Information about success and side effects would be appreciated!

You sound very well educated on this subject.
I just posted as a new patient not yet on treatment. I have an excellent PCP; she has not yet referred me to another provider for osteo but I will follow up after she reviews my dexa.
Is endocrinology the next logical step?
Thanks for whatever input you can provide.

If you haven't already, it would be a good time start researching local endocrinologists or perhaps even an Osteoporosis specialist. In addition research the various osteoporosis drugs as well as additional/adjunct approaches to handling osteoporosis. There is an abundance of information and experience here. You'll want to be prepared to ask many questions at your pcp appt. Glad you are joining us. OsteoBoston has had a variety of experts present and they post on YouTube.

Hi @joybo99. I was diagnosed by my PCP and Fosamax was prescribed. Subsequently, my podiatrist sent me to a metabolic bone specialist who is excellent, and he

prescribed Evenity for one year and then Tymlos. I currently am
under the care of a rheumatologist who specializes in osteoporosis and I started Reclast in May of 2025. I also have
an endocrinologist who is not up-to-date regarding osteoporosis and has demonstrated that he prefers to remain that way. So as you can see here, there are many specialists that treat osteoporosis. Using the overall search of "metabolic bone specialist " will show you a wide variety of doctors who have different specialties. My endocrinologist doesn't specialize in osteoporosis. One of my rheumatologists does, and my former rheumatologist doesn't.
Gosh, I hope I haven't complicated things for you!
It's very helpful to know what drugs are available so that you can ask your provider about each one and why they've chosen one over another. You can keep it simple and just learn the names or deep dive if you want to. Next thing is to ask your doctor what the long-term plan is. That's crucial, as some medications preclude others or need a specific sequence to optimize your results.
Glad you found your way here! Warm regards and best wishes.

@deborahla Sorry, I wrote a whole reply...but it disappeared!
Yesterday, I received the Reclast infusion, just the thought of it made me sick to my stomach (I am very hesitant about drugs!) The nurses at the infusion center were wonderful! The whole process took about an hour...nothing was painful!
Now to your question. My doctor believes that I will only need this 1 Reclast infusion. It will be followed by CTX BLOOD TEST....BTW, I had asked about this test (if you have done as much reading as I have...you know about CTX😁) before I started the Evenity but it was not part of the protocol at that stage.
Depending on the results of the CTX, I may need another infusion. It appears, as far as I can discern, that the blood test will be used to monitor my progress.
God bless your journey!

Thank you so much for your reply. It sounds like you had a good experience with the infusion (or at least not too bad). Did you take the full dose? Did you do anything special as far as hydration, etc.? I guess I was wondering if your provider thought you might not need ANYTHING if the recast works well. I have known one person who didn't but then I hear of many on this forum who do need other meds. That is what I am trying to figure out. I would. naturally like to be on as few meds as possible and if there is hope.... Thank you, Deborah Lanius

After being diagnosed with Osteoporosis in the spring of 2025 based on just a DEXA score of -3.2 lumbar spine, my PCP wanted to prescribe Fosamax….without doing any further testing! Fortunately, I declined the prescription, and started doing research. There are a LOT of materials out there, some made me very scared, but most educated me about the various medications, treatments, etc. I just finished doing all the various tests my endocrinologist had me do (CTX, P1NP, BSap, vitamin D, 24 hour urine test, to name a few). I meet with her in a few weeks to go over all the tests. At this point, I am leaning towards NOT going on any medications because my FRAX score (fracture risk assessment) came in very low which is a good thing. In addition, I am training 2-3 times a week, seeing a dietitian to make sure I am eating correctly, and have made lifestyle changes.
For anyone just diagnosed, BREATHE and educate yourself before starting on any medications. Like you just mentioned, each medication has to be done in the proper order, and people should not be on them for a long time (case in point, Fosamax) because the bones get brittle the longer you are on them.
Thanks to today’s technology, you can find good resource on YouTube or chatGPT so you no longer have to rely only on what your doctor tells you (who sometimes are not very well educated about Osteoporosis).
My favorite podcasts on YouTube are Margie Bissinger (she interviews many doctors and OP experts), OsteoBoston, Sarah Mapes….

Appreciated your comments n research … applicable to my Ptn ‘s condition

I will add to this conversation. My T score in my spine was -4.6 and hip -2.1 when I started my journey. I did one year of Evenity then had another DEXA. My T score in my spine was -3.3 and hip -1.3. My endocrinologist wanted me to gain more bone density so I am now on Prolia I have had 2 injections and will have another DEXA on Monday. Depending on the score I will do 2 more injections of Prolia or go straight to reclast.
The rebound from Prolia maybe none do to the short amount of time I have been on it.

If you are like me, the first time you found out that you have Osteoporosis, you were scared! I was just diagnosed in April of 25. One of the best podcasts I listened to was what to do when first diagnosed;

Anyway, breathe, then find out WHY you have osteoporosis. My PCP did the same as yours; he prescribed Fosamax without doing any tests at all!! I asked to see an endocrinologist and so far we have ruled out parathyroid or thyroid problems. We did find out I am deficient in Vitamin D and was not eating enough calcium or any of the other vitamins that help with it’s absorption, plus I am post menopausal.

Definitely educate yourself, there is a lot of material out there, but don’t let them scare you! I hope you can find a doctor who is an osteoporosis specialist, who will get to the root causes, who can give you good advice on whether to go on medication or not. If you are at the early stages of OP and are in good health, there are many things you can do (proper diet, correct exercise, healthier lifestyle) to get better bone mineral density without having to go on medication. And if you can, get a TBS score which is just as important as the DEXA score because while a DeXA score gives bone density, a TBS score will give you your bone QUALITY!!
Good luck!

Well, my doctor is well aware of my health history, so these are the directions I received:
Yes, I was told to try to increase water to 48 oz. the day before, the day of(I usually drink 12 oz with every meal...I don't always drink it all at once, but I leave it on the table till it's finished. So, I had to add another 12 oz.).
If I wasn't taking D and calcium supplements, I was asked to take 2000 IU OF D daily and Calcium 500 mg twice daily for at least 5 days STARTING the day of the infusion.
Since mild flu-like symptoms can be a normal side effect following the infusion for up to 3 days.
The instructions were that I would be given the Tylenol before the infusion starts and not to take Tylenol for at least 4 hours prior to the infusion. They recommended Tylenol 500 mg 6 hours after the infusion and continue taking every 6 hrs. As needed.
Everything happened as above. I was mildly tired. I did not need Tylenol after day 2. This is day 3, and I feel good.
As far as dosage: she took out one small bottle of Reclast and one small bag of saline, and attached it to the machine. It took @30+ minutes to empty the bottle
followed by the bag of saline. I was worried about having to go to the bathroom after all of that water! The nurse said to just call, she simply untethered me and I rolled away to relief!
So far all of my worries were wasted😉.
Yes, my doctor assured me that this should do the trick, but if I need more she would follow with the same process in a year or two,
which isn't as scary as it first was.
Blessings on your journey!