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Treating Osteoporosis: What works for you?
Osteoporosis & Bone Health | Last Active: Nov 3, 2023 | Replies (1084)Comment receiving replies
Am I understanding right that there is no medication that strictly builds bone *without also preventing resorption*? If I'm understanding right, the current medications available for decreasing bone loss offer only the following two choices as far as mechanism of action:
A) Stop resorption without building new bone. In essence, old bone builds up. Bisphosphonates, which are taken orally.
B) Stop resorption plus build new bone. In essence, old and new bone build up. Rank Ligand Inhibitors and Anabolic Agents (Tymlos, Prolia, among other RLI injectables; a patch possibly coming for Tymlos; and Evenity, among other AA injectables.
What I don't like about Bisphosphonates is that they stop bone resorption; therefore -- at least the way I picture what happens -- old, possibly unhealthy bone piles up that normally would have sloughed off due to being old/unhealthy. Am I wrong to be harping on the stops-resorption aspect? I've lived under a wrong general life-living mindset of "out with the bad, in with the good"? 🙁 I can't help but think there should be some med that's the equivalent of Restasis that triggers tear formation, except for new bone formation.
When I first started my research rampage into the various types of drugs available for treating bone loss, I had gotten the impression that the injectables strictly *built new bone* (without also preventing old-bone resorption) -- likely because the emphasis in various articles was their new-bone-building feature.
But in this below Tymlos patch writeup I'm getting the impression that the various injectable osteo meds are not strictly new-bone-building like I thought but also prevent resorption....just like the Bisphosphonates prevent resorption (though in bisph case without any bone building aspect). And preventing resorption is the part I don't like, if I haven't stressed that enough in this post yet.
https://www.webmd.com/osteoporosis/features/newer-osteoporosis-treatments-build-stronger-bonesI found a nice list of medication types, but it isn't thorough about their mechanism of action differences: https://www.medicalnewstoday.com/articles/osteoporosis-medication
Is there an Osteoporosis Medication Mechanism of Action table, or thorough narrative comparison anywhere that's something along the lines of the attached?
Replies to "Am I understanding right that there is no medication that strictly builds bone *without also preventing..."
I'm with you on being cautious about the anti-resorptives. Though they might have to be the drug of choice in some cases as the other options aren't good or not tolerated which is why I see all of them as a kind of Hobson's Choices.
"Injectable" only refers to the delivery mode, not to any particular class of drugs for osteoporosis. There are both bisphosphonate and non-bisphisohonate injectable.
Here's another of my personal caveats. I don't want 6-monthsworth of anything injected into my body if avoidable. No matter how convenient. To me, that's a heavy load of something unfamiliar to my poor little body :-(.
I think it was Chris' post that mentioned how much better she fared when her doctor reduced the dose-load of an injected anti-osteporosis drug and had it administered more frequently. And her side effects decreased considerably. To my mind, that's good medicine and a good approach.
If I ever take an injectable, I'd start small to see how I tolerated it. And then, if all goes well, decrease the frequency of injections/infusions with commensurate increase in per/dose session. But that's just my opinion.
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I wish that someone in the medical profession would respond to this. You have raised a number of questions about these medications we all should be asking. No one wants to fracture and become disabled nor do they want to take medications with adverse side effects and suboptimal (or no) benefit.