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Confused about my TBS score

Osteoporosis & Bone Health | Last Active: Mar 10 8:40pm | Replies (16)

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@katgirl

I'm so happy Forteo is working for you!

TBS: So the inside of my bones are normal (for now) but the outside of my bones aren't?

So much to think about in terms of hormone replacement. My grandmother did die of breast cancer. And I have my cancer history (although nothing that would be affected by hormones, I THINK). I haven't had a gyno since the hysterectomy. It occurs to me that this may be why the hormone piece was never addressed. But I didn't need Pap smears after the surgery and wasn't near menopause at that time, so I was told I didn't need one anymore. I wish I'd been offered hormones at the time to deal with the horrible symptoms!! Now this far out, I'm not sure. I go back and forth on that too. I would definitely have to find a new doctor for that. Neither the endo or my GP are fans of HRT at this point. They just want me on an osteoporosis med.

I would actually feel better about going on Forteo or Tymolos than Evenity. (If I have a really bad reaction to one of those I can stop them immediately. With Evenity, you are stuck with 30 days of bad effects if not longer. ) Ironically my endo told me to research them and get back to her about what I wanted to take. So I was going to tell her Tymolos ( you can ramp up the dose, it has been out longer) and then I found out I can't afford it with my insurance. Another reason perhaps to wait though. I get my insurance through the marketplace and maybe next year I could get a better prescription plan, but I doubt it. And then reclast wouldn't be covered. So I think I'm going to be stuck with Evenity. Which, for me, is the scariest of the three.

Do you mean pay for a Dexa at the same place I got it with my health insurance? Or go somewhere else. It took me a year to get my first Dexa the waiting list was so long. So even if I schedule one now, I wouldn't get it until next spring. UNLESS my new endo has more pull than my GP in getting things scheduled. I should try to look back and see what my insurance was charged for that. I would also have to get my endo or GP to call it in. My GP says if I'm not taking medication she won't give me another scan until year two. I'm not sure what my endo will say. I will ask. Doesn't a doctor have to order it for you?

That was why I was considering doing a REMS Echolight scan instead. Although the next sign up for those near me won't be until this summer. Out of pocket would be at least $250 I think. I've heard this type of scan is more accurate with us small, fine boned people. And I don't need a doctor's order. I'm definitely interested in getting this scan. It's the one thing I'm NOT waffling about 😉

So, how long do the bone gains last with these drugs? Do you go through years of treatment and then only have the gains for a couple of years? Or are these drugs so new they don't know yet?

What about bounce back? For instance, I know if men take testosterone, their own body stops making it. Does that happen with these drugs? (I think that is the problem with Prolia?). What about Evenity, Tymolos, and Forteo. Does your body know how to go back to doing whatever it does with bones? (And I realize you have to take reclast after the anabolic to lock it in---how well does it actually lock? and for how long?

I find it amazing that the endo said" here are the three anabolic drugs, pick one" and that was the extent of our conversation about any of this.
I got more information when I bought a new bicycle for heaven's sake.

I can almost guarantee I will be one of the people who has side effects. I'm extremely sensitive to everything!! I have MCS and a whole host of other sensitivities. I envy people who can take meds with nearly no complications.

Thanks for all your input and just for listening!

I should probably go rest my brain as well as my body now.

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Replies to "I'm so happy Forteo is working for you! TBS: So the inside of my bones are..."

yeah, katgirl read this tomorrow or the next day when you feel better.
Your trabecular bones are probably thin. Dxa describes the little section of bone squared of in the images. The femur is 30 to 50% trabecular The lumbar spine is around 90% trabecular.
TBS isn't addressing density. Your TBS is telling us that those tiny bones have not disconnected from each other. There is structural integrity. We only know they are thin from the dxa report. TBS software uses different information from the exact same images as the dxa.
It is still the held opinion that HRT can have an effect on breast cancer. With genetic risk, I'd
avoid it. I'll never take estrogen because I was ever so happy to be free of it.
I'd rather see you on Forteo. Tymlos contains preservatives concerning because of you chemical sensitivity.
Evenity is the latest. It hasn't been real world tested, but most people are having good results.
Prolia is the rebound drug. It is good for those without kidney issues or side effects and take it for the rest of their lives. It is the only osteoporosis drug that promises to leave your bones weaker than if you'd never taken it. Reclast has been somewhat efficient at blocking rebound from Prolia.
In general, men regain their baseline production of testosterone after quitting supplementation.
When you stop taking Forteo or Tymlos you won't return to lower than baseline. But you would lose the gain.
Things are in flux with those two medications. There aren't studies for use beyond two years. And many physicians are uncomfortable prescribing it that way.
The endocrinologist I see has promised to prescribe Forteo until my T score is at -1, when I asked for a third year. I was quite pleased.
I always think "sealing the gains" is a strange construction. The anabolics stimulate the process of rebuilding bone. All the other medications stymie or stop the living process substituting it with systemic senescence.
I want to be sure that you have checked with the pharmaceutical companies to see if they will help with the payment. Both Tymlos and Forteo have such programs.
I am sometimes completely unclear in these posts. Be sure and demand answers wherever I'm remiss.
Happy Dreams.