Connect
← Return to Statins and osteoporosis
Discussion
Comment receiving replies
@mayblin Hi thank u for responding. if i may ask only because i think many medical people think osteoporosis and penia is hapoening to thin bone wonen and wondering if u are on the thinner side abd if hrt made u gain any weight. i had to have k4l5 fusion with rods and screws last may and osteopenia. did 1 year of evenity. now they want me on fosamax. scared to death of atypical femur and hip frc from that drug it lays down mottled irregular bone; not strong bone. plus the terrifying jaw rot risk. im 70. now i also have burden of wirry of loosening screws just from fusion that can happen to normal bone person. im trying ti lose weight now my ability to do aerobics as intense as i want to my music i love to dance is taken away for fear of stressing l3 and s1 l5 more cuz of fusion.trying zepbound but still after 6 mo only lost 15 lbs to presurgery weight now 172. sickening. cant fit any my nice clothes yet. dont want to gain on hrt. what do u think. ?
Replies to "@mayblin Hi thank u for responding. if i may ask only because i think many medical..."
Connect
@lovesummer, yes i've always been on the thin side - BMI around 20. My weight did not change significantly while I was on either Forteo or HRT.
I understand your worries about the risks associated with a bisphosphonate such as Fosamax. But i think there are a few important factors to consider here: 1) the BMD gained on Evenity will be lost quickly if not followed by an antiresorptive. HRT typically takes 6-9mo to reach its full effect on bone, so the timing would not be ideal to protect those gains. Also, HRT has not been well studied as a follow-up for Evenity, so this approach (HRT alone) does not have strong supporting evidence yet. 2) the risk of AFF (atypical femur fracture) and ONJ (osteonecrosis of the jaw) with Fosamax are real but very rare. These risks are mainly associated with prolonged use (many years), and they can be managed with planned drug holidays. ONJ in particular is more likely linked to specific risk factors such as invasive dental procedures, poor oral hygiene, and cancer treatment, not typical osteoporosis therapy. 3) the stability of your fusion hardware is an important factor here too. This review shows bisphosphonates help protect the bone around spinal hardware, reducing the risk of screws loosening:
https://www.ovid.com/jnls/spinejournal/abstract/10.1097/brs.0000000000002608~bisphosphonate-and-teriparatide-use-in-thoracolumbar-spinal
4) regarding Zepbound - recent studies suggest that this class of meds may be associated with enhanced bone resorption and a higher risk of osteoporosis. This makes antiresorptive such as Fosamax after Evenity even more important.
I think your doctor's recommendation is sensible and well supported by the available medical evidence. You can also discuss your concerns and thoughts further with both your treating physician and orthopedic surgeon. Wishing you all the best with your treatment and recovery.