Just got back from seeing NP for osteoporosis/want a second opinion.

Your bones are not that bad, honestly. Your spine is really good. You could wait until you pass -3.0 according to Keith McCormick's book "Great Bones." I wonder if you could do a consult with him. He also wrote "The whole body approach to osteoporosis." I am pro-med for osteoporosis that needs meds but you seem to be in a gray area where he might be helpful and supportive.

The thing is, if you do Reclast or Prolia now, what comes next? Tymlos, Forteo and Evenity will be less effective. And you really don't want to do Reclast or Prolia for years. The sequence is all off and so is the timing. Unfortunately insurance only approves of the stronger meds if you have failed the anti-resorptives, or fractures, so PCP's and NP's start off with them. It is not their fault: they are following protocol and insurance requirements.

I am not a doctor so am not giving medical advice. But I hope you can find a doctor or NP more in line with your preferences. I did that with cardiology (didn't want to take blood thinners). I would strongly suggest an endocrinologist if you don't have one, and one who gives you some choices, including waiting for meds.

I think you've gotten great advice from windyshores. My bones are much worse than yours, and I am a fervent believer in any exercise that strengthens my body and above all improves my balance - a fall is your worst enemy. But don't count too heavily on an endocrinologist - the one I went to wanted to put me on Reclast and I refused, but I have refused all meds since a switch from Actonel to Fosomax caused a gerd reflex. Don't forget too that bone density is not everything - bone quality is important too.

And I totally agree with your feeling that doctors are being influenced by pharmaceutical companies.

I totally agree with doctors pushing drugs. Like others have told you, your scores are not that bad. I feel osteoporosis is a serious condition that is letting you know things are out of whack wirh your body. That’s why I choose to see a functional medicine doctor who is helping me. My rheumatologist told me to take Tums if I didn’t go the medicine route.🤦….I would suggest reading R Keith McCormick, DCs books. I wish I had done that prior to meeting with the rheumatologist so I could ask intelligent questions. There are other test for measuring bone health besides a DEXA scan that, IMHO, need to be done before prescribing osteoporosis meds. Good luck in your journey.

It is a little comforting to hear someone else question the big pharmaceutical companies in this issue. I felt like I was the only one. Drug companies make $14 billion a year on osteoporosis drugs and the target population is a group of older vulnerable people. A doctor convinced me several years ago that I needed to take drugs and they recommended Boniva. I ended up in the ER with a severe side effect. When prescribed medication of any kind, I never read the possible side effects enclosure because I don’t want my mind creating issues that might not actually exist, so I know the side effect was a legitimate occurrence. I have resisted taking any of the other drugs since. But the doctors always tell me I need to start taking one. A medical assistant told me a couple of years ago “off the record” that she completely understood my reluctance to take the drugs and that she herself was not convinced any positives outweigh the possible side effects. For those of you taking drugs, and doing well and showing improvement, I am genuinely pleased for you. I am just unable to get myself to the point that I feel the risk is worth it. My mother had osteoporosis and lived to 96 without taking any drugs. This is a difficult issue, and I honestly don’t know what the correct approach is.

@sandrajhunt and @mrossi although I posted here that in cases that are mild, drugs might wait (according to my doc and also see "Great Bones" by McCormick), I am a big fan of treating severe osteoporosis with pharmaceutical drugs. I just want to be clear. I have met with Keith McCormick and he suggests drugs for patients and took them himself. It depends on the DEXA, blood tests related to turnover, fracture status, and whether bone quality is okay.

Falls are not the only risks. For those of us with more severe osteoporosis, any unwise movement or even a cough can result in a fracture. I have seven fractures and the pain and disability are far worse, and more lifelong, than side effects from meds, at least for me.

The question is when to do medications and in what order. Insurance policies need to change to make bone builders first line with bisphosphonates or Prolia as follow up meds, rather than the other way around.

Thank you for the insight. I completely understand your position. For some reason it is just a very difficult decision for me to make….drugs or no drugs. I am 76 and of course want to live as long and as well as possible.

Resistant training does work. Yoga is a great choice and if you go online and search there is a link to 12 yoga poses for osteoporosis. My endocrinologist told me his wife had osteoporosis and she was able to just use hormones and did fine and now she is in her late 70’s no issues. It depends on your age and family history. I regret never taking them. I needed them 20 years ago right after that study came out saying they were bad for you so no one would prescribe them for me. Now they are finding that’s not true and women can benefit from them.
Do your research.

I had breast cancer that was fed by hormones so that is a caution. One out of 8 women gets breast cancer and the majority are fed by hormones. Just wanted to include that in the discussion.

Hi candy209:

I will have to start the yoga for osteoporosis.
I have arthritis in both knees so will have to just use some of the 12 yoga positions.

Hormones are off the table because I have had breast cancer.

Got McCormick’s 700 pg.
book, “Great Bones” 2 days before the NP osteoporosis appointment. So, I tried to read the area on meds. before the appointment and referred back to those pages again after the appointment.

Super book.

I refused all the meds the NP offered.
She is running some tests and said that I could think about it and would never prescribe meds without a parathyroid blood test and some others.

But, she expects me to choose one one the 3 if these tests are negative.

No thanks....