Is medication really necessary?

Posted by sgtmlt2 @sgtmlt2, 5 days ago

I was just diagnosed with osteopenia and they recommend that I start on Reclast. The idea of more pharmaceuticals isn’t appealing and I would like to know if weightlifting, a very focused diet, and perhaps the addition of supplements could be sufficient? I welcome any and all recommendations.

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sonyao | @sonyao | 1 day ago

In reply to @susanjohnston "Thanks so much. I start Tymlos on Monday and I am so scared. Now even more..." + (show)

I have been on it Tymlos since November, 2024 and have had no issues at all. Just had 6 month lab work and all is good. Will continue to take for a year and a half and then move to IV med per my MD. Good luck to you

cs53 | @cs53 | 1 day ago

In reply to @sondrachristo1 "So sorry you are going through all this, I know the journey is hard. You may..." + (show)

Oral bisposphonates sent me to the ER 20 years ago with chest pain and acid reflux (didn't even know what it was at the time).
The reason I never took bone drugs until I had to. I did the natural route with supplements and bioidentical hormones. Steroid shots for back problems and pain did me in. My Bit D was 40 last check.
What are bone turnover markers?

waptap2learn | @waptap2learn | 1 day ago

In reply to @sondrachristo1 "So sorry about your Mom, the loss of a parent goes so deep. You are so..." + (show)

Thank you! And thanks for y our input...definitely calcium from food as much as possible and adding magnesium, too.
I checked your Chronometer site, looks difficult to navigate, guess, like everything else, takes getting used to! Thanks!

sondrachristo1 | @sondrachristo1 | 1 day ago

In reply to @cs53 "Oral bisposphonates sent me to the ER 20 years ago with chest pain and acid reflux..." + (show)

I’ve been on 5 different osteoporosis meds, and I had terrible side effects from all of them. I just started hormone replacement therapy, it’s the last tool in the toolbox for me.
Have you tried Evista(raloxifene) it’s a SERM. It’s works like estrogen on bone receptors, but does not act like estrogen in places you don’t want it, like breast tissue. This was the last osteoporosis drug I took. The side effects were the least intolerable of all the others, but I wasn’t comfortable taking it. It’s the least effective of all the treatments though.
There are 2 bone markers - these are blood tests -
CTX or sometimes referred to as NTX - this marker looks at bone resorption, the bone breakdown or osteoclast activity. P1NP looks at bone building or osteoblast activity.
Depending on which drug you are taking, your doctor would expect to see a reduction in one or an increase in the other.
If you are taking teriparatide, this is an anabolic or bone builder so you would expect to see a higher P1NP.
If you were taking Prolia, an antiresorptive, which diminishes bone breakdown, you would expect to see a lower CTX.
It’s always best to get the bone markers at baseline before you start treatment so that you can determine the success of the treatment after taking the drug for a bit and then being retested.
Make sense?

gently | @gently | 1 day ago

In reply to @cs53 "Oral bisposphonates sent me to the ER 20 years ago with chest pain and acid reflux..." + (show)

cs53,
bone turnover markers measure particles in the serum that tell you if you are adding or resorbing bone. It tells you if a medication is working for you. Some suffer the side effects of a drug one or two years (until their next dexa only to find out that the medication wasn't effective.
CTX and P1NP each measure a specific fragment left in the blood during each process. It is best measured before the drug and two or three months after beginning to take the drug.
With drugs that work by preventing resorption of the bone CTX is the fragment that should be lowered. With drugs that work by building bone P1NP is the fragment that should rise while taking the anabolic.