Homework before osteoporosis treatment
For more than a year, I have been reading Osteoporosis related posts. Based on the discussions I think it would be useful if someone who has a good grip on this topic (e.g., windyshores and mayblin) can summerize the following:
- what lab tests one should complete
- what questions one should ask when getting a DEXA scan
- which osteoporosis meds and other prescribed drugs if taken have adverse reaction
- what precautions to take when taking osteoporosis meds and other OTC supplements
I think this would be a big help for those who are considering starting treatment for osteoporosis when they consult w/their PCP, Endo, and/or Ortho specialist.
Interested in more discussions like this? Go to the Osteoporosis & Bone Health Support Group.
On this forum, we generally share our experiences, refer to resources and avoid giving direct medical advice .
We recommend finding a doctor you trust, watching You Tube videos like Dr. Ben Leder's Combining and Sequential Approaches to Osteoporosis, and books like Keith McCormick's "Great Bones." Others will chime in with their favorites.
Not sure if you want to share your particular situation.
McCormick suggests a Trabecular Bone Score for bone quality as well as the DEXA for density. Personally I have only had the DEXA because I have fractures. Fractures, strontium, positioning and "area of interest" scanned can all apparently affect DEXA, as well as using different machines.
McCormick lists a lot of blood tests, including the usual CBC and metabolic panel. CTX (bone resorption) and P1NP (bone formation) are bone markers, somewhat controversial for guiding treatment. Parathyroid (PTH), calcium, Vitamin D and bone specific alkaline phosphatase are done by my doc. McCormick also lists osteocalcin. This is all in his book. It can probably be a lot simpler for most of us!
All of us have different reactions to meds. What are you considering? The choices are bone builders (Tymlos, Forteo) , anti-resorptives (bisphos-phonates like Reclast or Fosamax) and Prolia (my docs don't use due to issues getting off) and Evenity (which is bone building for the first half and anti-resorptive for the last half).
In general, hydration is good preparation for any med! Some of us talk with docs and do lower doses on some meds, to start.
If we knew what you are contemplating we can share our experiences with those. But we are all different. And make sure you have a doctor you trust who will work with you. If you discuss things with a good doctor, many of these questions can be answered.
As a 79 yrs old South Asian/Indian, for 18 mos., I am on Tymlos and tolerating quite well with decent BMD increase. Probably start Fosamax in the Fall.
I was thinking more about the newbies. Thanks
@rajmayo22 that's great that you are doing well on Tymlos. I think it was a good idea to have all the info that you listed but we are not allowed to offer medical advice so I did the best I could within those limits! Good luck!