Hesitant to begin drug treatment for my osteoporosis

Hi Lynn,

You're welcome and sorry my reply was way too long!!! Yikes. (just saw) I wish there was a way to be notified of a response. I didn't know you replied until just now!

That's great news about the REMS test and your bone quality. That should give you more confidence and encouragement as you continue on your brave and determined holistic journey. Just keep doing what you're doing!

I spoke with my general doctor today, but was disappointed she really didn't know how to interpret the data for the CTX and P1NP bone marker tests; other than telling me there's no tried and true "range". (not her exact words). But because my P1NP was actually 10 points HIGHER than the upper range, she said that's a good sign I'm building bone. But my CTX, which measures losing bone was also above, which means I need to get that one down. And it just confirms that osteoporosis diagnosis.....Change can take up to 8-9 months I have learned......Those are my first two "tracking" tests.

I also see a physical therapist, (you must be in Canada or UK, as they call them as you wrote elsewhere) to guide me in the exercises to help gain bone density and muscle strength. And my doctor just gave me a referral for an endocrinologist, but I don't know how helpful one can be. What did the endocrinologist suggest for your bone health? I'm just curious.

I find it very frustrating that there are few local bone specialists. I'm still looking!

Wishing you all the best. You're very lucky your GP will provide more in-depth tests. To my doctor's credit, she's checked my thyroid markers to make sure that's not the root cause. All is well in that dept. So far, for me, it's post menopausal and perhaps my plant-based diet, which I'm tweaking. (adding more protein, eating more foods that assist in bone growth - not just calcium but other minerals.)

Take good care, and you also have a nice weekend, wherever you may be!

I’m not an expert on the medications but I have done a lot of research. Many Osteoporosis “experts” do NOT recommend going on Prolia first because once you get off that, you have to go on another medication otherwise you increase the risk of a fracture . Why not try an anobolic (a bone builder) medicine like Tymlos or Forteo or Evenity first?? Just my opinion. Maybe you could ask your doctor??

@lilac2025
Hello Lilac,

Thank you for your reply. No worries, It was a great read and really spoke to me. My apologies, I should have used your handle and/or read the ‘how to’ instructions…I tend to dive in and figure things out on my own.

Yes, the REMS score was encouraging so plan complete every 6-12 months. My Dr advised DEXAs are only allowed every 5 years in Canada. What, I thought! Upon further investigation discovered those experiencing fractures and/or bone density below normal it’s every 3 years. Which is still too long. I wish to know my progress at least every 12 months. I’m happy to maintain my numbers ~ but would love to improve.

I hear you on access to specialist and tests. I’ve watched a few videos presented by orthopedic surgeons and pharmacists where links to CTX P1NP studies are often shared. I’m not sure if an orthopedic surgeon is accessible in Canada w/o a fracture or planned surgery. When first diagnosed, I ask my doctor what specialist I could meet with, orthopedic surgeons and/or endocrinologists. Still working her…

The endocrinologist recommended avoiding estrogen unless I’d been on it since menopause due to blood clot risk. But, I heard of studies where it was questioned or disproven so need to do more research. She shared some positive news, I thought my spine numbers suggested high risk of fracture, but she said I’m only moderate risk [she does not support the REMS test but results indicated my bone quality is not bad ~ so that’s a bonus]. She asked what steps I’ve taken. I shared I do planks, pushups and wall squats, and restarting upper body and lower body workouts 2-3 x week [fell off during covid]. She said I’m good w/o drugs or hormones if I keep up the calcium and the w/o’s. She wanted me on milk but I stated I reach 1200mg Calcium w greek yogurt, greens, nuts and seeds [basil seeds are really high].

Recently, I learned of the book Great Bones by Keith McCormick thanks so a post in this community. I look forward to reading about his journey to wellness with Osteoporosis. One of his sites list all the tests he suggests. I’m not sure if it’s ok to share links here so I would send you a private message with names of the doctors and links. Just let me know or msg me here. Keith McCormick is quite easy to find on line.

My physiotherapist and I discussed testing strength improvement in 6-12 months. If I’m getting stronger the bones are in a better place so I think strength testing is a good way to go. 



I’m no expert on plant based vs animal based but I learned from Dr Doug (The Dr Doug Show), we need 2.5mg of the Amino Acid Leucine to build muscles. I still need to do my research but I make sure to hit that daily. It’s easier and less work with animal proteins. Most days I’m close w/o chicken, eggs or cheese so just ingest Pea Protein powder to reach that number.

Have a great week! If you are in the USA Happy 4th of July!




Just be aware if doing plants and seeds that many contain oxalates. Oxalates can inhibit calcium absorption. Spinach and almonds are high in oxalates, for example.

I put it off for 25 years and I ended up with severe osteoporosis. I tried Boniva, a biophosphonate in my 40s when I had osteopenia. I had too much bone pain right away so I stopped. 25 years later I’m at the end of the osteoporosis scale, so I got approved for Evenity. My dr said it was the only drug class that both tore down old bone and rebuilt new bone, and that’s what I needed. After a year I had good results.

Then she said I needed a maintenance drug so I didn’t lose my gains. Since I didn’t tolerate a different biophosphonate, Prolia was a good choice as I could take it the rest of my life, once every 6 months. Reclast was one shot a year for 2-3 years only, with a little more side effects. But I had a lot of bone loss and that probably wouldn’t be enough since I’m young, I’d end up on Prolia anyway. She said Prolia was studied more than a lot of the older drugs, and thought I’d do well on it with my other medical conditions. I have the autoimmune disease generalized Myasthenia Gravis, a seizure disorder, neuropathy and some other minor ones.

I always felt nervous considering a new med, but I’ve done my research, talked to my drs, pharmacist and a lot of people online, slept on it, did some more research, and made my decision. I can honestly say I don’t feel bad about any of the choices I’ve made, because I followed this process, and that’s about as good as it’s going to get. I haven’t had any side effects other than a slight sore arm or the one time I had a little flushing because the syringe wasn’t brought to room temp first.
I wish I had started earlier because maybe I would’ve kept more bone, but glad I did it before I broke a bone. I feel better about it now as it’s all I can do besides getting the 1280mg calcium D&K recommended

So you incorporate weight bearing exercises? It has made a difference for me.

Hello @nannygoat5

Thank you for mentioning Oxalates.
I have researched Oxalates and I'm still at it. It appears almost everything I consume inhibits calcium absorption...next step is a spread sheet. In my opinion with my basic knowledge on the topic of absorption... timing is everything.

I know! I finally decided to just stick with dairy lol!

I am still on a biannual schedule for DEXA scans. My next one is in a year.

Hello, I was also diagnosed with osteoporosis but I never saw the report that indicates where exactly (spine, hips, etc) I am most vulnerable. I saw an osteoporosis specialist and he suggested Evenity injections once a month for a year.

Upon researching this, I gathered that if this drug does in fact help my situation, after a year you no longer take it and the benefits stop as well. So, then it’s on to another drug with different side effects. And so on and so on.

I will take my chances without this uncertain drug therapy. I will take supplements and be very careful not to fall or do anything to break any bones.