What to do!

Had a wrist fractue about a year ago but thar's all. I run a cat rescue so am fairly active re their needs. Eg, a bag of ltter is 20 lbs!

I trust my own doctor who I have been with for many many years. But he is a GP altho a GP in a tiny village about 10 miles from my village which is only 1450 population, I know he has many elderly patients as I have seen them in his waiting room! His initial recommendation to me to start was Reclast!
I left a message with the UW doctor saying I could not take Fosomax due to a throat condition I have which was diagnosed years ago which found my esophagus in dreadful shape & led to my going on a diet of only 50% of my usual intake of coffee, chocolate, fruit juice, alcohol,, anythng tomatoey & something else I can't remember. It hasn't been too bad altho decreasing coffee by 50% has not been fun. Anyway, no way could I take Fosomax & I would tell them to check with the Sauk Prairie Hospital if they insisted.

@guinivere I am really really glad you have a primary care doctor you have seen for a long time, and who you trust. There may be age or health factors influencing doctors' recommendations for you that we don't know about. I hope you can find an endocrinologist you trust, and maybe that will happen if you have a conversation with the current endocrinologist at UW.

Many of us would say that our doctors recommended bone builders with scores worse than, say, -3.2, but bisphosphonates (or Prolia) may be best in some situations.,

I cannot take Fosamax because of GERD and that is a good reason for a doctor to withdraw that suggestion.

Let us know what happens!

@gently, curious as to why you would recommend “crossing off” Evenity?

Beanieone, hi.
People are taking Evenity with good results. If there were no other (partially anabolic) drug, I'd be taking it. Some people are taking Evenity without gain and some with adverse effect.
There is a black box warning on Evenity with regard to cardiovascular events-stroke, mI, and athersclerosis.
The mechansim of action of Evenity is the blocking of a sclerostin pathway. Sclerostin has long been though to be preventive against the accumulation of placque in our arteries most especially in the heart valves.
This mechanism may prove to be safe or safe in a years long use of Evenity. We'll know because of the brave souls investigating the medication in their own bodies.
Heart disease is the #1 cause of death in the US, #2 in Canada.
Osteoporosis has no "end stage."
Forteo has been around for decades ( I write decades because I can't remember the year). It has a high safety profile. Adverse events can be as brief as several hours because you can quit the drug overnight. You are really trapped for at least two month if you have adversity with Evenity's application.
In general, I prefer a osteoporosis medication that builds bone. Evenity does that for the first few months and then becomes anti-resorptive. I don't want osteoclast reduction because I want bone turnover to make my bones stronger.
I would cheer anyone taking Evenity, but would't encourage anyone to take it.
I've just finished by 12th Forteo pen, and quite like the medication, though I know it isn't good for everyone.

I have no idea what to do. I am 84 with osteopenia. My physician also wants me to go on Fosamax but I have been told by a very reliable holistic chiropractic doctor that it causes the bones to become brittle so that when they break, they actually shatter!

ppat4pr,
congratulations, you've reached 84 without osteoporosis. I would side with the very reilable doctor. Any advantage with Fosamax is very slow, but it causes an additionl risk of osteonecrosis and atypical femur fracture more prevalent in those of us, like you, in our prime. It generally causes other anoying problems, such as reflux.
Fosamax and all the other bisphosphonates work by accumulating older bone. It prevents the normal process of remodeling that keeps our bones strong.

my two years on forteo are up in july. i am told that i will need reclast to hold my bones. this scares me because i am 77, have a few old gold crowns, and just had to have a cracked tooth under a gold crown pulled.

@ppat4pr it is true that anti-resorptives like Fosamax affect bone turnover , and it is turnover that creates new, quality bone. Bone density improves, however, on Fosamax. If Fosamax is used for a short time, the dental and femur fracture side effects are rare. At a certain age, I would even consider Prolia, but it is very hard to get off.

With osteopenia you may be able to try more natural approaches first, especially with the help of your more holistic doctor. But be careful. I am buying a hip pad for icy weather! Do your two doctors communicate? Is it a PCP who is recommending meds or an endocrinologist?

I will say that for my mother, starting at age 88, falls were an issue, so working on balance is a good idea too!

janflute not everyone has adverse reaction to Reclast. Some people are on bisphosphonates for many years and don't have problems with osteonecrosis or AFF. Your jaw should have recovered by July. If you are going with an implant, you might ask to extend your Forteo use.
Now that there is no limit to the amount of time allowed take Forteo patients are opting for a three year course. My hesitation for three years comes from the bone markers, which seem to become imbalanced between over the second year. We take a bisphosphonate after two years to "seal the gain." But what does that mean. Bisphosphonates do clad areas of the bone for seven to ten years. And they lower the osteoclasts number. So you have bone that is less flexible, doesn't repair cracks and can prevent fracture.
Findings from cadaver bones are that the bisphosphonate remains in the bone until breaks away at the margins of attachement.
It would be better if when we quit Forteo we could do bone scans every month to determine when bone loss ensues after treatement. What we use instead are bone markers at six month intervals. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2730878/#:~:text=Context%3A%20In%20postmenopausal%20women%2C%20bone,in%20men%20is%20less%20clear.
It looks to me like stopping Forteo for one month gives you the advantage of dropping CTX without the multiple possible and also the real disadvantages of Reclast.
Forteo helps to integrate the materials used for dental implants and has none of the risk of osteonecrosis or AFF.
My own plan is to do a reset after Forteo by stopping the medication, probably for a month, and then to enjoy the robust second application of the drug.
Alendronate might be an alternative to Reclast. It doesn't adhere to the bone for as long as Reclast. And you wouldn't be risking the severe reaction that some experience.