Osteoporosis treatments: What did you choose?

Posted by tdawnandrews @tdawnandrews, Jun 6, 2019

I was recently scheduled to have back surgery but was cancelled when my dexa scan showed osteoporosis in my spine. The recommendation is that I begin Forteo treatment. Wondering if I need to get a second opinion or if this is common. Are there any other alternatives?

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@sue225

I am on prolia. Forteo and prolia are two different kinds of medications. My doctor wanted me to take Forteo because it builds bone and builds it rapidly rather than just slowing down the process of bone breakdown. I opted for Prolia which is an injection two times a year. Forteo needs to be injected daily and because I have so much cancer in my family I did not like the black box warning about bone cancer. After one year on Prolia, (as of May 2019) there has been significant improvement in both my spine and hip and my doctor seemed pleased with the results. So, I went ahead with injection #3. I also take 2000i.u. of video daily.
Google both medications to learn more about them.

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Not video but vit d!

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@tdawnandrews

I'm starting on forteo this week. Is there anything I should avoid while on it?

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I've been doing the Forteo shots for three months now. I didn't really change anything that I do, or take. I did decide to do the shots at night for a couple of reasons. (1) Some people reported nausea or dizziness, so I figured doing the shots at night when I could lie down was best (though I have had ZERO nausea or dizziness), and (2) We travel, usually from East-to-West coast, so the time difference works better that way (I can basically still take the shots at the same time, just earlier in the day when on the West coast). Sooooo ... so far, so good.

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I have been on prolia since 2012 and vit D supplements. I water walk laps for excersize and have had excellent results in bone growth shown on scans and have not had any new fractures in years. What is the controversy of staying on prolia?

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I have read that there is evidence that Prolia can be taken for up to 10 years. The clinical studies beyond 10 years are not yet available. I have also read on many sites, including Amgen's (Prolia manufacturer) that you should never stop taking Prolia abruptly without a backup plan (taking another osteo med). There is a high risk of breaking bones including spinal compression fractures when stopping prolia so your doctor needs to have you on an alternate therapy. (I have been on Prolia for over 1 year with improvement to my bone density).

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@tdawnandrews

I'm starting on forteo this week. Is there anything I should avoid while on it?

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Can you let me know how that goes as I am debating on starting this as well.

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Just got my bone density scan back I had a slight change from 5 years ago. My spine got slightly worse, and my right hip showed a slight improvement of 1.6%. Can anyone recommend something natural to take to help improve my spine from getting worse. Looking for something you take once a day. Has anyone had any results taking Algae.cal or even a liquid calcium. Thanks for any suggestions you may have.

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Hi @d1076g and welcome to Connect. I see that you are looking for recommendations for natural supplements, so I moved your post to this discussion so you can connect with people who have osteoporosis.
- Osteoporosis treatments
https://connect.mayoclinic.org/discussion/osteoporosis-treatments-1/
I would check out Mayo's guide to calcium here: https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/calcium-supplements/art-20047097

Have you ever taken supplements in the past?

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@amandaa

Hi @d1076g and welcome to Connect. I see that you are looking for recommendations for natural supplements, so I moved your post to this discussion so you can connect with people who have osteoporosis.
- Osteoporosis treatments
https://connect.mayoclinic.org/discussion/osteoporosis-treatments-1/
I would check out Mayo's guide to calcium here: https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/calcium-supplements/art-20047097

Have you ever taken supplements in the past?

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Thanks to Amanda & d10766 for their posts. I am almost 80 & very limited due to multiple spinal compression fractures from osteoporosis despite what I thought was adequate exercise and supplementation.
Does the Mayo calcium supplement suggestion of 1200 mg. calcium/day if over age 71 apply to just the elemental calcium? Or to the total that is shown on the supplement container?
Is my understanding that calcium from ANY source has the same effects (possible constipation & bloat) no matter the source (algae, plants, carbonate, citrate, etc.) correct?

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Forteo vs. Prolia vs. Reclast?
At my recent DEXA, my lowest T-score was -3.3 (at lumbar spine). I previously took oral Alendronate for four years, and stopped in 2016. I haven’t taken any medication since then for the last six years. I’ve never had a fracture and I’m generally active and healthy and practice yoga almost daily. I have had ulcerative colitis in the past, but not active for many years. My endocrinologist recommended starting osteoporosis medication and gave me a choice between three options:
1) Forteo daily injections (followed by Reclast infusion)
2) Prolia every six months for 2-4 years, with re-assessment, and followed by Reclast infusion
3) Reclast infusion once a year for three years.
My understanding is that Forteo is the only one of these drugs that actually builds bone, so that may be best but I’m not keen on the daily injection. With Prolia, the bone density is likely to drop rapidly after stopping, requiring a course of Reclast immediately following. That leaves Reclast as my choice, but I’m still not sure if that’s the best option.
I’d be grateful for any information to help with this decision.
Thank you!

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@mint

Forteo vs. Prolia vs. Reclast?
At my recent DEXA, my lowest T-score was -3.3 (at lumbar spine). I previously took oral Alendronate for four years, and stopped in 2016. I haven’t taken any medication since then for the last six years. I’ve never had a fracture and I’m generally active and healthy and practice yoga almost daily. I have had ulcerative colitis in the past, but not active for many years. My endocrinologist recommended starting osteoporosis medication and gave me a choice between three options:
1) Forteo daily injections (followed by Reclast infusion)
2) Prolia every six months for 2-4 years, with re-assessment, and followed by Reclast infusion
3) Reclast infusion once a year for three years.
My understanding is that Forteo is the only one of these drugs that actually builds bone, so that may be best but I’m not keen on the daily injection. With Prolia, the bone density is likely to drop rapidly after stopping, requiring a course of Reclast immediately following. That leaves Reclast as my choice, but I’m still not sure if that’s the best option.
I’d be grateful for any information to help with this decision.
Thank you!

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Other options are Tymlos and Evenity. You can apparently take Evenity after Tymlos or Forteo, but not the other way around, so I would start with Tymlos or Evenity.

I like Tymlos because the dose is adjustable and I started at a low dose on the pen, then moved up. The injections are easy.

I am doing Tymlos for 18 months then depending on DEXA, will do either Evenity for more growth, or Reclast. My doc says I can take breaks from meds depending on monitoring results.

If insurance doesn't cover these meds, and you are income eligible, Tymlos and Forteo both have patient assistance programs. I have read and believe that the sequence of these meds is important and that it is better to build quality bone first, then use bisphosphonates to maintain, as my doc suggests.

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