Reclast infusion side effects?

@osteopatient2026 yes they are all good. I didn’t have as much of an increase as they wanted from the first year of TYMLOS but I think that’s because I wasn’t. I was injecting in the thigh most of the time which they had said was OK because I have a mobility problem to look at my stomach while I inject. So after much investigation, I stretched myself to only inject in my abdominal area. I went to the orthopedic surgeon yesterday, and there was a huge difference in the density of my bones down my spine. It is possible that part of that could be the difference between the film, capture of the x-ray, but we’ll see at the end of August when I do my next DEXA and see the doctor and figure out the next course of action for the following year. It will report back after August 20 on all the scores. I previously posted my CT X/PN1P and my 1.6% increase in bone density the first year and my base lines. Nobody should rely entirely on the tests because they are only approximations as I found out. Make sure you’re getting your DEXA with the TBS score so it’s consistent. That’s the most important thing from year to year. Your vitamin D has nothing to do with your bone density and neither does your calcium level so I wasn’t sure why you mentioned those. You should not do any supplementation without having labs first! When it comes to vitamin D and vitamin and calcium! If you carry genetic coronary artery disease and you supplement with calcium it is really bad as the supplemental calcium causes your arteries to harden. My calcium has stayed to consistent number my entire life exactly what it should be which has helped me avoid coronary artery disease progression. My vitamin D was low 11 years ago so I was put on a supplement and then the supplement was increased, but I get tested periodically so the vitamin D doesn’t go high. It also can be dangerous if it’s too high, so I keep it right in the middle. When they tell you to drink milk when you’re a kid to build strong bones, getting your calcium phosphorus and vitamin D it’s very different when you grow to be an adult and you may be lactose intolerant and inherit genetic diseases. Your natural immunities from birth wear off when you’re a teenager and 77% of Americans are partially lactose intolerant. I am both lactose and caffeine intolerant so drinking and eating dairy with lactose in casing did nothing but ruined my intestines by the time I got to be 60. Had to change my diet entirely.

@llander1966, you might ask about Forteo. It is particularly effective in the femoral head. It is seeming as though patients with autoimmune diseases are particularly susceptible to Recast's side effects long term.
People who do have side effects with Forteo can just quit taking the medication, because it leaves the body quickly.
There is a common wisdom spreading among endocrinologists that it is better to start treatment with a bone building medication. You might ask because the medications suggested to you are both antiresorptive.
While once a year or every six month treatment is tempting, it has the risk that you mention-- long term side effects.
You probably already know that because we are small boned our dexas overstate our bone loss.
I'm 75 on my fourth year of Forteo without any side effects.
If you do decide on Reclast ask for a lower dose and slower infusion.
Bless your choice with luck.

@gently Thank you! That is a very good suggestion. I did not know that endocrinologists are changing their thinking to starting with a bone building medication. Like you said those of us with small frames tend to see overstated bone loss on our scans. That is even more reason for me to take my time making this decision because I think I can wait a bit. I will ask my endo about Forteo. How long will you stay on Forteo? Is there an end point at which you must take a break or stop it? I really need to research Forteo now. Thanks again!

@loriesco
Yes…Checking Calcium and D are not directly connected to bone density. I understand that. Just good to monitor that one is not overshooting or under the ranges being looked at.
After-all the osteoclasts and “blasts” take and use it to build.
“Some” of the latest studies don’t show a correlation of calcium intake and an increase in coronary calcification…
So much conflicting information out there.
Love all your valuable information…
I was told it’s okay to inject in my flank…now I’m thinking that, like you said, there might be better absorption in the abdomen.

@gently
My doctor said it’s a 20 minute infusion that may be an option after Tymlos. Can you provide any links to the optimum length of time? I’m hearing 45-60 minute infusion

osteopatient2026, I'm often quoting the gentleman who ran final large clinical trial for Reclast "Things I routinely do when I treat patients with IV zoledronic that not all physicians understand. First, I order the infusion to dilute the 5 mg of zoledronic acid (which comes in 100 mL of D5W) into 500 mL of NS (normal saline), thereby diluting the drug from 5 mg% to 0.8 mg%. Then I order it to be administrated over 60 minutes, instead of 15 minutes. Giving an N-BP more dilute and more slowly makes it even safe{r] for the kidneys. The 3rd thing I always do is order the infusion nurses to administer 650 mg of acetaminophen to the patient during the infusion, and I tell the patient to take at home the same dose of acetaminophen (two regular strength Tylenols) with dinner and at bedtime the day of the infusion, with all 3 meals and at bedtime the day after the infusion, and a final (7th) dose with breakfast the 2nd morning after the infusion. These 8 doses total of acetaminophen reduce the chance of a symptomatic APR from 20-30% to <1%."
At the Stanford infusion clinic 60 minutes with the dilution is standard.

@gently
That’s great information…now if I can get my doctor to follow it…I don’t yet know if reclast will be my follow up or Prolia…I’m 65 but good to know…you wouldn’t happen t9 have a link to that dr and statement?

@osteopatient2026 if you have a choice, do it in the abdominal area. You don’t want to waste a whole year (like I feel I did.). As far as the coronary calcification, I’m not sure where your information came from, but that’s absolutely incorrect. The calcium is well documented and studied to be damaging to arteries and add to heart disease, plaque deposits, and problems with kidneys. Talk to any doctor or do more research online. When the doctor assesses your cardiac health, they do a calcium test to assess the condition of your heart and arteries. It is a gold standard. You do not have to worry if you don’t have heart disease or coronary artery disease in your family history. You do not have to worry if you are not taking calcium supplements. Please do not take calcium supplements until you’ve had a blood test and you know your calcium levels.
Avoid the confusion by knowing which resources to use.
1) A TRUSTED doctor. Doctors can be wrong even the trusted one so always speak up if you’re intuition tells you to.
2) trusted resources like the NIH the national Institute of health. It is a great place to do research and see studies that have been peer reviewed for verification.
3) AI is great to get a bunch of information that’s integrated all at once, however, look where AI is getting their information. AI always lists it sources. AI is getting better and better all the time but it’s absolutely fallible so again take it with a grain of salt, but use it as a springboard.

I am 69 years old and it is really hard for me to remember/routine all the things I learn and investigate at this age. It helps to use this website and enlist the help of others to get information. Trust but verify is more than a political slogan.
I do a lot of research and go armed to my appointments. Some of my doctors can be difficult to work with. They don’t like their authority challenged. That’s too bad. I have found that in today’s medical climate doctors have less time for us. They don’t look beyond the symptoms and things that show up in a 20 minute visit. That means you may need to email them and after the visit and do more research and then follow up with them. Sometimes they they just don’t have the time and it’s incumbent upon ourselves to do the work unfortunately. Fortunately, there are groups like this where people will help!

@loriesco
Impact of Calcium Supplements on Coronary Calcium Score
Evidence of Risk:
Taking calcium supplements may be associated with an increased risk of arterial plaque buildup, which can lead to higher coronary calcium scores. This is particularly concerning as elevated scores indicate a greater risk of heart disease.
Dietary Calcium vs. Supplements
Dietary Calcium: Consuming calcium through food sources does not seem to carry the same risk as supplements. In fact, a calcium-rich diet may be beneficial for heart health.
Calcium Supplements: Research suggests that individuals who take calcium supplements may experience a rise in their coronary calcium scores over time. This is not observed in those who obtain calcium from their diet.
Summary of Findings
Risk of Elevated Coronary Calcium Score
Dietary Calcium Low risk; may be beneficial
Calcium Supplements Higher risk; linked to plaque buildup

In conclusion, while dietary calcium is generally safe and potentially beneficial, calcium supplements may pose risks that warrant caution. It is advisable to consult with a healthcare provider before starting any supplement regimen.
Johns Hopkins University
Harvard University

So depending on which school you went to there is conflicting studies …nonetheless id probably err on the side of caution…
My CAC score was 9 …crazy how one doc says no and another says maybe…they aren’t researchers either so I do the same thing…my own research …
One school of medicine says no another says maybe…😉
In addition….Stanford…
In most people, taking a calcium supplement does not directly cause a higher coronary artery calcium (CAC) score.
A CAC score measures calcium that has accumulated in plaque within the walls of the coronary arteries, not the amount of calcium circulating in your blood or the calcium you've recently consumed. The calcium in arterial plaque develops through a complex process related to atherosclerosis (hardening of the arteries), inflammation, and other biological changes over many years.
Here's what the evidence suggests:
Calcium supplements do not appear to increase CAC scores in a direct or immediate way. Taking a calcium tablet before a scan will not affect the result.
Large studies on whether long-term calcium supplementation increases cardiovascular risk have had mixed findings. However, many well-conducted studies and reviews have not found a clear increase in coronary artery calcification or heart attacks among people taking recommended doses of calcium supplements, especially when taken with meals.
Calcium from food sources (such as dairy products, leafy greens, and fortified foods) is generally not associated with increased cardiovascular risk and is often preferred when possible.
Factors that are much more strongly associated with a higher CAC score include:
Increasing age
High LDL ("bad") cholesterol
Smoking
Diabetes
High blood pressure
Family history of early heart disease
Chronic kidney disease
If you already have a high CAC score
A calcium supplement is not usually considered the cause. Instead, the score reflects existing calcified plaque that formed over time. Your healthcare provider may consider your overall risk profile to decide whether you should continue calcium supplements, especially if you're taking them solely for bone health.

@lynnsusan
Only if you can handle the risk of your jaw rotting out. Personally, I cannot. I'm done with all of these meds. I got a huge kidney stone on Tymlos. Doctor knows not to even mention the idea to me.