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Evenity worked for me: Why I chose medication for osteoporosis
I just completed a year of Evenity and had my f/u Dexa. My first Dexa was in 2015 when I was in my 50s. My OB/GYN suggested it as I had broken a bone in my 40s. That Dexa showed osteopenia in my lumbar spine with a score of -2.4. At that point, I was adamant that I would not take any medication. I increased my calcium and kept up my running and weightlifting. I also decided that since I wasn’t going to take any meds, I wouldn’t bother with f/u Dexas. I started seeing a new NP who convinced me that I should see what my scores were in 2023. I was shocked to see that my lumbar spine was now-3.4. That was a real wake up call! Severe osteoporosis.
So I was still set on not taking medication, especially after reading a lot of the discussions on this site. I spent most of 2023 running more, lifting heavier, yoga, Algae Cal and Strontium (yes I know Strontium shows false strengthening). I hiked in NC that summer with a heavy backpack. But in the meantime, I read all of the books recommended, researched the medications, and made an apt with the osteoporosis center at our large teaching hospital. My plan was to see if I could improve my results naturally. I would pay for another Dexa out of pocket to see if anything changed.
In Oct I went to see the provider that runs a large osteoporosis clinic. I told her my plan. She was very honest with me. She said I would be wasting my time and money. She felt that my osteoporosis was genetic. I was already doing everything I could including bio identical hormones and my score was worse. She said to stop the Strontium which I did. She said that osteoporosis was a chronic condition. You can improve it with medication but once you stop, you will begin losing bone again and go back down. I would have to be on something for the rest of my life. I elected to start with Evenity. My labs were good and remained good. I had no side effects from the medication. I chose Evenity due to my Medicare coverage. I have Medicare A/B, plus a D plan and a gap plan. Tymlos and Forteo had large monthly deductibles. Evenity was covered at 100% because I went to an infusion center and it was covered under Part B and my gap plan. Also Evenity targets the lumbar spine and that was my biggest problem. Even though I had a lot of hesitation, I decided to trust my provider who follows a large patient population of osteoporosis. I was concerned about side effects but I pulled up the actual clinical trials and read them. The # of severe side effects were actually very low and were almost equal in the placebo and medication group. My provider confirmed that and said that my chances of a severe side effect would be very low but my risk of a fx was very high and that would change my life. She said that the serious side effects were not showing up in the general population of people taking the medication.
My latest Dexa showed improvement in my lumbar spine to -1.8 (from -3.4). I will switch to Prolia next month. I would encourage anyone hesitant to start medication to read as much as you can and discuss with your provider. I also chatted with the infusion center nurses and other patients that I met at the center about Evenity and Prolia to see what their experiences were. Everyone said the same thing, that most patients do very well. Occasionally, someone needs to change their medication but that was rare. Also, I’m pretty healthy. There are some patients with multiple comorbidities and they might have more issues.
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Google it. I did and just went for an appointment. TBD.
How do you get your insurance to cover your office visits with a functional doctor? I'm paying cash and it's adding up.
Replying to @tillymack .....Hi, I also do the BHRT, the pellets, also estradiol and testosterone, and take progesterone in pill form. I have been doing it for quite a few years. While it works for me, it may not work for others. I remember being in my gyno's office and a lady said she hated them, made her feel bad. I'm 73 and I also used to have osteoporosis and was on fasomax and others and hated it. I quit the meds, took calcium and vitamin D and worked out at gym, I reversed it in about a year and half.
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2 ReactionsThanks so much for your reply. Congratulations for starting BHRT before the window of opportunity closed; I think it's too late for me. That said, you're approach appeals to me as well. Can you tell me more about your workouts at the gym?
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1 ReactionI believe the thinking on age limitations regarding starting bhrt/hrt is changing.
Thanks for letting me know! Can you give me any details?
What i am noticing is this: rather than clinging to the pronouncement that "experts agree that HT helps to control moderate to severe menopause symptoms such as hot flashes when initiated within 10 years of onset of menopause or under age 60 years." I see more of find a provider well trained in the area of menopause and hormone therapy. Also mor discussion of increased safety with transdermal treatment. Also more attention to issues other than just hot flashes such as vaginal atrophy and dryness, loss of or decreased libido, protection against cognitive decline, senile purpura, uti, muscle tone, etc. I dont know your age or philosophy on quality of life versus quantity. At 76 it was right up my alley and wirth any supposed risks. Life is risk in my book. Also, I take into consideration the absolute pittance provided for research on womens health especially menopause compared to money for mens health. Note: I did not begin taking it for my osteoporosis but believe it may offer some benefit. I take osteoporosis meds.
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1 ReactionWindow of opportunity? According to my doc, you can get them always. I always ask her "when do I need to stop?".....she says as long as they are working for you, you don't need to stop. She went on to tell me that a very elderly lady wanted to continue dancing and needed a "lift", so she got on them.
My workouts are just about everything, upper body, lower body (which I hate)...both free weights, machines, and sometimes bands. I hate going to the gym, but after I'm there I'm glad I push myself to go. It always feels great afterwards. In the beginning I did get a trainer, I wanted to make sure I didn't hurt myself by doing them wrong. Osteoporosis always need weight bearing exercises. Hope this helps.
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1 ReactionReplying to @monkhhi Thank you for your post. It was very encouraging. I will have my 11th Evenity injection next month. I am wondering why you are transitioning to Prolia vs ReClast? I’ve read a lot on both and trust your opinion based on your cinical knowledge and your “team” of specialists. Thanks and many blessing !
I could have had either Prolia or Reclast from what I remember. I chose Prolia because I didn’t want to have to get a 30 min infusion (that’s just me) with Reclast. My doctor rec Prolia after my year on Evenity. That’s what most of her patients were on. So far Prolia has been fine. No issues at all. I know if I have to stop it for any reason, I will need to move to something else (probably Reclast) right away because stopping Prolia can cause rapid bone loss once it is stopped . I’m not expecting any major bone gains on Prolia, like I had with Evenity. I just hope to maintain my gains. The other reason that I chose Prolia is that I talked a lot with the infusion nurses at my center. They said they give more Prolia than Reclast now and now with Evenity they do more Evenity followed by Prolia. They said they see very few issues with Prolia. I didn’t have anything against Reclast, I just felt that Prolia was a better fit for me. Good luck with whatever you choose!
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