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STOP! Don't do this if you have osteoporosis
Osteoporosis & Bone Health | Last Active: Nov 12 11:04am | Replies (255)Comment receiving replies
I am a 70 y.o, active female and was diagnosed with severe osteoporosis a few years ago. I am slightly underweight for my height; I walk 30 mins at least 3x/wk and exercise regularly (flexibility and weight bearing). Very few "pains & aches" and have never had a fracture. I get a Dexa scan every 2 years.
I think years of steroids for asthma exacerbations were the culprit. But Fasenra (a biologic) has completely controlled my asthma since 2018, and I haven't needed steroids since then.
I was on Fosomax for several years, then my gynecologist recommended stopping. She suggested I see an endocrinologist, who prescribed Prolia (1x/6mos). I did that for one-an-a-half years, then was advised that Prolia actually doesn't strengthen the whole bone and can result in fractures that are difficult, if not impossible, to repair.
My endo was not happy I just quit the Prolia regimen without consulting her (couldn't get an appointment for 4 months!). I consider myself knowledgeable and proactive regarding my health, but this clash of viewpoints has got me frustrated and concerned...who's right and what should I do now?
Replies to "I am a 70 y.o, active female and was diagnosed with severe osteoporosis a few years..."
@proudgrandma as you may know and is frequently discussed on this forum and by my doctors, Prolia has a very risky rebound and we are supposed to follow it with a bisphosphonate to avoid rapid bone loss and increase in fracture risk (see also McCormick's book "Great Bones" and Dr. Ben Leder's video on YouTube on Combinations and Sequencing). If you have done fewer than 3 Prolia shots, you might be able to do Fosamax. If you have done more than that on Prolia, McCormick and others advise Reclast.
It's interesting that you have only been on anti-resorptives which increase density by affecting turnover vs "bone builders" like Forteo, Tymlos and Eventiy. I have been told we cannot do Forteo or Tymlos right after Prolia but I don't know if Evenity is possible. It is complicated. I hope you can discuss with your doctor.
But stopping Prolia cold turkey is reputed to be risky!
ps @isabelle7 I am assuming you meant Prolia, not Forteo, in your last lines!
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@proudgrandma
I’ve done a ton of research on steroid-induced osteoporosis. My husband has it and it’s bad. He’s got three fractures and is restricted to lifting nothing more than 5 pounds and can’t bend down making life difficult.
The drug that I found to be best for steroid-induced osteo is Forteo. It’s expensive and it’s daily injections so a lot of doctors don’t bother to tell their patients about it. But it’s supposed to be the best for rebuilding bone. His endocrinologist agreed with me. She put in a prescription and we are lucky insurance will cover it. He starts it on Monday. I think it would be worth discussing this with your doctor. And if you’re not happy with your doc I’d find a new one. For him the endocrinologist has been the most knowledgeable.
Something to know about Forteo. As soon as you go off it you can begin to lose bone quickly unless you immediately begin on Reclast which I believe is a once every six month injection at a doctor’s office. Or you can do Fosamax again but I’ve read that Reclast is superior.
I hope this helps.