Any non fracture members?

@kfhoz

Great paper -- many thanks. Old age, by itself, no matter what you do, is likely the most common culprit in bone breakage.

My take: Low bone density by itself won't necessarily predict bone breakage or worst case scenarios. Besides a DEXA, a bone quality (TBS) and FRAX (USA) score (you can calculate it yourself online) are useful in deciding if and which medicine to take.

Other than that, a good diet, adequate sleep, exercise, stretching, avoiding risky behavior that could result in falls, selecting a doctor that you have confidence in, and (for me) taking a drug that has no day-to-day side effects, is a reasonable approach.

My recommendation: Do your research to become informed, selecting high quality information sources and then take your own "reasonable approach."

I’m 83 and had one fracture from lifting. Then two fractures from too strong therapy. Had Kyphoplasty in last two. Bone was extremely hard for dr to insert needle which attending nurse told me very unusual for osteoporosis which made us believe the therapy was issue. I have had OP since breast cancer in 2002. First T score. -3.1. Went on Actenol for two years until severe reaction. T score after that wad -3.7. So i took no more meds being most were all the same biphosamates. T scan was six years later was -3.2. Next in five was -3.1 six years ago. Last year -2.9. So mt OP has not progressed even getting older but has improved. Of course everyone was adamant I take Tymlos which I have tried four times this past year and had to stop due to extreme back pain adding to my existing back pain. Now it’s been 18 months, had new mri last month which was no change from last one in March 2025. Spine stable but I do have the ongoing desensitization due to muscle guarding my spine not unclenching. My long story here is when I look at other drugs, can’t take a couple due to heart disease. Can’t do Prolio due to recurring and on daily meds for UTI’s. It’s been mentioned that not having a new fracture in 18 months and not a horrible T score, I might be better to just be monitored and do special exercises. It’s difficult for me for I wanted to do what was best for me taking bone meds, but it’s like doors are shut on that due to other side effects that would be more dangerous for me than a fracture. But I worry about it all.

@joyboudreau
I hear you. I was 60 when I fell on the edge of a wooden ramp and cracked three ribs (I'm 66 now). For Heaven's sake, I think anyone at any age would have broken something with that fall. Of course, I was immediately sent for DEXA scan and of course it showed osteopenia. I was immediately told I had to start on medication. The nurse practitioner in charge of the Fracture Prevention Clinic gave me a brochure so I could choose which medication I wanted. My husband was already on Forteo, but he has rheumatoid arthritis, and definitely had weak bones. I had my choice of Forteo (don't remember why I didn't choose that one), Tymlos (caused cancer in rats, though at notably higher doses than ever given to humans), bisphosphonates (had watched a friend of my Mom's go through jaw necrosis on that one - no thanks), Prolia (once you start you can't ever stop or you will lose any and all progress made) and probably more meds I'm not remembering. I weighed my options and chose the Tymlos, knowing that I had a strong family history of kidney stones, and that was a potential side effect. I told the NP about it, but she just kind of blew it off. Sure enough, over a year in I started getting very bad abdominal pain. It wasn't in the area where kidney stones typically cause pain, so it took 9 months for me to be diagnosed (I stopped the Tymlos on my own). I even saw a urologist who announced that my pain was not typical kidney stone pain, but he would send me for pelvic floor therapy, because he hadn't known anyone who didn't benefit from pelvic floor therapy! That night I ended up in the ER with terrible pain. The proper scans were done, and I had a very large kidney stone stuck in my right kidney. No way was it coming out on it's own. Had to have a procedure to have it removed - miserable experience. I decided right then that there was no way I should have gone on any of those meds, and unless I had obvious severe signs of osteoporosis (not just a bit of osteopenia), I would not go on any of the drugs again. I don't really think I ever needed to go on the medication to start with, and I am angry that I wasn't smart enough to just say no. Obviously there are a lot of people with severe osteoporosis who must have these medications, but I do not believe that everyone who has osteopenia, or has a fracture caused by something that would likely give anyone a fracture, automatically needs to be put on these drugs. It took me awhile to get past the anger I felt from my experience (maybe I'm still not over it). Live your life, don't let numbers on a dexa scan report scare you to the point that you are afraid to live. PS, a week ago, I stepped backward and tripped on our small dog and took a hard fall right on my rear end, trying to avoid crushing the pup. Yep, I broke my tail bone. Of course I was immediately sent for a dexa scan - results were basically the same as one from two years ago - osteopenia. Am I going to go back on meds? Heck no. I know my post will probably make a lot of people angry, and I'm sorry - I'm just telling my story and my opinion.

@stress101 I can understand your being stressed.
I will be 83 this week and am choosing not to take any more meds other than Vit D with K2, Calcium and walking on the treadmill 40 minutes each day.In the past I did five years of Actonel and three years Reclast imfustions I tried other meds and could not tolerate them, thus my DEXA scores from my hip remain the same -.3, neck at -2.3 and spine -2.7. Neck and spine did improve. What I am understanding is once taking Evenity you have to continue with something else and pray for no side effects. What was not pointed out to me until I read what others have posted, is that being small boned my numbers could be overstated, since I have not had a TBS reading with my DEXA. I called the clinic to make sure their equipment was capable to give that score too. Aging out is what makes my decision today. All I can do is the research, read what has worked and not worked for others and let go and leave the rest in God’s hands.

@researchmaven Definitely a good philosophy…just wondering what drug you’re actually taking with no day to day side effects? Thanks so much
Regards,
Pam

Question for anyone - is there not a difference between fragility fracture and regular fracture? I have osteoporosis currently but was told in the past a DEXA isn't done until the magic age of 65 (15 years post menopause for me) or if you should fracture. I broke my wrist a few years before age 65; the surgeon who put it together with plate and pins said my bone looked great and healing was basically perfect. I asked him about a DEXA and he didn't think it was necessary. I did not pick up something and spontaneously break a wrist. I was in a car wreck and the airbag broke it; emt and ER doc said they see this type of break all the time. Is there a difference in how fractures are perceived (traumatic vs fragility) or is everyone who breaks anything in any way after a certain age considered osteoporotic? After wrist healed my PC sent me for DEXA scan, and numbers did show osteoporosis, which I am treating. Seems odd to me that all fractures are considered equally. My nephew broke his wrist falling off a scooter (age 27) and did not get a DEXA...