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Rudysmom, I was first diagnosed with osteopenia, then osteoporosis, then after 18 months of Fosamax, no improvement in osteoporosis. I consider myself healthy, even with modest arthritis and hypothyroidism, both managed with meds. My whole adult life I have eaten healthy foods, consumed calcium-rich foods and now exercise daily (it was 3-4 times/week while I was working.) I am physically active, muscular, and while I trust my doctor, I don't totally trust the scans. I don't feel my lifestyle mandates changing habits. She asked me to look into Prolia and Reclast, neither of which look guaranteed to help. I appreciated seeing an article referenced in this forum on over-diagnosis of thin women, but since it's from an anthropologist, I suspect the MDs will dismiss it.
I may ask my GP to recommend a rheumatologist for more specific advice.
Replies to "Rudysmom, I was first diagnosed with osteopenia, then osteoporosis, then after 18 months of Fosamax, no..."
@wagsofbevis Research the drugs available before you make your decision. Research a drug's "absolute risk" not the "relative risk" of fracture prevention. For example, "According to the review conducted by the ACP (American College of Physicians), the relative risk reduction of hip fractures with bisphosphonate treatment for at least 3 years is 36%; however, the absolute risk reduction is only 0.6%. Framed as number needed to treat, 167 patients need to be treated for 3 years to prevent one hip fracture."
If Fosamax didn't help you, I wonder whether Reclast would help since it's also a bisphosphonate. From what I've read, bisphosphonates offere minimal benefits as far as fracture prevention. They slow down the loss of bone but also slow down the formation of new bone. Your DEXA may appear better, but you could have older, more brittle bones. I wouldn't want to take Prolia because of the high fracture risk once you stop taking it. It must be followed by a bisphosphonate to lock in your gains.
Here are some articles that may be of interest.
https://www.amjmed.com/article/S0002-9343(24)00101-3/pdf
https://www.consumerreports.org/cro/2012/04/popular-osteoporosis-drugs-come-with-mounting-concerns/index.htm
Check out Brick House Bones on Facebook by Dr Lisa Moore, a PT specializing in osteoporosis. She offers a lot of free exercise videos and other information.
Also, check into information in this support group about high doses of Vitamin K in the forms of MK-4 and MK-7 which have been shown to help osteoporosis when taken with Calcium and Vitamin D.
@wagsofbevis Here is an article about DEXA scans and petite women by Dr. Susan E. Brown, PhD. https://betterbones.com/osteoporosis/bone-density-testing-do-small-boned-women-get-a-fair-shake/
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@wagsofbevis
If you do decide to entertain the idea of Osteoporosis drugs at some point, I wonder about your doctors recommendation of either Prolia or reclast. I wonder about the possibility of an anabolic such as tymlos, forteo or evenity next instead. However I am not a doctor and I don't anything about your medical history. Sequencing of these medications is very important. It is also quite important to understand whether any physician who treats you has the training and experience in osteoporosis and bone health. Let us know how it goes.