I'll just put my whole take on this article and others like it here in one place. I have had osteoporosis for 15 years. There are things I agree with here, and things I don't agree with. You have to understand that articles like this are manipulating just as much as the drug companies. Be skeptical of everyone.

The argument that bone loss is "natural" has some flaws, because we now live into our 90's, in many cases. Women used to die closer to menopause and so osteoporosis was not an issue. Though the image of the "hag" or "crone" bent over was the image of osteoporosis and you still see women like that today.

I would not medicate osteopenia. Most doctors are not doing that anymore. The whole movement to do that was absurd and harmful. First line drugs built density but over time could result in brittle bones, resulting in atypical fractures and even necrosis of the jaw- the latter very very rare and mostly due to higher doses for cancer patients. The further problem with Prolia is that bone loss accelerated when stopped so once you start Prolia, you are kind of locked into meds to follow- though perhaps a biphosphonate could "lock in" the gains.

Insurance covers biphosphonates and Prolia first and once you fail those, have severe osteoporosis, or fractures (or some combo of these) you can take bone growing drugs like Forteo, Tymlos or Evenity. This is backwards. Bone growing drugs should be first, but they cost money. Some doctors will apparently help advocate for these.

Okay so for early osteoporosis, say -2.5 to -2.9, things are murky. During that time I read Keith McCormick's book "The Whole Body Approach to Osteoporosis" and also a book entitled "The Myth of Osteoporosis" and others. I have been reading for years. I also did tai chi for years. I had 2 spinal compression fractures from a fall and was told my spine was more fragile as a result. I tried Fosamax and failed (GERD). I tried Forteo and my heart went crazy. I went to an immunologist to try to get desensitized. I wanted drugs but was also scared and sensitive to them.

I got breast cancer. This contradicts the linked article by the way. My bone density was well below -3.0 at that time so according to the article I should have been protected! I took aromatase inhibitors. (For me these were potentially life-saving. Others with low risk or low estrogen scores may decide differently.)

I began an aromatase inhibitor already with pretty bad osteoporosis. My oncologist wanted me on Reclast but my bone doctor said no due to my afib, and didn't want Prolia. I couldn't take Forteo. We assumed Tymlos would also be impossible. I tried to get on a trial of the patch, thinking maybe I could handle that. My bones got 5% worse the first year on Femara, then settled to a 2.5% loss, the same rate as before Femara ever since menopause.

I went off Femara at 5 years due to bone issues, at the request of my oncologist. I wanted 7 years. At that point I was doing sword tai chi and feeling strong and athletic.

I went to a hospital for my COVID vaccine and didn't want to use the rest room. I brought a pot in the car. I lifted my behind up to get on the pot and felt something tear. Three spinal fractures in one moment.

The pain is indescribable. My independence was threatened. Instant old age. Trouble doing laundry, doing dishes, cooking, shopping. THIS is what all the hooplah is about. Granted, if I had not made that one stupid movement, maybe I could have gone longer. But a cough, a hug, opening a window, something would have happened. I was getting close to -4.0 and that decline happens fast after menopause.

Another effect of fractures is that the spine is shorter, making less room for organs. I cannot eat much at a time, and there are potential breathing issues. Osteoporosis really is a serious problem.

My Vitamin D level is 52, excellent, I take Vitamin K, adequate calcium, walk every day, and do tai chi. But now I am in pain forever. People say they don't want to take meds so their life is "normal." Well my life is not.

I am now on Tymlos. I fought to be on it. I started at 1/2 dose and landed in the ER with afib, just like Forteo. I cannot connect the afib and Tymlos: could be coincidence. I met with two cardiologists and two endos (mine was out of the country). I told the Tymlos folks and my docs that I was starting at two clicks out of 8 on the pen. Over a few months I have moved up and take 7 clicks most days. I also switched to the morning.

I will do ANYTHING to stay on Tymlos. I don't care if I go bald or have to spend hours in bed or whatever. Yes it has side effects. I wish I had taken it earlier. People DO go from severe osteoporosis back to osteopenia on these drugs. My doc will follow up with either Evenity (depending on progress) or 1/4 dose Reclast administered slowly after drinking lots of water and medicating. He will monitor me and add or take away drugs as appropriate.

The whole reason for this problem- osteoporosis- is that we live longer. Yes it is natural but it is also crippling. If severe enough.

If you have osteopenia or mild osteoporosis, I suggest buying McCormick's book and try to maintain what you have. McCormick himself took meds for a while but since has followed a "whole body approach." If your bone loss progresses or if you are already at the point where fracture risk is high, please please consider medications. And try to find a doctor who will start you off with bone growing drugs.

Evenity grows bones but also affects resorption/turnover the way Prolia and biphosphonates do. As a result it "turbocharges
bone growth but may possible have some of the bone quality issues of the other drugs. Tymlos and Forteo grown bone but retain turnover.

I have a kid with multiple health conditions and am caregiving my mother, as well as myself. I have prevented harm from doctors in sooooo many cases so I am not naive, believe me. But osteoporosis puts us between a rock and hard place. I thank the stars for Big Pharma who made insulin and anti-epileptics for my kid, Tymlos and Femara for me, and heart meds for my mother who has made it to 95. Yes they are geared to making money. But capitalism fuels drug development and many medications that result, prolong life and prevent suffering.