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Need Advice - What drug to Follow Up Evenity
Osteoporosis & Bone Health | Last Active: Nov 23 6:59pm | Replies (63)Comment receiving replies
My t-score is -4.8, so the endocrinologist wants me to start Evenity ASAP. I am concerned about stroke risk, since I also have AFIB. And what do I transition to when the year of Evenity is up? My mother and aunt both had trouble with Fosamax, so I want to steer clear of that. I envy the person who said they were back on their HRT. I cannot find a doctor to prescribe it for me (I'm 65). I've asked three so far and all have refused, for various reasons, ranging from the fact that I am over 60 to the belief that it will not help my osteoporosis. Should I try to see a rheumatologist before I commit to anything? Would they be more willing to at least think about HRT? I am feeling undone by all this, since these decisions will have definite consequences, either good or bad. Sigh.
Replies to "My t-score is -4.8, so the endocrinologist wants me to start Evenity ASAP. I am concerned..."
@callmekate A t-score of -4.8 is serious business. I would not rule out Evenity (the most powerful and fastest bone builder) because of AFIB. As to stroke risk and cardiovascular events if you look at the research you see a slight elevation in events in one study and none in the other major study. Certainly if there is an elevated risk it is not great as too many people are taking Evenity now and those CV events do not appear to be happening.
Try to balance the risk of fractures with a -4.8 vs the very slight maybe potential increase in risk (and maybe no increase of risk) with Evenity.
I am biased - I chose Evenity and had great results and no side effects worth even mentioning.
I would investigate the CV and AFIB issues and discuss with doctors but I wouldn't reject it out of hand. With quick searches I don't see any mentions of AFIB with Evenity. There is some concern about AFIB with bisphosphonates which you would likely need after Evenity. Not sure about Prolia. You definitely need a good doctors guidance with these issues.
I would suggest you see a Functional Medicine type doctor for BHRT. My wife starting BHRT in her seventies working with our integrative cardiologist. It is definitely doable and it would probably still help your bones but not work as a powerful bone builder like Evenity.
Good luck to you
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@callmekate
I also woud avoid Evenity because of the afib.
I suspect HRT will not be sufficient fracture protection for your bone density .
Have you considered the bone building medications Tymlos or Forteo.
I agree with your endocrinologist's encouragement to begin treatment right away.
I would ask the endocrinologist for Tymlos and ask for an introductory pen so there'd be no waiting.
A gynecologist might be more likely to prescribe HRT.
You could see a rheumatologist or another endocrinologist, except I wouldn't encourage the wait.
Reclast is another option. I consider Tymlos and Forteo better medications, but Reclast would offer you fracture protection.
Bless your struggle with luck