Dr recommending fosamax after serious wrist fracture .

I read that fractures of the wrist after age 60 are a sign to physicians to check bone density. It seems you have done this. I have osteopenia just about turning into a diagnosis of osteoporosis. I have risk factors and my doctor wants me to consider medication, also. I can understand you want to get a different opinion. My post is just to affirm that a fractured wrist would make a doctor think like yours has.

Don't want to tell anyone what to do but...bridget11 I could be you! Broke one wrist (car wreck) in my early 60s, plate and screws, could have had a cast but surgery is a quicker fix apparently; surgeon said bone looked great. PCP ordered dexa since the protocol is scan at 65 or earlier if a bone breaks. I did not do it as it was during covid; fear. Broke second wrist traumatic fall; another plate and screws, again surgeon said bone looked great. At this point dexa ordered by PCP (I was over 65 the magic age for a screening Dexaat this point anyway), 2 years ago showed severe osteo; referral to endocrinologist. Honestly I would love to see -1.8 without any change for 6 years! But there many pieces to the diagnostic puzzle, T scores from DEXA, TBS, REMS, bone markers (CTX for example), your size, confirmation of soft bones etc. I feel a PCP is not qualified to do the "deep dive" into osteoporosis; endocrinologist or rheumatologist seem to be the 2 top specialties who also treat osteo. Maybe ask for a referral to one of these?

Your PCP may be right and it never hurts to get a second opinion. It would be best if you could see a specialist.

In my experience with both myself and with my wife, a PCP is not the right person to treat osteoporosis. Most of them prescribe Fosamax because it's the oldest medication and that's all they know about. I recommend finding an endocrinologist who is experienced with osteoporosis. Honestly, even my wife's first endocrinologist was no good. 😉

I tried all the oral medications after I went through early menopause and they gave me horrible GERD. Then I broke my left wrist. Was able to have an external fixator so no plates. I did Forteo for 16 months and had great results. I had one Reclast infusion and had horrible jaw pain. Refused further treatment at that point and my bone density stayed stable for osteopenia for about 15 years maybe a little longer. I started Prolia last year because I have had multiple fractures and really don’t want more! I don’t know if you get better results with anabolic medications but if your insurance will allow one of those I would got for that! I would also find a good rheumatologist or endocrinologist before making the decision.

Have you had a DEXA scan? No medications should be started, in my opinion, until you've had a scan to establish you baseline T-score. Starting an anti-resorptive may not be the best option for you if you have severe osteoporosis (T-score of less than -2.5 and/or a fracture). The latest protocols recommend starting on an anabolic (bone building) medication first, not an anti-resorptive like Fosamax.

I agree with others who have recommended finding an endocrinologist who treats metabolic bone diseases like osteoporosis before starting any medication.

Have been on Fosamax for 3+ years & developed osteonecrosis in my jaw.
The enlargement has stretched my gums in the area so it has split open. Also began to have severe stomach issues. Had some improvement in bone density but not worth the side effects.

For what it’s worth, I’m 79, small boned and have shrunk to 5 ft. I see 2 endocrinologists and have had my forearm scanned at the same time as my spine and hips for the last 2 years. The forearm has a reading of -4.1 and I visualize it snapping every morning when I do my plank routine. Both doctors say that is unlikely but who knows. And both say there is little that current meds can do to built the type of bone in the forearm. Equally depressing, they view the readings for my spine, which are pretty good, as totally worthless due to my scoliosis and the number of bone spurs that are being seen as “bone”. So we are focusing on maintaining stable readings at the hips. Getting older isn’t for wimps!

Good luck with many docs who don’t offer many options. ENDOs generally prescribe, often without concern for side effects..…one alternative is HRT patches which don’t have side effects and should not cause coronary problems in patch form…I’m not a doc, but that has appeal for me, especially considering my own medical issues/history. It’s our personal medical profile that helps determine what the best path is….Wishing you the best….meanwhile,, do what exercises you can, especially balance and resistance…check your diet and consider a really well-researched supplement.

@jozer Thanks for your reply - this is really helpful. Two bad broken wrists sounds horrible. This has been the most painful experience I have ever had - including 3 kids with no drugs, 3 other surgeries for running injuries, and 10 marathons! I had my first Dexa scan at age 54 because I have family history of osteo. That was negative 1.2 but was just hitting menopause. 4 years later it was -2.0. I did some studies at the university for running stuff and I had 4 dexa scans in 2 years and they all hung in the same -1.8 range! I had started focusing on strength training during this time to improve my running. Only later did I learn it helped the bones too! It is so crazy that your surgeon said your bones looked good even though your t scores were bad and I am the opposite. I am definitely going to ask for a referral. I live in Ann Arbor so I have access to good medical options.