Struggling with making an osteoporosis treatment decision

Hi @zaa. My doctor didn't say, but I trust him and it was his drug of choice. Another doctor I trust also recommended it. I think if a drug has been around a while and is effective, some doctors prefer to go with it vs. push the new drugs, which may not have a track record. Usually, after five years on alendronate, or a similar drug, a "drug holiday" is recommended. I'm hoping to get back some bone density - with exercise and supplementation - to be able to get off it before then.

The temporal artery biopsy is pretty much the state of the art tool for diagnosing GCA. I had it done at the end of May. There is also an imaging technique, but it's pretty rare. GCA can result in stroke or blindness so it's nothing to mess with. I think if there's any hint of GCA it's prudent to have the biopsy done. I'm glad I had it done before the Delta variant started gaining ground here.

It sounds like the result of your biopsy was negative. Is that so?

Unfortunately, my DEXA scans did not get better. Probably because I’m still on the prednisone. I’m tapering off now but i was on 20mgs a day until January. I would definitely recommend getting an endocrinologist ! I have an appointment the end of August to discuss all the things I’ve read about on here. I’m also going to ask about a physical therapist who specializes in osteoporosis so i can care for my bones better.
The dental issues from these drugs are rare according to my endocrinologist. He recommends that i get my dentist to carefully follow my jaw health.
What worries you the most?

Hi @zaa. My doctor didn't say, but I trust him and it was his drug of choice. Another doctor I trust also recommended it. I think if a drug has been around a while and is effective, some doctors prefer to go with it vs. push the new drugs, which may not have a track record. Usually, after five years on alendronate, or a similar drug, a "drug holiday" is recommended. I'm hoping to get back some bone density - with exercise and supplementation - to be able to get off it before then.

The temporal artery biopsy is pretty much the state of the art tool for diagnosing GCA. I had it done at the end of May. There is also an imaging technique, but it's pretty rare. GCA can result in stroke or blindness so it's nothing to mess with. I think if there's any hint of GCA it's prudent to have the biopsy done. I'm glad I had it done before the Delta variant started gaining ground here.

It sounds like the result of your biopsy was negative. Is that so?

With a-3.1 I would do Forteo, Tymlos or Evenity. Those stronger drugs won't work as well after taking alendronate. Too many docs start with these "front line" drugs. Trusting doctors feels good but honestly, in every medical situation, whether osteoporosis or cancer, I have benefited from both a second opinion and self-advocacy.

I’ve had TMJ for years and wear night guard due to grinding my teeth. My CT scan last year shows arthritis in my jaw. I had a rare internal resorption on bottom front tooth and it was removed just before I was diagnosed with PMR. So no implant for me, just empty and really worried over time, the teeth can shift backwards and be totally useless, not to mention pretty darn ugly. Jaw bone may never be able to accept implant but, so far, I can’t get answer. I’m still trying to figure out someone who can answer questions on this and have dentist appointment tomorrow but they are not TMJ jaw health experts. Perhaps I should do some digging into that too.

My dentist was on vacation so saw another in office that was NOT helpful. On my list to search for new dentist with experience in my areas. Seems to be very difficult to get dentist/doctor appointments. Just trying to get into general practitioner is out 5 weeks and really isn’t something I should be waiting on. I think people are ending up in emergency rooms due to long wait times to see someone.

Ok, Made a decision to go with Prolia vs Evenity and will begin in Oct. On one hand, I’m uncomfortable because my understanding is Prolia indirectly builds bone by suppressing the natural bone-sloughing of old cells, and Evenity allows the natural process of building/sloughing to continue. I like that. On the other hand, I’m less uncomfortable because a specialty pharmacist and two doctors have all told me their negative experiences with Prolia have been minimal. That was heartening, and that impacted my decision. I received approvals from Medicare and my backup insurer for Prolia but not what my final cost will be. I alerted my dentist at my recent appointment and they did bone measurements to begin tracking for that possible side effect. So I guess this will be it. 😳 Hopefully I won’t experience the horror story of side effects. I wish nobody had to!