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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pedsnurse61 | @pedsnurse61 | Apr 3 7:17am

In reply to @guinivere "Can someone let me know the titles of the books pedsnurse61 refers to?" + (show)

" Great Bones" by R Keith McCormick.

gently | @gently | Apr 3 10:14am

In reply to @pedsnurse61 "" Great Bones" by R Keith McCormick." + (show)

You might read this before you order
https://food4healthybones.com/wp-content/uploads/2022/10/The-Importance-Of-Bone-Markers-With-Dr.-Keith-McCormick.pdf
You may still want the book. McCormick is on various video interviews as well.

cez | @cez | Apr 3 10:32am

In reply to @guinivere "I had my first meeting with my UW Endocrinologist today. All went well until she said..." + (show)

I understand your dilemma.
I have been putting off the decision for over a year now.
I’ve seen my Endocrinologist twice in that time, she has been very patient and understanding about me not being ready to commit, and wanting to research more first, But, the time has come that she wants a decision. (Basically, there’s no reason to go to a specialist if I’m not following her recommendations.)
I’m just afraid to pull the trigger and commit to the medication plan, I’m not afraid of the side effects, but I’m very afraid of the risks.
(As I sit here with a fractured foot due to osteoporosis. )
My friends are my worst support system in this case, they ALL say no way would they take any of the medications .

windyshores | @windyshores | Apr 3 10:56am

In reply to @gently "You might read this before you order https://food4healthybones.com/wp-content/uploads/2022/10/The-Importance-Of-Bone-Markers-With-Dr.-Keith-McCormick.pdf You may still want the book. McCormick is..." + (show)

@gently when we read McCormick's personal story, which included severe osteoporosis in his 40's and 22 fractures, it is encouraging to see that Forteo and a short course of alendronate left him able to pursue more natural approaches, and he has stayed stable. However I do wonder how that relates to those of us who have gone through menopause, which he does not experience. Is there a male equivalent for hormonal change affecting bones?

mayblin | @mayblin | Apr 3 11:24am

In reply to @windyshores "@gently when we read McCormick's personal story, which included severe osteoporosis in his 40's and 22..." + (show)

Here is a graph for direct visual effect comparing male vs female bone loss as we age. Sure there are individual variations and comobidity has a big influence too. I had a big drop after 54 (dx at 59).
https://www.google.com/search?q=age+related%3Abone+loss+men+vs+women+graph&oq=age+related%3Abone+loss+men+vs+women+graph&gs_lcrp=EgZjaHJvbWUyBggAEEUYOdIBCTE5NDgyajBqOagCALACAQ&client=tablet-android-samsung-nf-rev1&sourceid=chrome-mobile&ie=UTF-8#vhid=_Jl1sqVRSTVkTM&vssid=l

gently | @gently | Apr 3 11:50am

Windyshores,
McCormick has status on Connect.
(Except with normahorn, who doesn't care what McCormick thinks, to my great amusement )
I'm amazed that he can collect a substantial cash fee for telehealth without the agency to write insurance-usable script.
He does say somewhere that he's the proof that osteoporosis meds don't have to be for life. Wish it were so, but am pretty sure that's only a good thing to tell male patients. The other information he provides is excellently easy to understand.
Men don't experience a powerful testosterone drop, as women do.
Usually it is a small enough drop that it doesn't affect their bones. When the drop is very small, men will often notice a disturbing decline in function and take testosterone.

The exception (the equivalence) is with ADT (androgen deprivation therapy) for prostate cancer. The drop in testosterone is sudden, dramatic and takes the bones with it. It is common for men considering deprivation therapy to take osteoporosis medications in advance of any bone loss as the loss in considered inevitable.

Irrelevant, but interesting, is the reduction in tumor size after two months on ADT. Prostate tumors depend upon testosterone for growth. After long administration of ADT, tumor will produce its own testosterone.
Just two months can reduce tumor size by half.

guinivere | @guinivere | Apr 3 7:25pm

In reply to @cez "I understand your dilemma. I have been putting off the decision for over a year now...." + (show)

I understand where you are. I have some friends like that too & I have had to stop listening to them because this is MY decision about MY body, not theirs. The best we can do, you & me & everyone else here, is to gather in all the relevant information you can find & then let it all sit in your mind & sooner or later you will know what to do. Everything has risks but I think doing nothing is one of the worst. You can do what you know you have to do.

gravity3 | @gravity3 | Apr 4 7:50am

In reply to @cez "I understand your dilemma. I have been putting off the decision for over a year now...." + (show)

I am sure that your friends mean well...however, no one can tell another what is best for them. We all have such individual needs and reactions. What does it mean when you say you are not afraid of the side effects just the risks? What do you see as the risks? What is you relationship with risk... perceived or actual?

njhornung | @normahorn | Apr 4 8:26am

If one is discussing the situation with friends, those frienfs have every right to say what they would do. Not what we should do but what they would do. If they are not allowed to state that, why are we even bringing the issue ip with them?