New diagnosis at 56 yo. Looking for advice on non drug therapies.

I was 57 when I was diagnosed with a T-score of 2.8. I'm very health conscious and have always exercised (I was a dancer), used weights and ate a clean, organic whole foods diet so I was really shocked. I refused meds, thinking that if I just do more, do better, I could beat this. I told the doctor I would take 2 years, work harder than ever and build back my bones. Two years later I was at -3.2. I then realized that I would have to go on drugs to stop the decline. I went on Forteo as I felt it was the most "natural" of the drugs since it is parathyroid hormone. I had no side effects. First year I went to -2.8, second year I actually lost a little and went to -2.9. Moral of the story is, it's easier to save bone than try to gain bone. Had I gone on Forteo right away, I would have been out of the osteoporosis range. Hindsight is 20/20. That said, at your age you could look into HRT which might maintain your bones and with the right diet and weight training, potentially build some bone. I went on HRT after Forteo to maintain the gains and it appears that it has been effective for the last 7 years as my T-score remained steady with some slight gain shown this past year.

My opinion is that Dr Lucas is a charlatan. He's ridiculously expensive and hawks products. I'd steer clear of him as well as the Bone Coach, Kevin, who charges a fortune as well. I'd stick with Keith McCormick. He is legit, very knowledgeable and charges a reasonable fee for a consult. His book Great Bones is an encyclopedia of osteoporosis. He really knows his stuff and is not out to merely make a buck but to help people through.

You are getting good advice here about medications and HRT, and I agree that any expert, with a few exceptions, who sells an expensive product or service is highly suspect. Since you specifically asked about non drug therapies, I will share my perspective, but emphasize that it is unique to me, and everyone has a different situation. I would suggest you first make sure there isn’t any treatable explanation for your low density, which requires testing, investigate if you need improvements in nutrition, and then encourage you to find a good weight lifting program with a personal trainer who knows what they’re doing. If it doesn’t increase your bone density, it may slow down the loss, and will at least strengthen your supporting muscles to help prevent falls and fractures. My DEXA results were like yours at your age, and I stubbornly refused medication. I am now 69, with a -3.7 DEXA lumbar T-score, but I also did two REMS which show a decent fragility score and a -1.8 lumbar T-score. I’m not relying on that just because I like the score better, but it did make me pause when the doctor offered Evenity this spring. He is supportive in my decision to continue waiting a bit longer, given that I’m doing all the right things otherwise. In the meantime, I have not fractured, which would of course lead me down a different path, and I have added supplements and paid close attention to nutrition, but the best thing I ever did was add significant strength training, if for no other reason than to make me stronger overall and more confident in how I move. All that being said, I think the meds are good, or at least improving. I’m just keeping an open mind and watching how people manage the complicated sequencing of maintenance, because that process is probably why I hesitate the most.

I go to osteostrong and am in year 3. I think it’s been a good program for me. But I had an appointment with my orthopedic doctor today and he feels I should consider going on one of the drugs as my bones look like “egg shells “.
So here’s my question…Is anyone going to an osteostrong type program and taking a drug too?
Thanks for your help
Pat

Yes, his program is all online.

Could you please explain how a spinal fracture was the result of excessive pressure on ribs from bending on a hard surfac?

It is not obvious to me how this happens. I can understand a rib fracture or bruise resulting from this pressure but not a spinal fracture.

Guess I should have paid better attention in anatomy class.......

Have you researched and proposed other drugs to your physician? Why reclast? If he didn't explain it might be useful to ask him/her. Are you taking other prescription drugs. If so, it is easy to forget that they all have "possible" side effects.

Count me in positive med results.
Over 21 percent bone density gain in my spine after 2 years of Temlos. Towards the end of my regiment,I did experience some pretty significant nightime leg cramping, that has resolved.

I think it was a combination of extreme spinal flexion with pressure on the ribs attached to T8.

Thanks for your input.
My lowest score 1 year ago was -2.6 in The left femoral neck. Everything else is still osteopenia. I started on BHRT about 3 months ago and also I started strength training and have a personal trainer, plus I modified my diet so I'm hoping that all of this will at least keep my bones stable.

Every situation is a bit different. My mom had pretty severe osteoporosis so my whole life I exercised regularly (on top of weight bearing and daily exercise regiment I also hike almost daily, ski, practice martial arts a few times a week, etc). I always took calcium and vitamin d. At 51 I had my first DEXA and my spine was -3.4 (with the lower lumbars -4), similar in hips. When I met with the osteo doc he noted genetics can be a bitch. Obviously not taking drugs was not an option for me. I went on two years of Tymlos (an anabolic bone building drug) and had almost 20% increase in spinal density (about 4% in hip). I had zero issues. Last month I had my first reclast infusion to “lock in the gains”. I was so nervous but knew I had to do something. I had a little bit flu like symptoms the day following the infusion (which they had told me would happen), and no other issues. My mom initially delayed taking osteoarthritis meds, she broke 16 bones and lost 4 inches of height. She has been on Prolia since 2018 and no breaks since with no side effects (she is aware of the issues with getting off Prolia but they decided it’s a good fit for her, she will likely stay on it for the remainder of her life, she is well into her 80s). You could maybe discuss hormone replacement therapy as a possibility for now (if post menopause) with your doctor, it can benefit more than your bone I understand. Good luck on your journey. I do recommend talking with a specialist, the order you take the drugs matters if you end up going that route.