Significant osteoporosis: I need a bone plan

Yes my dr has suggested either one and I’m debating based on side effects which one as I’m leaning to Forteo at this point,

So in consulting again with my Dr I misunderstood what she said, currently she is only recommending Forteo.

Thanks very much for your reply. May I ask, is there a reason that one would wait 18 months after starting Tymlos or other drug for a followup bone scan? Is it an insurance issue? I would have thought that annual tests would be required because, if a treatment isn't working, it would allow the treatment plan to change.

Thanks for information on refills. I thought it would be only 30 day refill so thats a relief.

My endocrinologist suggested Evenity, Forteo or Tymlos (in that order). I personally felt that Evenity was too new, with an unusual mode of action, and that I would like a drug that had a longer time in market. Also, I cannot find anything suggesting that Evenity is better particularly at bone building. But, again, I'm having trouble finding research reports on any of them.

I would have trouble making any impact with diet, because I already eat a whole, organic diet. I get quite a lot of dietary calcium. I can increase exercise but, was already pretty active (ie 5 days/week).

The one thing I am considering is adding HRT to standard treatment of Evenity, Forteo or Tymlos. My endocrinologist supports that , with the usual cautions/about the risks. I had an early menopause which I believe contributed to osteoporosis. But at the time HRT was getting a really bad rap and several doctors refused to prescribe it because I had no menopausal symptoms. I should have insisted.

I have to say I'm also super depressed about the diagnosis. Which is probably what everyone feels at the time. I am 60 but have the bones of an 84 year old.

Hello. I sound similar to your case and also @heyhey including Depression. I also need help. I’m -3.6 with a -4 at my L4-5 and hip -2.7.
They recommend tymlos for me but my biggest question is if this grows new bone increases density is it ACTUALLY good and flexible bone?!
If it’s not Strong flexible new Bone, isn’t that More fracture risk even if you have increased bone density?

And even if it is good bone and not at increased fracture risk , once you get off tymlos you have to go on a bisphosphonate type to keep it due to reversibility of the anabolics.
So then, from my understanding, that bone will definitely become
Brittle (because the drug causes the old bone- that’s naturally SUPPOSED TO BE replaced - to stay- but it is old/ brittle and more risk of fractures.

Vitamin k mk-4 of 45 mg / daily used in Japan apparently instead of bisphosphonates can significantly reduce FRACTURE risk even though bone mineral density does not go up. Has anyone done this vitamin K large 45 mg daily? Doctors will think it can cause extra clotting but the functional doctor said no , once we get enough K for clotting it moves on to help bones and other things in the body; and that It doesn’t increases clot risk. So I’d ask for coagulation labs to be safe and ask your doc first.

Re HRT I heard A Osteoporosis speaker say once we’re 5 to 7 years past menopause, our estrogen receptors have basically dried up and it really won’t respond to HRT anymore. 🧐 true?

❤️👉🏼 Would love to hear from those who’ve done Forteo tymlos and vit K 45 mg and reduced fracture risk.
I don’t want to go on Tymlos and then bisph. Or Reclast if I’m just going to end up with higher BMD but more brittle, higher fracture risk bones?!!

Hello. I sound similar to your case and also @heyhey including Depression. I also need help. I’m -3.6 with a -4 at my L4-5 and hip -2.7.
They recommend tymlos for me but my biggest question is if this grows new bone increases density is it ACTUALLY good and flexible bone?!
If it’s not Strong flexible new Bone, isn’t that More fracture risk even if you have increased bone density?

And even if it is good bone and not at increased fracture risk , once you get off tymlos you have to go on a bisphosphonate type to keep it due to reversibility of the anabolics.
So then, from my understanding, that bone will definitely become
Brittle (because the drug causes the old bone- that’s naturally SUPPOSED TO BE replaced - to stay- but it is old/ brittle and more risk of fractures.

Vitamin k mk-4 of 45 mg / daily used in Japan apparently instead of bisphosphonates can significantly reduce FRACTURE risk even though bone mineral density does not go up. Has anyone done this vitamin K large 45 mg daily? Doctors will think it can cause extra clotting but the functional doctor said no , once we get enough K for clotting it moves on to help bones and other things in the body; and that It doesn’t increases clot risk. So I’d ask for coagulation labs to be safe and ask your doc first.

Re HRT I heard A Osteoporosis speaker say once we’re 5 to 7 years past menopause, our estrogen receptors have basically dried up and it really won’t respond to HRT anymore. 🧐 true?

❤️👉🏼 Would love to hear from those who’ve done Forteo tymlos and vit K 45 mg and reduced fracture risk.
I don’t want to go on Tymlos and then bisph. Or Reclast if I’m just going to end up with higher BMD but more brittle, higher fracture risk bones?!!

Hello. I sound similar to your case and also @heyhey including Depression. I also need help. I’m -3.6 with a -4 at my L4-5 and hip -2.7.
They recommend tymlos for me but my biggest question is if this grows new bone increases density is it ACTUALLY good and flexible bone?!
If it’s not Strong flexible new Bone, isn’t that More fracture risk even if you have increased bone density?

And even if it is good bone and not at increased fracture risk , once you get off tymlos you have to go on a bisphosphonate type to keep it due to reversibility of the anabolics.
So then, from my understanding, that bone will definitely become
Brittle (because the drug causes the old bone- that’s naturally SUPPOSED TO BE replaced - to stay- but it is old/ brittle and more risk of fractures.

Vitamin k mk-4 of 45 mg / daily used in Japan apparently instead of bisphosphonates can significantly reduce FRACTURE risk even though bone mineral density does not go up. Has anyone done this vitamin K large 45 mg daily? Doctors will think it can cause extra clotting but the functional doctor said no , once we get enough K for clotting it moves on to help bones and other things in the body; and that It doesn’t increases clot risk. So I’d ask for coagulation labs to be safe and ask your doc first.

Re HRT I heard A Osteoporosis speaker say once we’re 5 to 7 years past menopause, our estrogen receptors have basically dried up and it really won’t respond to HRT anymore. 🧐 true?

❤️👉🏼 Would love to hear from those who’ve done Forteo tymlos and vit K 45 mg and reduced fracture risk.
I don’t want to go on Tymlos and then bisph. Or Reclast if I’m just going to end up with higher BMD but more brittle, higher fracture risk bones?!!

Just as an example of what can go wrong with bone health medications, I was put on Prolia for osteoporosis and got rashes and severe bone pain after both of the two injections I received. Switched to Tymlos and wasn't monitored as often as I should have been after the first four months resulting in hypercalcemia, hospitalized and told I could have died as bad as the blood chemistry was. After that I was given an infusion of Reclast that resulted in severe body aching, swollen, red, non-functional hand and migraines for 5 days. After all this, I'm just trying to eat well, take calcium and vitamin D supplements to maintain any bone health. A previous bone health doctor mentioned putting me on Forteo but it never happened.

I am avoiding Prolia because of the drop in bone density when you go off. I think a lot of your problems could have been averted with better advice on calcium intake, better monitoring, and starting at a lower dose. I started Tymlos at 2 out of 8 clicks of the pen and am still not up to full dose and my doc is fine with it. Ditto Reclast. My doc will give me only 1mg and test to see if that is working, after my Tymlos.

I went 14 years with osteoporosis, with no osteoporotic fractures, but when I did finally fracture it was 3 vertebrae and so painful and for a few months I lost my independence. It was from one stupid movement. Just make sure you don't wait as long as I did.

It sounds like you need a better doctor, rather than avoiding meds. But I don't know your DEXA scores. If insurance was paying for Tymlos I assume not good.