predisposed so have regularly exercised since my 20s and have maintained a healthy diet. Since the diagnosis, I have upped the frequency of weight lifting and the use of resistance bands and I am doing what has been advised in terms of diet and supplements.
My Plan D insurance will only cover Prolia and Forteo. I have decided against Prolia and am reluctant to start Forteo. Backing up a little, I enjoy adventurous vacations such bicycle trips and strenuous, long hikes. In September, for example, I hiked a portion of the Camino de Santiago. While training, I slipped and fell three times on big rocks and didn’t break anything. Last year, I took a bicycle trip in Europe. I tried out an electric bike which got away from me and I took a hard fall – it hurt, but no fractures. I know that my bone density is low as reflected by my low T score, but I also believe the quality of my bones is good, and the DEXA score is only part of the equation. One of my doctors said, “Oh, you did your own DEXA test.”
Like everyone, I want to avoid a fracture more than anything so I am willing to consider Forteo, but here is my concern: Is there a chance I might hurt the integrity of my bones by going on it? Might I inadvertently worsen my own situation by taking medication just to improve my DEXA score?
I also want a life plan that needs to last maybe 30 more years. We take a medication for a year or two, then switch to another medication for a year or two. Then what?? None of the MDs I have talked to have had a satisfactory answer. Maybe they are waiting for new drugs to hit the market.
I’m really struggling with the decision. I know I am the only person who can make it, and I will have to be responsible for the outcome, but I would really like to hear what thoughts others have. Thanks so much - any input is welcome.
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And I have one of the potential secondary causes but there is nothing that I can do about it but to accept the fact and move on. Of course, I want any osteoporosis treatment to not accelerate the progression of my condition.
I have a few secondary causes too. And they left out aromatase inhibitors for breast cancer- which reduce estrogen so I had a kind of super menopause!
As I’ve posted here before, I am on Evenity - ten months- and feel very alone when I meet with my disaffected endocrinologist. Yesterday, I went back yo my rheumatologist who had also prescribed Evenity. I had allowed the endocrinologist to manage my course of Evenity instead of the rheumatologist.
He forgave me for that, spent a lot of time with me, ordered the blood tests that Dr. McCormick suggests, showed interest in Dr. McCormick in general, made eye contact, etc.
Rheumatologist said that I have to go on Reclast the month after my last Evenity injections.
So, that is the plan.
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4 Reactionslynn59 & babs10, we should compare notes going forward. I'm starting Forteo in April, 66 yo, 118 pounds, and don't meet the income guidelines for Forteo. Just had baseline biomarkers and DEXA. My endo is suggesting Reclast as follow up drug but is ok if I want to go on Fosamax. I'd like to explore hrt also. There's time to figure that out down the road.
I met with McCormick last year. He's suggestion was Forteo followed by Fosamax (or generic form Alendronate).
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2 Reactionslynn59, I struggled for over a year with what to do. My lumbar spine is -3.4 and -2.2 hip, 14 years post menopause. I met with McCormick and had my PCP run the tests McCormick suggested. Net, my bone loss is primarily menopause related. I'm a landscape photographer and carry a heavy backpack with equipment. I want to shore up my bones so I can keep going out on long photo hikes. I finally gave in and decided to go with an anabolic so that I don't have an issue 10 years down the road. I'm 66 so figure if I do anabolic for two years and follow with med to lock in the gains for another year, I should be able to take a holiday for another 10 years (fingers crossed). Assuming I have good results with Forteo, I may be able to use Forteo again in the future now that they've lifted the black box warning. My endo has said her colleagues are now using Forteo with a lifetime use of 4 years.
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4 ReactionsAgree re not using McCormick as model for post menopause female.
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1 ReactionAs a side note: I have seen McCormick for years but I also listen to my doctor(s). I like to have a variety of opinions for any health challenge.
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5 ReactionsAgree again.
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2 ReactionsYes let’s keep in touch as I’ll be going on teriparatide in April too. I’d love to start HRT but I’m very nervous as so many of my doctors are against it for cardiovascular reasons. I think I’ve decided to try Actonel to lock-in my gains and if I can’t tolerate it, then I’ll go to Reclast. But I could change my mind on that!!
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2 ReactionsThat sounds like a pretty good definition. But I'm commenting here because I don't think the terms are as black and white as they seem. I mean if someone has osteoporosis at say 70 and doesn't have any of the medical conditions listed and has not taken any of the meds listed as causers of bone loss does that really mean they have a condition called primary osteoporosis that is somehow different than secondary osteoporosis?
I think it's just as likely that we cannot identify all the reasons osteoporosis develops in one person and not in another. Just because we cannot identify them in 2024 does not mean in the future we won't be able to. Or even that a smart of enough doctor or nutritionist or researcher or patient might not be able to identify more causes today.
I'm a 73 year old male so no post menopause issues. I had extra tests done as suggested by Lani Simpson. She and I could not identify any definite secondary factor for my bones continuing to worsen rapidly. So I'm taking Evenity hoping that will improve my bone density but I don't see that thinking in terms of primary vs secondary is very helpful, at least for me. I think I have more going on than just getting older but at present I cannot figure it out. So Evenity, resistance exercise, supplements in a do everything reasonable I can type approach. Hopefully that will be enough to build some bone back no matter what is causing the faster than normal decline.
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