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What would you do? Medication.
Hi, I am interested in lay people opinions given I have received so much conflicting advice from MDs. It’s astounding and I’m sure I am not the only person who is confused and wary about any decision I make.
I am 68 years old and have significant OP – my T score is a -3.5. I was diagnosed in October. I knew I was genetically predisposed so have regularly exercised since my 20s and have maintained a healthy diet. Since the diagnosis, I have upped the frequency of weight lifting and the use of resistance bands and I am doing what has been advised in terms of diet and supplements.
My Plan D insurance will only cover Prolia and Forteo. I have decided against Prolia and am reluctant to start Forteo. Backing up a little, I enjoy adventurous vacations such bicycle trips and strenuous, long hikes. In September, for example, I hiked a portion of the Camino de Santiago. While training, I slipped and fell three times on big rocks and didn’t break anything. Last year, I took a bicycle trip in Europe. I tried out an electric bike which got away from me and I took a hard fall – it hurt, but no fractures. I know that my bone density is low as reflected by my low T score, but I also believe the quality of my bones is good, and the DEXA score is only part of the equation. One of my doctors said, “Oh, you did your own DEXA test.”
Like everyone, I want to avoid a fracture more than anything so I am willing to consider Forteo, but here is my concern: Is there a chance I might hurt the integrity of my bones by going on it? Might I inadvertently worsen my own situation by taking medication just to improve my DEXA score?
I also want a life plan that needs to last maybe 30 more years. We take a medication for a year or two, then switch to another medication for a year or two. Then what?? None of the MDs I have talked to have had a satisfactory answer. Maybe they are waiting for new drugs to hit the market.
I’m really struggling with the decision. I know I am the only person who can make it, and I will have to be responsible for the outcome, but I would really like to hear what thoughts others have. Thanks so much - any input is welcome.
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I had a hysterectomy years ago and was only on an estrogen patch. The doctor said I didn't need progesterone. If I remember correctly, studies at the time only showed a potential increase in breast cancer cases for women on the estrogen/progesterone combination, not estrogen replacement alone. I was on the lowest patch strength possible, .025 and felt great.
I am 70 and after many years of osteopenia I got a -2.5 in my lumbar spine in DXA scan. I am very active and lift weights three times a week in addition to walking with a weight vest and doing yoga and working on posture. I am with you. I will not take prolia. I was diagnosed and treated for breast cancer in January and am now on anarobase inhibitors which can affect bone quality but my breast surgeon said weights and lifting progressively harder weights are the way to go now. She said Prolia has caused bone cancer in animals. I saw an Endocronologist and a rheumatologist and both wanted me to do a reclast infusion. So both Prolia and Reclast prevent you from losing more bone but they don’t build bone. Your body constantly makes and loses bone. My physicians all agreed to let me wait two years with lifting weights progressively harder, making sure I do impact exercises to stimulate bone growth (like heel drops and marching barefoot etc) as well as yoga for balance and strength ( hugging your muscle to your bones helps build bones) and posture. Having the right alignment requires stength from your core and again hugging your spine to build bone. I take 1200 mgs of calcium a day split since your body only can absorb 500 mgs at a time and 3,000 UI of Vit D with K-2 which is essential for absorption. I try to eat a healthy diet filled with essential minerals and calcium and have even included eating 6 dried prunes a day since recent studies show bone improvement when eating them. I am also having a REM scan done soon to measure the quality of my bone to determine strength. Like you I have had several falls and haven’t broken anything but doctors claim high risk just looking at the DXA scan. Very few doctors do the REM test who can has been used in Europe for years to help determine your risk. I will not just automatically take drugs like prolia because you cannot stop them unless you start something else and from all my research it is possible to improve your bones through diet and exercise. Check out this article from NPR. It gives some insight into the history of osteoporosis and the DXA scan numbers. Wishing you the best. Hope my insight helps. Good luck.
https://www.npr.org/2009/12/21/121609815/how-a-bone-disease-grew-to-fit-the-prescription
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1 ReactionThanks @mkoch, Maryann. It's good to know that you felt great. Are you still taking estrogen?