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@windyshores

@fearfracture I disagree with this statement:
"Are you fracturing or have you had any fragility fractures? If you aren’t fracturing, there is no life-or-death situation."

Osteoporosis has no symptoms. We can feel strong and invulnerable and then fracture in one moment. That happened to me. I was doing sword tai chi. I fractured three spinal vertebrae in a few seconds, with one unwise movement.

If scores show serious osteoporosis, I don't think anyone should wait for fractures to go on meds.

The problem is less doctors and more insurance companies who want us on anti-resorptives first, when anabolics might be better to start.

As for guidelines protecting docs from liability, I totally agree. And many women have taken bone meds prematurely, even before they have osteoporosis. Each med is best taken for a limited amount of time and we can potentially run out of that time!

But I hope people will understand that you do not want to wait for fractures. Take it from someone who knows, every single day.

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Replies to "@fearfracture I disagree with this statement: "Are you fracturing or have you had any fragility fractures?..."

I hope your fractures have healed and I can understand how you would disagree with my comment "Are you fracturing or have you had any fragility fractures? If you aren’t fracturing, there is no life-or-death situation." But that was directed to one person, a person who already has an osteoporosis diagnosis, meaning she is aware of her condition, and who seems to be taking action to prevent fractures.

In your case, it sounds like you had not yet been diagnosed w/ osteoporosis, meaning when you fractured. Am I correct? Did you 1st discover you had bone loss when you fractured?

It wasn’t until approximately 2.5 yrs after my diagnosis and after discussing my osteoporosis with 2 different doctors that I learned what my t-scores actually meant. In 2019, my lumbar spine t-score was -3.9. Both my PCP and my endocrinologist discussed my BMD with me and never explained anything. In the fall of 2021, I had an appt with a random teledoc dr. and he explained that every standard deviation was 10%.

From July 2019 through November 2021, I made zero adjustments to my physical activities. When I was diagnosed, I was in the middle of moving—lifting boxes, moving furniture. Additionally, in the fall of 2021, prior to my teledoc appt. I spent a good deal of time digging up well established bushes—root ball and all. It was grueling work. I was bending over and jumping up and down on a shovel spade. Fortunately, I had no issues.

As soon as that teledoc dr. explained that my lumbar spine BMD was approximately 39% less than the average 30 y.o., I spent a good deal of time researching how to move to protect my bones.

Two basic things ppl with osteoporosis should avoid are forward flexion of the spine and twisting of the spine. I used to bend over and touch my forehead to my knees and place my palms on the floor—I don’t do that anymore.

I practiced doing hip hinges while holding a yard stick to my back to keep it in line and I watched videos about how to do everyday tasks when you have osteoporosis: laundry, getting in and out of the car, the dishes, etc.

The thing about osteoporosis is doctors take DEXA scan results and act like T-scores mean the same thing for everyone and the truth is they don’t.

I frequently read posts from ppl whose t-scores are better than mine but they are fracturing. Fragility fractures are a bigger indication of bone quality issues than DEXA scan results.

One DEXA scan tells us very little about our bones. It can’t even show bone loss. It only shows approximate areal density of one’s bones at one point in time. Without more info, there is no way to know what that really means. I would bet a million bucks that my t-scores, even between the ages of 25-30, were never 0, meaning I believe my bones were probably always below the mean.

I’m not against taking osteoporosis meds when necessary but I am against taking any medications without a good idea that what you are taking is right for your condition.

Bisphosphonates don’t work for everyone, and I have seen some info that seems to suggest that taking bisphosphonates before anabolics reduces the effectiveness of the anabolics. Additionally, since it seems that it’s not a good idea to take any osteoporosis meds for too long and since other osteoporosis meds need to be followed by bisphosphonates, it seems that taking a little time to make sure there are no other issues that need to be addressed (parathyroid, thyroid, Celiac, T2D, etc) and finding the best solution is better than just taking an osteoporosis med just because that is the only “answer” most doctors can come up with.

In my case, I also have hypothyroidism. It was diagnosed in 2017 and if doctors did their jobs, it would have been caught decades before—there is even a chance I could have prevented it.

I started taking levothyroxine in 2017 and because my endocrinologist failed to do proper testing before prescribing osteoporosis meds, I’m now left wondering if my bones had started to improve on their “own” once I had the hypothyroidism diagnosis and started treating it. My own experience is just another example of why proper testing is critical before just starting meds.