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What to take for osteoporosis

Osteoporosis & Bone Health | Last Active: Nov 20 8:59pm | Replies (34)

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@gently

elizabeth1, your doctor may be correct. Knowing your health history might give them the best knowlege of what medication would work best for you.
Prolia is one of the most convenient an injection every six months.
It works in a way that is different than any of the other interventions. Prolia halts the body's normal process of bone acquisition. We have cells that break down the bone and cells that lay down fresh bone. Prolia is very effective at stopping the breakdown of bone, consequently you won't lay down any new bone. The increase in bone density will come from the collection of older fissured bone. This non-active bone less blood supply. While you are on Prolia for two years your fracture risk will be lower.
Unlike bisphosphonates the cells that break down bone are halted in the last stage of development. When you stop Prolia they will develope and be released with a vengeance on your bone. It is most common to take a bisphosphonate immediately following Prolia to try and cause those cell to die. The most effective of those bisphosphonates is Reclast. There are many articles and much discussion about how to stop Prolia safely.
There was a study indicating that taking Prolia with Forteo gives a better gain than either drug alone.
It isn't a popular option because it is difficult to get insurance coverage for two expensive medications.
You might want to use the search box for Prolia side effects.
In my opinion Tymlos and Forteo are safer pharmaceuticals that enhance the normal processes to build new vascularized bone.
I withhold a little panic I feel when anyone chooses Prolia. Wishing you the best luck.

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Replies to "elizabeth1, your doctor may be correct. Knowing your health history might give them the best knowlege..."

@elizabeth1 I think @gently has shown admirable balance and restraint 🙂

Keith McCormick's book "Great Bones" explains the dramatic rebound effect when Prolia is stopped ( loss of bone density, increase in fracture risk) as well as the details of getting onto Reclast afterwards.

Dr. Ben Leder mentions doing Forteo for 2 years and intersecting with Prolila after 6 or 9 months (sorry I can't remember) then staying on Prolia past the end of Forteo and then Reclast.

My

If your bone scores aren't too bad Prolia might be a great choice. Also if you are in your 80's because you might not have to stop! The only other thing my doctor and the above resources say is that Prolia may reduce the effectiveness of bone building drugs like Tymlos, Forteo or Evenity.

My own endo doesn't use Prolia unless there are no other options. Every provider is different.

I hope you have an endocrinologist you trust who may have very good reason to be prescribing Prolia. Ultimately of course it is up to us to decide but it helps to have a doctor you can converse with.