Newbie confused by doctor options to choose, including Keith McCormick

Dear Staci: WOW!!! But I can understand. You want answers!

Good luck and please let us know what happens with both. I was thinking of consulting with McCormick but opted for a local functional medicine doctor, which turned out to be an expensive mistake. I then went to see the orthopedist Dr. Bush and get a REMS scan. So far I am satisfied with his guidance but am curious about McCormick.

Thank you so very much windyshores! I will study this article.

Some general thoughts:

If your scores are less than, say, -3.3, or even -3.0, the advice by McCormick is not going to be different from a good endocrinologist. With severe scores, this isn't that complicated. There are 5 choices, Forteo and Tymlos as anabolics, Prolia and bisphosphonates as anti-resorptives, and Evenity as both. I think the main choice is between the anabolics Forteo or Tymlos, and Evenity. I chose Tymlos first and am now doing Evenity.

I research and come up with all kinds of complicated questions which noone, including McCormick, can answer. It's good to be informed. But in the end, I think it really is simple. The problem is insurance.

Docs are told by insurance to start with anti-resorptives, which can later affect the effectiveness of anabolics. The docs need a reason to authorize anabolics. If we qualify for free drugs or financial assistance from companies, then insurance does not dictate our treatment, but the overall policy needs to change.

For those with better scores- that is when it gets complicated, I think. Meds or no meds? And then how to approach things "naturally." McCormick, naturopaths, integrative medicine docs, dieticians, exercise experts (Margaret Martin) all are very useful in that situation and I have found endocrinologists know less about this in many cases.

I understand the issue of quality of life but as a person with several fractures, I will take side effects (if tolerable) over more fractures. But that's me. I am almost done with anabolics and hope I have earned some years without fractures! I will prioritize natural methods to keep my gains after a year or two of low dose Reclasts.

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Interesting to hear different doctors' take on which med. The doc I consulted is pretty experienced in treating osteo for years now. The recco for me was to take Tymlos. I asked about Evenity and doc had strong opinions against it - won't prescribe or recommend Evenity to patients right now. Feels it's still too new, without enough real-world results yet and is leery on the elevated heart risks seen in some patient results.

This doc is fairly cautious/conservative though. So take that for what it's worth. As we know, other docs feel differently. Is it any wonder we're confused? lol

For the person asking about a Mayo consult via zoom - they refused when i tried. They said first appt MUST be in person, regardless of where the patient lives. Won't do virtual. 🙁

Thank you so much Windy! So much information!

I'm in the same place that you are. 3 infusions but want to stop . Dr will prob disagree

Dr McCormick may mot be able to order tests for us, but i contacting his office for a consult, I found that he does want to see what has been done. Like 2 years of lab tests & a healthy history.

Hi Annette!

How much detail did you provide in the questionnaire? How soon were you contacted and how quickly did they schedule an appt? Are you getting your osteoporosis treatment through the Mayo, or was your appt only a consult for recommendations on what meds to take, etc? Thanks.

To all, I’ll say Windy shores has summed up the med options well. I personally saw an endo after a fragility spine fracture and I’ve been an athletic active person my whole life- but realize now my activities weren’t the kind that you need to do to really impact your bones. Anyway, the endo though really discussed all the drug options in detail and based on my preference to not mess with Evenity cause it’s so new recommended Forteo. They knew nothing when I asked about what wt bearing or other exercises I should be doing. Did say to look up Margaret Martin on YouTube. I did that. Then from there really drilled down in my effort to learn as much as I could to make a decision I felt comfortable with. I saw Clint Rubin right out of the gate talk about the Marodyne , and his sister , Janet, I believe, who is an endocrinologist at a well known NC university. Interesting to hear them discuss Op from both their perspectives. Bought McCormicks Great Bones book . He said in there if going to an integrative / functional dr to make sure Osteoporosis was their specialty . He gives a list of questions to actually ask when you call their offices to see if the one you choose is a good choice or not. I did that. Felt none of them really were and very expensive for first visit with long wait time. All of them talked about one follow up visit - which stunned me -the eval of 1 1/2 hr and a follow up. What??? !!!Looked at price between those people and McCormick himself and price was comparable, or less to talk with him, so decided to do that. I mean all that time I was researching and trying to get a TBS along with my DEXA so I’d have that info before seeing him. That was a difficult process , but I accomplished it . Before meeting with McCormick I had my 6 month follow up up with my Endo who now had changed cause the initial one was a Fellow and had since moved on . When I saw the new Endo I had already done a significant amt of research and knew quite a bit. We had a great discussion and I told her that I’d read McCormicks book, of which she’d never heard of , and I also told her I had an upcoming initial consult with him and asked her if she’d work with him and me together. She seemed to go along with it. I told her bluntly that until I felt good enough with my knowledge of the options I wasn’t rushing into any med. I since have met with McCormick another time with just some quick calls to his office for some clarification, Anyway , all along this way I’ve been to Margie Bissinger’s Osteo Symposiums now 2yrs, and joined her Happy Bones Happy Life community where you get a few guest lectures each month , a question and answer session, and a Happiness Training Lesson . McCormick and many higher level people are her guest lecturers. I’ve gone to be evaluated and observed the Onero Program based off of Belinda Becks LIFTMORE research .Though not doing it per say because the closest one is 3 hrs away . And though McCormick and I had decided I’d start Forto just after the 2024 new year - many tests and hurdles jumped and just this past Friday I was trained for the Forteo shot and have done it now 2 days at home on my own . NO PROBLEMS - NO DIFFERENT FEELINGS AT ALL. Hope that continues!!! I am positive and will say I also just finished a very intensive root causes of osteoporosis program with Kim Millman . So with taking the anabolic and with my more full understanding of how to live my life from a metabolic way I feel I should have all things working for me . And just to say this I choose Forteo because I fractured my spine , my hips are pretty good AND I had no interest at this point doing Evenity as it has not been out on the market long with any far reaching history!!
That was quite a rant , but maybe helpful to someone!!!
Good luck to all navigating this issue!!