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

I so agree! Maybe with all of us putting our collective heads together we can find some answers. Until then let’s continue to support each other and share what we have learned.

Most of us lose bone as we lose estrogen. Estrogen counters the production of the cells that break down bone. What I can understand is why we aren't advised to have dexas at menopause or at 50 whichever happens first. We know about hot flashes and weight gain; why don't we know about osteoporosis. Genetics? Sure it's the double X.

Yes, reduce fractures. Some of the drugs are better at that then others, but the % of reduction is small when you read the studies. The truth is the drugs make your bones more brittle in the the long term. Also, it is designed to keep you on the drugs for life because the studies are only done up to 2-3 years. That is why they take you off and put you on different ones. More people fracture with osteopenia than osteoporosis because there is more of THEM. I say we have freedom in this country to make our own decisions but we must be an advocate for our own healthcare and do our own research.

Hello @dvargo,

As we often see in the discussions on Mayo Clinic Connect, treatments are as individual as the person taking them. It's never a one-size fits all situation. That is why it is important to be informed and talk with your provider to find out what is right for you.

One big factor for patients to consider when diagnosed with osteoporosis is the risk vs. reward of risking bone fractures without medication and the potential side-effects of osteoporosis medications. It is important to work through this with your provider because the severity of the individual diagnosis is different for everyone and therefor can change the timeframe of a treatment decision. While we all have control over our medical decisions it is important to keep the guidelines in mind when using Mayo Clinic Connect: https://connect.mayoclinic.org/blog/about-connect/tab/community-guidelines/.

There are two osteoporosis drugs that don't make your bones more brittle. Tymlos and Forteo.

How do we know that? I'm not aware of any studies that determine bone quality after taking these meds. Also, after taking either of these drugs, you have to follow up with a drug like Fosamax to maintain your gains and I Fosamax maintains old bone, which can be brittle.

Daisy17, hi. One way of knowing is by the way the medications work. Most of the medications block cell that dissolve defective bone. Bisphosphonates attach to the bone preventing these osteoclastic cells from attaching causing the death. Prolia stops these cells from developing fully and Evenity blocks a protein necessary for their production. The pth 1-34 medications increase the production of both types of cells the osteoclasts that dissolve older and damaged bone and the osteoblasts the cells that produce new bone.
Then there are the warnings on all the other meds about osteonecrosis and atypical fractures. In a sense all of the clinical trials signal issues about bone quality except Forteo and Tymlos.
There are actual studies about bone quality. https://www.healio.com/news/endocrinology/20220726/2-years-of-teriparatide-restores-bone-quality-to-premenopausal-levels#:~:text=Teriparatide%20r estores%20bone%20mineral%20quality,that%20of%20healthy%20premenopausal%20women.%E2%80%9D
There are other less accessible studies, animal studies and pathological studies. https://journals.plos.org/plosone/articleid=10.1371/journal.pone.0229820
Not to obscure your point about how ephemeral these bones are. It may become more common to stay on Forteo or Tymlos now that the restrictions have been removed.

Hope my story is helpful.
I got my first DEXA at menopause. My choice not my doctor’s. Osteoporosis in spine snd Osteopenia in hip. And found out I’d had a vertebral fracture from a fall in my 40’s. I chose to carry on until the time I couldn’t exercise any more and check in at 70 yrs old. My choice agsin. My spine scores had got worse as I had Dexas every 5 years. But they started at -3.8 and last one just had was -4.5. Hip is still pretty good scores but are getting worse.
So now I fell and/or lifted or combination and had 2 fractures in spine. Had my last DEXA. Now I am looking into getting on some meds. Not looking forward to it. Need a specialist hopefully who listens and cares. I did find it takes much research snd getting feedback from this group and it really is a hard choice! Also I don’t want to lose anymore height as that was a symptom I’d never kept on top of.
Anyway we are all different and make choices as best we can. Have to be as positive as possible right?
Best wishes to us all.

Brenda, wishing you luck on finding a good specialist; there are a lot of them out there. We make the best decisions as we see them and shouldn't look back either pridefully or regretfully. They are hard choices and we don't have guarantees. I hope you hang out here and tell us how it goes for you. Bless your choices.

Just posted this on another page Walking not enough YOu have to find someone who does the Onero program (basis for LIftmor study in Australia) tho they are not all over yet. This article explains why the program works though, maybe trainer can duplicate it for you /
https://howardluksmd.substack.com/p/osteoporosis-prevention-and-treatment