Hesitant to begin drug treatment for my osteoporosis

It is difficult to know how much of a role the supplements played in my slight bmd increase from -3 to 2.6 spine over a 10-month period. I suspect that the bhrt I started about 6 months after the supplements has had the largest impact. Had I not taken the bhrt, I could confirm whether or not these supplements with high protein diet helped. Keith McCormick refers to his patients CTX came down with supplements, diet and exercise alone they're OP was not too severe. I am confident that the bhrt was the main reason for my CTX bone turnover rate reduction from 688 to 138 over 8 month period. It is true that these supplements are expensive, but I reduced the dosages by half after reading Keith McCormick's suggested dosages which greatly reduced my costs. I also order from iherb whose prices are the lowest I've found for good quality. I am small like you at 5'1 and a half, 125 lbs. My REMS Echolight shows my bone quality still quite good as well and I am waiting to have TBS. I don't wish to take medication either and have so far not fractured. It would seem to me that bone quality and stopping further progression is most important. My progression of bmd loss appears to have stopped with a slight gain even. I am hoping to maintain this over the long term sounds like cheap monitoring with bmd scans and bone marker tests.

I am new here, just as a few minutes ago. I can empathize with not wanting to start drug treatment. I only recently found out I have osteoporosis at age 65. And, for my age, my doctor said my lower spine was severe, but femoral neck of my hip not as bad. In any case, what a shock! But, like you, I have tried not to panic and look at the big picture. I’ve been researching the topic, purchasing books and listening to bone health experts for two months now . . . . I’ve learned that various types of weight training and IMPACT exercises can help increase bone density. But the most important thing I learned is that a DEXA score doesn’t PREDICT a fracture. It just alerts you to having more vulnerable bone density that “could” fracture. But what holds our bones in place, in part? Muscle! And, muscle strengthening pulling at bone stimulates bone growth if there’s enough impact and pull. But I’m likely preaching to the choir, as you sound like you’ve also looked into all of this to take a holistic path, as I am. Balance exercises help us stay up to prevent falls and keep our balance. In any case, this is the first entry I’ve written on here, so just learning about it all. I apologize if I’ve errored in any way. I’ve added new foods to my diet that are helpful, also. I’m sure you know — and I’m like you, that we need to educate ourselves and do whatever we can through education, diet & exercise to prolong any drug interventions. I was given two years to give it my best, without medications — according to my doc, before I get another DEXA to see if there’s any improvement. But The DEXA isn’t the only marker of bone health! There are OTHER tests that help assess bone remodeling — how much bone we are currently losing and how much we’re gaining. This was VERY important for me to know NOW. Once I found out about these tests - I was determined to get them! (even if insurance won’t cover them). My general physician agreed to order these on my account, though it’s not a “routine” test given. I’m waiting on the CTX and P1NP boner marker tests, just to see how much bone I’m losing and how much I’m gaining now. (I had been going to the gym for the past year, I might add). Everyone who has osteopenia or osteoporosis, even without being on medications, should know the health of their own bones, so that you can assess it in 8 months or more to see if the changes you make, make a difference. I’ve learned that what’s important is the RATIO of these tests. I will start another thread on another day about how frustrating it is to find anyone who knows how to interpret these tests!!! The health care system, at least in my area, is lacking in so far as helping those who do NOT want to go on medications — and offering tests to assess bone health like these. I’m not too happy about that and rather frustrated, to be honest! I see you wrote a year ago. How are you doing now?? I have no idea if you can private message people on here, as I’m new at this. Keep on doing what you’re doing and I wish you all the best!

I am new here, just as a few minutes ago. I can empathize with not wanting to start drug treatment. I only recently found out I have osteoporosis at age 65. And, for my age, my doctor said my lower spine was severe, but femoral neck of my hip not as bad. In any case, what a shock! But, like you, I have tried not to panic and look at the big picture. I’ve been researching the topic, purchasing books and listening to bone health experts for two months now . . . . I’ve learned that various types of weight training and IMPACT exercises can help increase bone density. But the most important thing I learned is that a DEXA score doesn’t PREDICT a fracture. It just alerts you to having more vulnerable bone density that “could” fracture. But what holds our bones in place, in part? Muscle! And, muscle strengthening pulling at bone stimulates bone growth if there’s enough impact and pull. But I’m likely preaching to the choir, as you sound like you’ve also looked into all of this to take a holistic path, as I am. Balance exercises help us stay up to prevent falls and keep our balance. In any case, this is the first entry I’ve written on here, so just learning about it all. I apologize if I’ve errored in any way. I’ve added new foods to my diet that are helpful, also. I’m sure you know — and I’m like you, that we need to educate ourselves and do whatever we can through education, diet & exercise to prolong any drug interventions. I was given two years to give it my best, without medications — according to my doc, before I get another DEXA to see if there’s any improvement. But The DEXA isn’t the only marker of bone health! There are OTHER tests that help assess bone remodeling — how much bone we are currently losing and how much we’re gaining. This was VERY important for me to know NOW. Once I found out about these tests - I was determined to get them! (even if insurance won’t cover them). My general physician agreed to order these on my account, though it’s not a “routine” test given. I’m waiting on the CTX and P1NP boner marker tests, just to see how much bone I’m losing and how much I’m gaining now. (I had been going to the gym for the past year, I might add). Everyone who has osteopenia or osteoporosis, even without being on medications, should know the health of their own bones, so that you can assess it in 8 months or more to see if the changes you make, make a difference. I’ve learned that what’s important is the RATIO of these tests. I will start another thread on another day about how frustrating it is to find anyone who knows how to interpret these tests!!! The health care system, at least in my area, is lacking in so far as helping those who do NOT want to go on medications — and offering tests to assess bone health like these. I’m not too happy about that and rather frustrated, to be honest! I see you wrote a year ago. How are you doing now?? I have no idea if you can private message people on here, as I’m new at this. Keep on doing what you’re doing and I wish you all the best!

If you decide on starting meds, a question I might ask my (endocrinologist?) is......why not a bone builder first? I'd want to know the prescribing physician's rationale.
It is my understanding that sequencing these drugs is very important and that a bisphosphonate before may blunt the positive effects of a bone builder (tymlos, forteo and evenity).

Hello,
Thanks for that important information. I am 58 and I discovered I had osteoporosis about 18 months ago and have been researching ever since.
My femoral neck is -2.2. My BMI is 20.6 and was told it is highly recommended
that I start medicine. I was told to start on Reclast but after researching it I discovered if anything goes wrong it stays in your system and have to suffer the consequences which seemed severe. I decided to go on Forteo because it was an anabolic medication meaning it promotes bone formation and a well known endocrinologist said it's best to start with an anabolic drug. He also said to NOT start with Fossomax-the sequence of medication is extremely important.
Unfortunately my health insurance does not cover Forteo at all! I may have to start with Tymlos instead. I may have no choice. I discovered the side effects of Tymlos are belly fat, joint pain, tiredness, diarrhea, fatigue and bone or joint pain. I asked my nurse practitioner about utilizing other tests and she did not know anything about alternate tests.
I am seeing Dr Chatterjee in Columbus OH and she is Dr Chatterjees nurse practioner. I know I need to go on medicine but very hesitant.
Thanks for the info you provided it truly helped.

Hello,
Thanks for that important information. I am 58 and I discovered I had osteoporosis about 18 months ago and have been researching ever since.
My femoral neck is -2.2. My BMI is 20.6 and was told it is highly recommended
that I start medicine. I was told to start on Reclast but after researching it I discovered if anything goes wrong it stays in your system and have to suffer the consequences which seemed severe. I decided to go on Forteo because it was an anabolic medication meaning it promotes bone formation and a well known endocrinologist said it's best to start with an anabolic drug. He also said to NOT start with Fossomax-the sequence of medication is extremely important.
Unfortunately my health insurance does not cover Forteo at all! I may have to start with Tymlos instead. I may have no choice. I discovered the side effects of Tymlos are belly fat, joint pain, tiredness, diarrhea, fatigue and bone or joint pain. I asked my nurse practitioner about utilizing other tests and she did not know anything about alternate tests.
I am seeing Dr Chatterjee in Columbus OH and she is Dr Chatterjees nurse practioner. I know I need to go on medicine but very hesitant.
Thanks for the info you provided it truly helped.

I am learning so much by reading these comments. However, I am looking for comments from anyone taking Fosamax. Of course, the list of side effects scare most anyone, but so far, so good for me. Any comments will be much appreciated.

Did the recommended limit of 5 years fosomax/alendronate. No problems but I followed the instructions without deviation