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@awfultruth just to be clear I agree about possible overdosing, I posted a similar thread about Evenity dosing. Results may tend to be better for most people, but for some of us, less is more.
I just don't think the system is going to change. Class action suites, reports to MedWatch and our complaints to doctors haven't changed the protocol. Again, I think the issues favoring the 5mg dose are money, time, convenience, compliance, and the need for infusions by cancer patients.
On an individual basis, we can ask our doctors for lower doses but they most likely will want to follow the protocol unless there is medical justification for a low dose (like my kidneys and afib). Failing that, a sort of guerilla tactic is to decline the full infusion (I declined the second Evenity shot twice). I think many people don't know they can do that: that is what I meant by "passive."
For many Reclast is not an evil drug and very helpful. Another endo- I forget his name but another poster sent it to me_ has a video on the positives of Reclast that was enlightening. My friends take it with no problems.
I happen to have severe reactions in the first 5 days and a variety of side effects (pins and needles, GERD, dizziness, neuropathy) that I don't like to discuss ordinarily but just to show I am in solidarity with those who are suffering. I have these even at a 20% dose which makes me wonder if dose is even relevant. I have lupus and a wonky immune system.
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@windyshores On your thinking that the dosage may not be relevant you mention having side effects at a 20% dose so you wonder if dose is even relevant. Not to argue that you are wrong or in particular wrong about a drugs effect on your body - but I do think of it a bit differently.
And I think it is different for my body.
First thought was how do you know that you wouldn't have responded worse if you had a full dose?
Second thought along that line is that I've been extremely food and chemically sensitive for 40+ years. All those years if people asked me why don't you try just eating small amounts of a food and building up resistance to it. That could solve your problem. I would always reply that the dose didn't matter, I react to tiny amounts of foods I cannot eat (including those injections of minute amounts of whatever food was being tested). Anything I reacted to no matter the dose just made me more reactive for a few days. There was no build up of resistance or immunity.
Those discussions-arguments were sometimes pretty unpleasant to me and it was hard for me to have clarity and have a really nuanced discussion. I would argue that the tiny dose idea just would not work. I could react strongly to one blueberry I did not have to eat a bowl of them to react. There was not a safe dosage!
At my worst that was perhaps true. But looking back I think that probably a bowl of blueberries would probably have had worse consequences than the single blueberry. If you react to a single blueberry strongly it becomes difficult to judge things clearly.
I see I could go on forever with my thoughts about this. Maybe I can just say that even though emotionally I might have thought the dose didn't matter because one bite of something could make me feel bad for a day - in fact dose did matter and could make the reaction be stronger or last longer.
So this is not to argue against your experience but to suggest that there are many ways of reacting to drugs (and foods and all kinds of things) and that dosage could matter in different ways to different people. For me dosage does seem to clearly matter in most everyway I can think of. And of course that doesn't mean that a standard dose of Reclast will cause a problem for me but if I can get roughly the same benefit with a lesser dose of any powerful med I'm going to want that lesser dose.