Treating Osteoporosis: What works for you?

Hi there! I used the pen until all medicine was gone, but kept it in the refrigerator. My doc said that was fine.

Technically my year would be up in October I think, when I first got to 6 clicks. You are right, I want to do Evenity next.

I am taking care of my elderly mother on hospice right now and my Tymlos side effects are almost nothing at this point at 7 clicks. I might even try 8.

It is hard for doctors in other specialties to give opinions. They don't really know and are afraid of liability. I talked to three cardiologists and three endocrinologists after the ER and my main doc basically said it was up to me. I actually think a pharmacist might be more helpful.

You are dealing with SOOOO much. I hope you can go back on and start at 2 clicks and see how it goes. I find Tymlos to be the least threatening in terms of health. The best of bad choices I guess.

Please keep me posted and take care.

Is K2 useful in osteoporosis treatment? Do the endocrinologists recommend it?

A neurosurgeon friend and my PCP, endocrinologist and female cardiologist (who was s college gymnast and reed thin so worries about some future osteoporosis all recommend vitamin K2. Aside from some other benefits, my cardiologist takes it (and put me on it) because there are several studies showing that it helps prevent free-circulating calcium from building up in arteries. I don't know if K2 would be as important if one's calcium came only from food sources, with no calcium supplements though. I take calcium so also take the D3 and K2 and magnesium, potassium and silica...hopefully in some vaguely intelligent overall balance ;-).

Whether recommended or not there is sufficient evidence to suggest it is a bone healthy vitamin. You cannot rely solely on a doctor’s advice; my doctor didn’t even know enough about it to have an intelligent conversation about it … a vitamin!

I have really good doctors but I had to wade through a lot of not-so-good ones to find these. And 2 will likely retire soon. Having the not-so-good ones is how I became The Reluctant Researcher, lol. [Not exactly true as I'm a researcher by nature and it was part of a career.] I developed test questions that I subtly fit into conversations with prospective doctors and never went back to those who unknowingly failed an interview.

Then double-checking everything, including prescriptions, became second nature, which is actually good. A hospital nearly killed a friend with meds he's allergic to...as noted in his %:#! record and all family pets can only be seen with me in the room after a different near medical negligence. A family friend who heads a hospital says his only real fear is ending up in one with someone who cares about at his side 24/7. So I think that, it's best if patients question and double-check stuff, get second opinions (which insurance companies have become more willing to cover once they started seeing the financial payoff) and value their own thoughts and doubts and get more feedback if necessary to have confidence about medical decisions. No matter how well-intentioned medical personnel are, I'm the only one who was to live with any unintended consequences!

I'm no expert on this stuff but, just thinking, isn't it a good idea to keep with a drug that seems to do what it's supposed to, if one has no side effects? That sounds like the optimal situation - an effective drug, for which the substitutes are problematic, hopefully doing no harm? Buy there might be good other reasons involved in the decision that need consideration too I realize.

@callalloo, @kilh has a complicated medical situation that makes returning to Tymlos a serious decision one way or the other. No way you would know that but just to explain.

Thanks.

NSAIDS caused bisphosphonate failure in one study. Heads up as this might be true with other bisphosphonates. See article and study cited (with links) below. It caught my attention as a friend is on an injected bisphosphonate and, for a different issue, takes a lot of Aleve. The doctor never mentioned a connection though her DEXAs show zero improvement though she's now in year three.

"For women treated with clodronate, the bisphosphonate failed to reduce osteoporotic fracture risk in those who used NSAIDs (HR = 0.95; 95% CI, 0.65-1.41; P = .81), but did reduce the risk in those who did not receive NSAIDs (HR = 0.71; 95% CI, 0.58-0.89; P = .002)."
https://www.healio.com/news/endocrinology/20220616/nsaids-reduce-efficacy-of-clodronate-in-preventing-bone-loss-fractures?utm_source=selligent&utm_medium=email&utm_campaign=topicalert&M_BT=8019573958709
Potential Adverse Effect of Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) on Bisphosphonate Efficacy: An Exploratory Post Hoc Analysis From a Randomized Controlled Trial of Clodronate
https://asbmr.onlinelibrary.wiley.com/doi/10.1002/jbmr.4548

Here's an excerpt of the study previously mentioned that noted the need for better prognostic protocol than DEXA reliance.

"However, half of patients with incident fractures have BMD value above the diagnostic threshold of osteoporosis defined as a T-score of -2.5 SD or more below the average value of young healthy women. Clearly there is a need for improvement in the identification of patients at risk for fracture."
https://pubmed.ncbi.nlm.nih.gov/15615078/