Which doctor is best to treat Osteoporosis?

@jtdesignertbdl unfortunately for some of us, the dangers and effects of fractures are worse than most side effects on drugs. I have trouble tolerating medications (and have afib, lupus, kidney disease) and have managed to take them with altered dosing strategies. Some people on the forum have no side effects, some have many.

If your osteoporosis is mild, look into holistic approaches for sure. Keith McCormick's book "Great Bones" covers both holistic and medication . approaches. Doctors' arsenal is pretty much limited to medications.

I have both types of doctors, a RA and a Endocrinologist. I originally gone to an Endocrinologist years ago fir my hypothyroidism. I started with a RA doctor a few years ago for Gout from kidney damage from taking Prograf/Tacrolimus for liver transplants since 2000 and inn2017. My Heptologist was the one to order my bone scan in 2018. My Endocrinologist stepped up to treat my osteoporosis with Calcitrol and Prolia shots. My RA doctor saw this in my records and started to monitor my osteoporosis with my Gout too. I feel lucky here. Both are willing to monitor treatments.

Why don't we get regular dexa scans; we get mammograms. I was told by my gynecologist that they were not done until a woman turns 65. I broke a wrist (car wreck; airbag) at 62 and I asked the orthopedic surgeon if I should get a dexa. He said not necessary. We lose bone throughout our lives; notably after menopause. Why don't we get a dexa at menopause and perhaps every year or two after that? At this point I have severe osteoporosis and other than nasty expensive medication (plus prescription Vitamin D ongoing)I have not been given any information on what else I can do. I found some answers on the internet; not through my doctor. Sure would have been nice to have the opportunity to try to possibly hold off osteoporosis.

I have been asking this same question, and grateful for all the replies. Within the past two years my Dexa scan numbers went from Osteopenia to Osteoporosis ranges. I was pro-active and asked for these tests myself - never were they recommended from the PCP. And even with the results, his recommendations are simply to take a supplement of Vitamin D. I went to a Functional Medicine practioner who recommended a high dose of Vit D, and that level came up within a “normal” range within 4 months (I had to ask the PCP for the lab order to retest). I had a discussion with a woman I respect who is now giving herself “shots” (I don’t understand yet) but she says it is her Gynocologist that she leans most heavily on. Since re-locating, I have no specialist and am wallowing in how to find one, and which specialty. I also have osteoarthritis in my hip (already had a replacement on the other side….that surgeon has left his practice and was in New England). Clearly my hip needs replacing, but with the Osteoporosis diagnosis now - I am very concerned. At the moment I’m seeing a Chiropractor who is treating a disc degeneration in my lower spine, but is not able to address the hip issue and knows little about bone density. I’ve been listening to Dr Doug’s podcasts and find them insightful given his attention to the quality of research. He expresses his frustration at the lack of studies made specifically on post-menopausal women 10 years and beyond.

It's worse for men in one way: doctors don't even *think* about osteoporosis for us. I had a stress fracture in my spine last year, age 64 at the time, not from a fall. Even the orthopedist who treated me didn't say "Hmm, you didn't fall, and this happened.., maybe you should get a bone density test." I had to pursue this for myself - and now I'm on Tymlos. 😉 I've had annual physicals for years, and no doctor has ever mentioned it to me.

McCormick says everyone should get a test well before they're in their 60s.

I consider not asking or ordering a simple dexa scan in later years (60)s
is poor patient care. They ask blood work mammograms for women and prostate exams so why not a simple 15 min dexa scan?.

Hello @rlr602024 and welcome to Mayo Connect. I appreciate your concern in finding the right doctor to treat your osteoporosis as well as getting a good recommendation regarding the feasible options for a hip replacement. As your chiropractor has indicated that he/she is not able to address the bone density issue, I would highly recommend that you begin some consultations to specifically address that issue.

I would suggest getting a referral to an endocrinologist. I would also recommend that the endocrinologist you choose be part of a multi-disciplinary medical center (such as Mayo Clinic) or a university medical center. At health centers such as these, you will have recommendations and referrals to well-trained doctors who can communicate with each other in the same hospital system.

If you would like to consult with a Mayo Clinic doctor, here is a link with appointment information, http://mayocl.in/1mtmR63. Otherwise, if you live near a university medical school that would be good as well.

From your post, I'm guessing that you are having a lot of pain related to the osteoporosis as well as the hip problem. Is this the case?

I've read recommendation for dxa at 45. But at the very least women should have a dxa at the onset of menopause. The 5 years following menopause are critical because our bones need estrogen.
We depend on physicians to be knowlegeable outside of their speciality. Research has expanded our understanting of psysiology so extensively that it is difficult to stay abreast even in a single field. I would be wary of a internests, gps, primary care specialists prescribing osteoporosis medications. As patients it is important to do our own research, carefully.

Luckily, I have a great OB/GYN who insisted I get my first DEXA at 51, which showed osteopenia in my hip. I started on HRT, calcium + Vit D at the same time but did not take medication for another 6 years until I had progressed into osteoporosis in my hip.

If not for her, I would never have had a DEXA. I'm grateful she was on the ball.

Oopsie, what state are you in as that is great news your Ob/Gyn was proactive and on the ball. Figures was a woman 🙂