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← Return to Reclast, Actonel or Evista?
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Just wanted to give an update on my 2nd opinion I received today. Well technically 3rd if you count the Gynecologist who diagnosed me. First Endocrinologist basically dismissed me as you can read in my original post. This Dr was very understanding, listened to me and answered all my questions even before I asked them. She mentioned how she prefers anabolic meds before antiresorptive as you typically have better results. She also prefers Forteo, Tymlos and Evenity, but she said insurance won’t always allow those until you have a fracture. Which is ridiculous. She wants blood work done first to see why I have osteoporosis, wants to check my bone markers. Also wants to do a 24 urine collection to see how much calcium excreting. I felt like she has her ducks in a row. If insurance allows it she’d like me to go on Evenity. I mentioned Evista she said I could do that too but wants to see what bloodwork says first. So I feel like I’m in good hands.
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@rudysmom, i like your new doctor; ruling out secondary causes is a critical first step before diving into treatment. If both doctor and insurance are on board, anabolic first is the preferred strategy among specialists to "build first, then maintain". You've won half the battle already!
I was about your age at diagnosis, though my lumbar Tscore was worse. I did Forteo followed by HRT (started at age 61). You might've read my story already: https://connect.mayoclinic.org/discussion/forteo-teriparatide-followed-by-hrt-my-experience/
One advantage of HRT or raloxifene is that their effects are reversible - unlike some of the bisphosphonates - though they carry their own risks. Also, estrogen is FDA-approved for prevention rather than treatment, some doctors are more cautious with it in complex cases or for patients who've already had fractures. But i think it's worth discussing if it is feasible in your case.
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@rudysmom Sounds like a very good doctor!! you are lucky to have a choice in endocrinologists. It can be very hard to get in to see one here. I have used both Forteo and Evista after 13 compression fractures and feel very lucky to have no further fractures since 2016