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Thanks for recommending "Great Bones", Yes I have read the entire 700 page book which was worth every page! That book has a vast amount of vitally important information I couldn't navigate this situation without. I know Keith McCormick doesn't promote HRT for women my age, with such low score and recommends it for prevention rather than regaining. There seems to be new information lately about the benefits and safety of HRT even for women long past menopause. I recently watched an interview with McCormick in which he states he has changed his position somewhat on HRT. I'm not hopeful the HRT can reverse my loss but hope it may stop the progression. My REMS Echolight fragility score showed incredibly that my bone quality was still on the border of green zone low fracture risk which may explain the mystery of why I haven't fractured yet with spine at -3.5! The REMS results were similar to DXA at -3 spine and -2.6 total hip compared to DXA at -3.5 spine and -2.5 total hip. I'm hoping with some quality of bone remaining and avoiding a fall I may be able to cope. I hope to start HRT in the near future with naturopath who specializes in it and menopause, but haven't consulted with her yet so not sure what she will recommend. I will have another DXA in 6 months, a year from my last. The internal medicine doctor from the Osteoporosis Clinic in Vancouver recommended Evenity which is at least an anabolic I would want. I would have wanted Tymlos if I chose a medication, but it appears Tymlos isn't available in Canada. I have read many of your posts on Tymlos which have been so informative and helpful for me. Thank you so much for sharing all your experience. The doctor said Forteo is available for a mere $12,000.00 a year! Evenity costs $8000.00. But even the cost is not my first reason for wanting to try all my options first. I may eventually book a video appointment with Keith McCormick if he still offers this. (Far less expensive than the medication costs!) Thank you again for responding.
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@debbie1956 What was the Dr. MacCormick interview that you listened to? I am also using his book as my guide..but books have the issue of not being able to update easily. I am hoping McCormick will issue updates as he sees fit. I am also in Canada (Ontario)...I believe there can be coverage for some of the meds esp if you have a fracture. I didn't think I had a fracture (no outward signs and my spine is not too bad at 2.0) until I asked my doctor for an x-ray and a subtle vertebral wedge fracture was found. Not happy about that but hoping it will qualify me for medical if needed. Alot of women don't get the xray after BMD tests..my doctor didn't suggest it so I assume it isn't protocol. I am waiting for an apptment with an endocrinologist so can confirm drug coverage then.
Hi Debbie1956. I’m from Canada too. We have a new bio-similar, ONERO, available in Canada that is half the price of Forteo. I started it 3 months ago. At first I had some serious side effects (extreme fatigue, heart palpitations) but I stuck with it and the side effects disappeared after a month thankfully.
I’m 65 years old with T-scores similar to yours. DEXA shows -3.3 in spine and -2.8 in hips. My REMS scan showed slightly better results and my bone quality was still in the green (bordering orange). I haven’t fractured yet. I downhill ski fairly aggressively, backcountry ski, and cross country ski in the BC during the winter months, so I felt I had to build bone to continue doing these sports. I was reticent to try Evenity as it is relatively new compared to the use of teraparatide, plus I have a family history of cardiovascular problems, so until speculations of it causing heart issues are proven wrong, I’m sticking with ONERO for two years, likely followed by an oral bisphosphomate or maybe Reclast (although that makes me a little nervous). I’d love to try HRT, but cardiologist says since there are other options to mitigate bone loss open to me right now, it’s probably better to use those (I’m 17 years post menopause). I hope after 3 years of drug therapy (2 yrs ONERO, 1 yr Actonel), I can take a drug holiday for at least 3-5 years. Then I might try Evenity? Or another round of teraparatide?
Good luck with your journey and I’m sure I’ll be reading your input to this site again. We have some wonderful contributors.
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@debbie1956 those expenses are daunting but it seems you are considering medications at some point. I was confused about whether the REMS was reassuring or close to the DEXA!
For years I had a false sense of safety. I thought, as long as I don't fall. But at -3.7 spine, it just took one unfortunate movement to fracture 3 vertebrae in my lumbar spine. At the time I felt strong and powerful (McCormick says the same thing) . So that's just a caution. Lifting, twisting, opening windows etc. etc. are all risks.
I am more leery than most about HRT for anyone because my breast cancer was fed by hormones. But having gone through both menopause and the super menopause from cancer meds, I understand that people are uncomfortable, sometimes very uncomfortable. And the other angle of using HRT for bones makes sense. In my early days of osteoporosis I tried things that were milder approaches, including calcitonin- which is very weak!
I was not able to tolerate meds and tried for years. I could not tolerate Fosamax or Forteo and tried to get on a trial early on for Tymlos. I was so grateful to finally get on Tymlos with its adjustable dose. I could not tolerate Evenity and stopped at 4 months. We all tolerate different things and we should not have to suffer financially while we try!
Good luck and thanks for understanding that I only post because of my fracture experience 🙂 I hope you will share your experiences, whether with HRT or a med.