Has anyone not used medication after First Dexa scan spine -2.8?

Posted by rmasters @rmasters, Aug 15 6:05am

I am 57, 5'2" and 110 pounds and have just had my first DEXA scan spinal -2.8 osteoporosis, femoral neck and hips -1.3. I exercise and eat well. I did go through surgical menopuase at 50. I have a blocked LAD artery and use injections of repatha for this. I am giving all these details because I really don't want to start any of these medications and wondering if anyone has ignored pressure from doctors, all of mine are encouraging Reclast. I am scared and tired of looking at all the pros and cons of everything. thank you in advance

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ny2ganana | @ny2ganana | 20 hours ago

In reply to @gravity3 "@ny2ganana Stress fractures and jaw issues are rare. Are you concerned about having more fractures?" + (show)

@gravity3
I think I got the compression fractures by moving furniture and replacing my flooring. I’m not concerned about getting more and I’m being for mindful of what I shouldn’t be doing. Removed all trip hazards in home and mindful of where I walk. I won’t take meds or be pressured into taking any by a doctor.

roseincalifornia | @roseincalifornia | 20 hours ago

In reply to @ou14mejc "@roseincalifornia agree! I put off the medications for years because of the side effects. My doctor..." + (show)

@ou14mejc Congratulations on the improvement in your spine. A -1.3 t-score is amazing! The new bone that the anabolic meds build is actually stronger and more flexible than our "normal" bone of the same density. Scientists have done finite element analysis to prove this.

Good luck on your back surgery. Having strong bones definitely puts u in place for a more successful surgical outcome. I have also read that Evenity is good for the hips.

Wishing you the best!

rose140 | @rose140 | 7 hours ago

In reply to @ou14mejc "@roseincalifornia agree! I put off the medications for years because of the side effects. My doctor..." + (show)

@ou14mejc
Thank you for your post best wishes for the future

sistermac | @sistermac | 6 hours ago

In reply to @roseincalifornia "@ny2ganana You are right that there are "no guarantee(s) to keep me from breaking any bones..." + (show)

@roseincalifornia

@ny2ganana

You are right that there are "no guarantee(s) to keep me from breaking any bones either."

But in numerous peer-reviewed studies, medication has been shown to drastically reduce the risk of fracture (see the bottom half of this post)

"Make an informed decision" -with all due respect, based upon what you are writing, you are sadly uninformed. "I also have 2 compression fractures that I know of and have no interest in starting any meds that I will need to take the rest of my life" If u were informed, u would know that doctors advise against taking OP meds for a lifetime - usually people cycle in and out of them every few years.

Already having 2 compression fractures means you are much more likely to have more fractures. 2/3 of spinal fractures are "silent" - you appear ok, but lose height. Basically you are playing Russian Roulette. Sooner or later u will have a "non-silent" fracture where u will face permanent disability and chronic pain.

Your numbers are in the -3 's (severe osteoporosis) means it is too late to rely only on supplements/diet and exercise.

Given your level of resistance to medications (despite fracturing multiple times), I do not expect anything I say to change your mind. In writing this, I just hope to convince others (with T-scores at the -3's or lower) to at least see an endocrinologist. They will give u a battery of blood and urine tests to try to find the underlying cause of so much bone loss. And then based upon your current medical state, they will present you with medication options. They will also discuss how exercise and diet/supplements fit in.

=======
There was a massive international study done which synthesized data from millions of person-years across multiple cohorts worldwide. It demonstrated that a prior history of fracture roughly doubles the risk of any future clinical fracture. See: https://researchnow.flinders.edu.au/en/publications/previous-fracture-and-subsequent-fracture-risk-a-meta-analysis-to/

Paper: “The vertebral fracture cascade in osteoporosis: a review of aetiopathogenesis” (Briggs AM, et al.).
Key Finding: Specifically focusing on the spine, this paper details how sustaining a single osteoporotic vertebral compression fracture drastically alters mechanical spinal loading and exponentially spikes the risk of sequential adjacent or systemic fractures.

Here is an overview of popular osteoporosis medications, broken down by category and their approximate clinical fracture reduction rates based on major clinical trials.

Antiresorptive Medications (Slow down bone breakdown)

1. Alendronate (Fosamax) – Oral (weekly/daily)
Vertebral fracture reduction: ~50% decrease
Hip fracture reduction: ~40% decrease
2. Zoledronic Acid (Reclast) – Intravenous infusion (yearly)
Vertebral fracture reduction: ~70% decrease
Hip fracture reduction: ~40% decrease
3. Denosumab (Prolia) – Subcutaneous injection (every 6 months)
Vertebral fracture reduction: ~68% decrease
Hip fracture reduction: ~40% decrease
4. Risedronate (Actonel) – Oral (daily/weekly/monthly)
Vertebral fracture reduction: ~40–50% decrease
Hip fracture reduction: ~30–40% decrease

Anabolic Medications (Build new bone)

1. Teriparatide (Forteo) – Daily subcutaneous injection (typically limited to 2 years)
Vertebral fracture reduction: ~65% decrease
Non-vertebral fracture reduction: ~35–53% decrease
2. Romosozumab (Evenity) – Monthly injections (limited to 1 year, followed by an antiresorptive)
Vertebral fracture reduction: ~73% decrease (compared to placebo)
Hip/Clinical fracture reduction: Significant reduction (demonstrated superior risk lowering in comparative trials against bisphosphonates like alendronate)

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@roseincalifornia I will go as natural as possible with exercise, diet and no falling…

followheart87 | @followheart87 | 5 hours ago

@ny2ganana, I want to point out that there are various potential underlying causes of osteoporosis that are important to find out. It's not just due to aging/postmenopause. Osteoporosis can be a symptom of another problem. Wouldn't you want to find out if there is something else going on? Even if you decide you don't want medication, it behooves you to find out WHY you are losing bone density. For example, celiac disease is one underlying cause of osteoporosis that most people don't know about. There could be parathyroid issues. There could be cancer. There could be autoimmune issues. At the very least, it would be smart to get a consultation to find out what's going on. That way you can make a BETTER informed decision.

kfhoz | @kfhoz | 3 hours ago

In reply to @sistermac "@roseincalifornia I will go as natural as possible with exercise, diet and no falling…" + (show)

@sistermac @ny2ganana Reducing trip hazards and risk of falling is a great goal for all of us with osteoporosis. But risks remain and I consider the additional ways people have broken bones in my own decisions.

Here are some real examples of specific people breaking bone that I recall offhand:
1) a relative broke a bone when a loose dog ran into her and knocked her over.
2) reaching into the bathtub to clean something and pressing to hard against the edge caused a broken bone (not sure if I got that description perfect, but it was on here I read it)
3) auto accident/incident where low trauma would not have broken stronger bone.

Other ways that I do not know of specific people, but I have heard of include:
4) having a rolling walker roll forward and leave one falling backwards. That may be many years in my future, but I want to build bones now that can withstand that type of fall.