What to do!

With those numbers at your age I don't think you have much choice, sadly. -2.5 is officially osteoporosis. My doctor told me that older osteoporosis patients sometimes fracture their bones merely by turning over in bed. As to Fosamax v. Prolia all I can say is that Fosamax gave my mother severe jaw problems, so I am biased. Others will be in a better position to comment.

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Guinivere, tell your doctor that Fosamax is too slow, Prolia is too dangerous and with your numbers you need an anabolic.
Of course, you don't have to decide today, but your doctor is afraid you might fracture. It's good that the office called you right away and good that she is concerned.
Windyshores gives the best advice and has the most experience. I would cross off Evenity, but it's better than the two you are offered.
You should call them so they can get started in case there is a slow-down with insurance.

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Guinevere, after they give you the rush.
I'd thought to suggest you have them expedite your request. Your doctor may have to do some research. After, the office will have to get insurance approval. It can take some time expecially if the insurance doesn't want to approve and they have to appeal. Still, your request should have generated a response. I suspect they were surprised, probably expecting you to resist.
Excellent choice, Tymlos.
I especially like that you left the re message this morning.

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@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!

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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!

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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.

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@guinivere hope you can do Tymlos!!!!
Your description of where you live makes me want to visit!

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Guinevere, after they give you the rush.
I'd thought to suggest you have them expedite your request. Your doctor may have to do some research. After, the office will have to get insurance approval. It can take some time expecially if the insurance doesn't want to approve and they have to appeal. Still, your request should have generated a response. I suspect they were surprised, probably expecting you to resist.
Excellent choice, Tymlos.
I especially like that you left the re message this morning.

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