Spine Doctor and hip doctors opinion .. scared to start taking them

I would say it's extremely important to meet with a doctor that specializes in Osteoporosis. My mom had osteoporosis early and eventually broke 16+ bones and lost four inches of height. I wanted to avoid that fate as did my sister. We have always eaten well, made certain we had enough calcium and D, excersized including weight bearing daily, etc, etc. Had my first DEXA at 51 and my spinal T score average was -3.7 with my lowest 2 lumbars -4. Obviously, not taking medication wasn't an option. I made an appointment with a specialist, but it was several months out. In the meantime I was able to consult with a PhD who oversees many of the osteoporosis drug trails to discuss the different options, outcomes, order the drugs are taken, etc, etc. Eventually I got into the osteoporosis specialist doc. He did note that genetics can be a bitch. After much testing to rule out any other causes, checking my kidneys, etc, etc we discussed options. Eventually decided on going onto an anabolic bone building medication to help "build up my bones" before I would switch to more of a maintenance drug such as a bisphosphonate. I used Tymlos for two years (daily injection, it's very simply like an insulin pen). I had a 16% BMD increase in the first year and about 4% in the second year. I then had an annual Reclast infusion to "lock in the gains". I will have two more annual infusions and then go off drugs for a few years since Reclast remains in the system for several years. Once it starts to decline (will have bone marker testing done to determine when that is occurring), we will discuss next steps in the process. Osteoporosis is a long term condition and the order you take the drugs and for how long is extremely important (an anabolic isn't as effective if a bisphosphonate is taken beforehand, for example). Most of the osteoporosis drugs have a limit to how long they are recommended to take, so planning ahead with someone who specializes is important. I was terrified to start the drugs after reading the forums, but I'm glad I did as not doing so would mean a certain future of broken bones. My mom has now been on Prolia for 7 years and is back to dancing and living life in her 80's. My sister started on bisphosphonates in her 40's so she was able to stop her loss before it was as severe. She's now on a "drug holiday" and will resume when her markers indicate it's time (likely 3-5 years). I would note when I recently had shoulder surgery the surgeon noted "why not just do weight bearing exercises" when I mentioned I had osteoporosis, not helpful. Again, I had exercised daily, wear a weighted vest, had always done weight bearing exercises as recommended to prevent bone loss, practice martial arts, ski, hike regularly, etc, etc. Sometimes medications are needed or you just continue to lose bone density. Had I caught mine earlier, HRT might have slowed my loss, but I didn't, so here I am now treating it as best I can. Unfortunately, my doc is now retiring so I am in search of another specialist in the Seattle area (which isn't easy to find, but worth waiting for). Luckily I already know the plan for the next several years. Many of the drugs available today didn't exist 20 years ago, so at least we have so many more options now with more on the horizon. Good luck with your journey. Ask a lot of questions when you meet with them.

I met an orthopedic surgeon at a wedding and he said the medicine fills up the holes but makes your bones more brittle. Poor quality. This is do the fact the medicine interferes with natural remodeling/formation of bone. I mean he fixes fractures all day long so he should know.

If you have Medicare, you might find that you must take the oral form for a year before they will allow the injections

Totally agree

My own opinion so take it for what it is worth. I would start with the anabolic drugs first; tymlos or Forteo. They build bone don't patch it. If I remember correctly the trabecular bone is the inside (what you want) and the outside is cortical bone (is that right)?. They also will not cause jaw necrosis a rare side effect. Yes, some people get it but it is rare. Medicare or your insurance may require you to take another drug first but get your doc to write a letter saying you really need to start with one of these first. He/she should know how to phrase it. It may work.
After 2 years maybe something better may come along as a follow up drug.
Exercise and diet are also possibilities but you have to be diligent. I know someone who hasn't gained any density but hasn't lost any either.
Good luck

Doctors are scary no mater what.
I am going in for a Lumbar Puncture and maybe that will help in analyzing my back problem. It appears to be either osteoporosis or brain fluid leakage. My brain MRI indicates a fluid leakage. The Lumbar Puncture should clear this up. Diclofenac Sodium RX from spine Doctor has been helping and now seeing Neurosurgeon.

Thank you for your comment , I just went again with the spine Doctor, He told me to ask the endocrinologist if she would allow me to try one year of diligent walking and vitamins and do a dexa again. (to see what happens), and if I would have to take medicines, yes he suggested Forteo or Tymlos . What do you think -3.5 on lumbar spine no fractures yet.,,,

I never took oral meds. Went from Forteo to Tymlos to Evenity and now Reclast.
I’m on Medicare. While I’m here, I should say that I never had any side effects from any of them and went from osteoporosis to osteopenia.
I know that I am very fortunate.

If your T-score is -3.5, walking and vitamins isn't going to do the job, not even close. -3.5 is severe bone loss.

I suggest trying Tymlos. It worked really well for me.

So did that Dr think the bone meds offered benefits that outweighed the risks?