Undecided choice of drugs for Osteoporosis

I also have an osteoporosis diagnosis. My bone density testing showed osteopenia but I am treated as having Clinical Osteoporosis because of multiple falls with fractures. I have high risk and Frax scores. I chose the Reclast infusion and agree that it is a frightening decision. But, I have a broken knee and don’t know how it happened and have had a broken forearm, broken nose and broken fingers all from falls. To prevent a fall that is totally debilitating seems better addressed before it happens and Reclast was the recommendation by my endocrinologist. You will know when taking medication makes sense for you. Trust yourself and your health care provider.

@hlp123 the CTX and P1NP blood tests. Make sure to do them fasting and always at the same time in the morning.

I did Reclast, the side effects were few and lasted bout 8 hours. I had a low grade fever and the chills. Once the fever broke I was fine. It’s been 10 months, planning my second infusion in February. I did drink a lot of water and took Tylenol prior to my infusion plus the infusion was given gradually which I was told reduces the after effects.

Why do people not all with Evenity which actually builds new bone? Why do they just prescribe the other kind of drugs that actually don't build new bone? Just curious.

It is my understanding that bone building drugs must be followed by one of the others to retain bone.

Great question 1956.
Our bodies are all different.
Sometimes an unknown cause of osteoporosis is operative. If you have parathyroid disease your body might produce too much parathyroid hormone. If you take a drug like (my favorite) Forteo, which works by increasing parathroid hormone, you already have too much and you'll probably get sick.

But I should have started at the beginning. Twenty years ago there were no anabolics--no drugs that actually build bones. All we had were the bisphosphonates (well, and salmon calcitonin which doesn't work). Bisphosphonates don't let your bones remodel. Normal processes of repair are stopped. Bone builds by holding older bone in place. The cracks that normally develop still developed. So you have this bone that is only stronger than no bone. But that is all you have to prevent fracture. And bisphosphonates prevented more fractures than they caused.

In 2002 Forteo was approved by the FDA. It had a black box warning about the possibility that it could cause bone cancer. Mandated after market studies completed just this year removed that concern (and the black box). Tymlos followed Forteo with the same warning also removed.
Prolia was next and widely hailed. Years have proven that it can be a dangerous bone breaking drug if not followed by other drugs.

2019 Evenity. The hazard warning with Evenity is cardiac. Some dismiss the warning and prescribe the drug In the years ahead, patient health will inform us whether the drug is too dangerous to take or as safe as Forteo.

Prescribers are largely influenced by what has happened in their practices. If they have a patient who was harmed by Prolia, they won't prescribe Prolia. And, they are more reluctant to trust Evenity.
Sometimes cost and insurance coverage controls the prescription.
Interesting question, complicated answer.

I agree with the CTX and P1NP blood test that will let you know where you are at this point in time . A 24 hour urine calcium is also important.

I had severe constant leg cramps from Prolia. I stopped it. I’ve taken all the bone builders & nothing helped.
I’m done with medications. I walk & carrying cat litter boxes is my weight bearing exercises. All meds have side effects.

Thank you for your response. Yes, we are all different, and I've noticed throughout my life a lot of doctors do not consider this. I think our medical healthcare is scary. I'm a very small person (child size) and because I am an adult, most doctors would give me medication adult milligram size which many times have had adverse effect. I've noticed any new medications the cost is usually in the thousands in today's world. I remember taking Acutane when it was an experimental drug at the time and I was able to pay out of pocket. Since 2011, I've noticed these medications all very expensive and the quality of care went way downhill. Health Insurance is in control of the health care and they don't consider the individual.

Thank you !!!
I really appreciate this information. I have so many doctors and not one of them, including my endocrinologist, has every done these tests !!!!