Here is a link to the info https://www.nps.org.au/australian-prescriber/articles/bone-turnover-markers it’s actually an article and I’m not sure if it references the source. This is a link to a study that seems to suggest the amnt of calcium taken comes into play https://pubmed.ncbi.nlm.nih.gov/11833002/

and this study seems to support taking/eating calcium before you exercise, which I started doing after I read the Calton’s book, Rebuild Your Bones, potentially lessens resorption
https://pubmed.ncbi.nlm.nih.gov/35977107/
Yes, I took osteo-meds. From January 2020 to July 2021 (1.5 yrs) I took alendronate. It caused digestive tract issues so I took a 4 month holiday and in November 2021, I had my 1st zoledronic acid infusion. My endocrinologist expected me to have another zoledronic acid infusion in November 2022, but I chose not to have it.

To date, I have not had any major side effects from the infusion. My reason for not having the 2nd infusion is because I’ve come to realize that my endocrinologist isn’t being as thorough as he should be. I’m really unhappy with him. For example, he did not order any tests, not even a 24 hr calcium urine test, prior to prescribing osteo-meds. Because of this, my BTM (bone turnover markers) were not tested and I have no true baseline values.

Instead of the 2nd zoledronic acid infusion, at my request, I had BTM bloodwork exactly 1 year after the 1st infusion. The problem is that bisphosphonates don’t just leave your system after you take them. For prescription drugs, bisphosphonates have a pretty long half-life, so there is a chance that since I’ve taken bisphosphonates it skewed my November 2022 BTM results.

When I saw my endocrinologist in December 2022, I asked him to review my BTM results. His only comment was that my osteocalcin was near the low end. Note, osteocalcin is “interesting” because from what I gather, it can be an indication of both bone formation and resorption. When I got home, I pulled out my BTM pdf (something I rec’d when I signed up for a BTM webinar) and it clearly states that bisphosphonates lower osteocalcin and that hypothyroidism can lower osteocalcin. So, why, if my endocrinologist is “concerned” about my low osteocalcin level, is he prescribing bisphosphonates, and since he treats my hypothyroidism, he should know that that alone could cause my osteocalcin to be lower.
Here is a link to the BTM pdf I mentioned above https://s3.amazonaws.com/Food4HealthyBonesPDFs/FFHB+Blood+Test-Bone+Markers.pdf

I knew that hyperthyroidism causes or speeds up resorption and therefore can cause bone loss. I’ve recently learned that hypothyroidism slows down bone formation and therefore can lead to bone loss. It sounds like these 2 conditions do the same thing but there is a difference especially when it comes to how to treat the bone loss.

Bisphosphonates seem like a good option if bone turnover is excessive or high but for someone whose problem is with bone formation it seems crazy to treat bone loss with a drug that is supposed to slow resorption.

Additionally, bisphosphonates can lead to brittle bones because they slow resorption and that means that old bone that should be sloughed off, isn’t. I’ve recently read that hypothyroidism can cause brittle bones. So coupling hypothyroidism and bisphosphonates doesn’t seem like the best idea.

It sounds like we have very similar concerns, meaning how can we stay in one piece and pain free for the remainder of our time on this planet.

Some points of concern that I factor in are what if I get cancer or in a car wreck. If I take bisphosphonates now and in 10 years I’m diagnosed w/ cancer and have to take cancer meds that destroy bones and they want me to take more zoledronic acid to protect my bones from the cancer meds, will I be able to? Or what if I get in a car wreck and break my jaw, will I suffer with ONJ.

A 65 y.o. friend has been having issues with a tooth and the dentist can’t see what is going on, not even with x-rays (note this person doesn’t have osteoporosis). The dentist’s expert guess is that there is a crack in the tooth. Apparently a crack in a tooth doesn’t necessarily show up on x-rays. My friend is going in to have the tooth removed. Who’s to say this won’t happen to me at some point, and again I think, what about ONJ.

What were your gains on the alendronate? I’m surprised that you lost all the gains. Have you ever had your BTM tested. Maybe you have excessive turnover. Have you been tested for “secondary” causes of osteoporosis?

I’m not sure if you mentioned this or not, but have you been through menopause? and if yes, how long ago? Did you do HRT?

Not sure if I mentioned this in my original post but I went through pre-mature menopause at age 32. I did not do HRT and I’ve been told by several doctors that now it’s too late. However, after hearing about women in England being given HRT even later in life, I decided to ask my new OB/GYN and she is willing to prescribe it. I’m seriously considering starting HRT in the near-ish future.