I've been on letrozole since mid-July, and my August 2025 DEXA scan shows I'm on the cusp of an official osteoporosis diagnosis. My oncology doc and PA are recommending I have a Reclast infusion. A serious GERD history rules out oral meds. Their recommendation was not unexpected regardless of the most recent DEXA. They had told me before beginning my treatment that they'd be recommending some sort of drug treatment for bone loss because of the AI.

Prior to my invasive breast cancer diagnosis in the fall of 2024 and afib diagnosis August 2023, I did yoga, some resistance or weight bearing exercise and took bone supportive supplements (MK4, nattokinase, and strontium citrate intermittently). Once I needed to take blood thinners for the afib, I had to stop all the bone supportive supplements because they were also natural blood thinners.

So here I am. Someone, like many readers here, who has done everything possible to stay off of heavy prescription drugs for osteoporosis, now about to take some of those powerful drugs. In my case, it would be Reclast. I actually dread the osteoporosis drugs more than the chemo drugs which were time limited.

I asked my PA about testing my estrogen hormones (e.g., estradiol, estrone, & estriol) PRIOR to starting Reclast and in the early stages of taking letrozole. She said she would not order these tests because she felt they were not useful for women 10 years past menopause (moi!) In addition, she thought such tests provided an inaccurate, snapshot view of hormone status because the hormones fluctuate.

Does her view seem accurate? I don't want to pursue unnecessary testing but part of me keeps wanting measurements of some kind since these are such powerful drugs with major side effects.