DEXA scores: mild vs. severe

Can I ask why you prefer Forteo over the others? My doctors are recommending Prolia or Reclast for my -3.1 spine and I’m leaning towards the bone building drugs, even though they say I may never need them. My thoughts are why not build better quality bone while I’m still in my mid 60s and very active. I’ve had two endocrinologists recommend Evenity if I decide to go that route, but for some reason I’m a little reticent to go with it as it is the newest.

I am not quitting yet.....certainly have thought about it though. I may continue through the entire year. My main issue is finding a follow-up drug other than prolia
Thanks

I started on Fosamax in 2020 following the removal of one of my parathyroid glands that was causing calcium to be leached from my bones. I see my endocrinologist in March. Since 2020, I underwent chemo and radiation for breast cancer. I looked at the mayoclinic.org site to see what might be next. It explains the uses of the drugs, their roles and why they might be suggested by a physician. Check out mayoclinic.org/drug and symptoms/osteoporosis /treatments That may help explain the differences in treatment options,

lynn59, my thoughts follow yours. Why build a weak bone when there are medications that build strong bone. And faster.
I chose Forteo over Tymlos because it is a lower dose and because it has been around longer with mandated aftermarket studies. Some individuals can't tolerate Forteo, and for others it isn't effective. If that were true for me I'd take Reclast.
If you take Prolia or Reclast first, the anabolic effect will be blunted. Even as those drugs cease to be effective when you quit taking them, the residue remain in your bones. Forever they say.
When Forteo was limited to two years in a lifetime by the black box, physicians would say--save that powerful drug for when you are older and need it more desperately. Now we are able to repeat Forteo with intervals each application as robust as the first.
You may "need them" already, Most fractures happen in individuals with osteopenia.
With scheduled injectibles, the physician can be certain that you are compliant.
The cardiac risks with Evenity may prove to be unfounded. I'm hearing that it is very effective, but even without any risk factors , I'd wait. But then, I really have the perfect drug.
wishing you the best

"End" works. My thought: don't ever take Prolia. Don't even think about Prolia. I could even favor Reclast if it were standing next to Prolia.

With the costs of Forteo and Tymlos and the inability of some to tolerate one or the other, wouldn't it be nice to be able to obtain a one week supply to test? Those who have a bad reaction would not have paid for and be stuck with a month's supply.

@prettyflower I recommend reading more about Prolia and other medications in "Great Bones" by Keith McCormick. It was published in 2023 and has a very comprehensive section on osteoporosis medications. It may help you with your decision. There are also a number of excellent youtubes and articles that discuss osteoporosis medications, including Prolia.
Good for your to gather more info so you can make an informed decision. Prolia is a rather tricky medication to discontinue (or delay) -- see "Great Bones". Please be careful if you select it. Personally, it sounds like a rather scary medication.

@prettyflower @gently -- Per "Great Bones" book (pp. 568-569), an anabolic, or bone-building, medication (i.e., Forteo, Tymlos, and Evenity) doesn't work as well when followed by an antiresorptive, or bone-remodeling, medication (e.g., Fosamax, Reclast). The antiresorptive medication blunts the body's bone-building response and reduces the amount of new bone laid down. I don't know if length of time between ending the antiresorptive drug and starting the anabolic drugs plays a role in effectiveness.

Gravity3,
I receive my 7th dose of Evenity next week and I am also concerned about what to do next. My endocrinologist wants me to go on Fosamax. I am concerned about that as I have GERD. I went to see my long time gastroenterologist who said “No worries.” He said that if I take it correctly, it passes into my digestive system “like anything else “ and will not cause any harm. Still. I am skeptical.

Susan
I finished 12 months of Evenity in October and have taken 4 doses of alendronate. Previously I might have had a few bouts of GERD responding to occasional TUMs or Pepsis. Very concerned about taking alendronate but absolutely NEVER taking Prolia. I had textbook improvements with Evenity. So far I had non problem with week 1 and 3 of alendronate but weeks 2 and 4 experienced heartburn 1 1/2-2 days after taking not the day or night of so I am being very mindful and careful to see where this goes.

My endo says at least 2 years on alendronate. I’ve always wondered if evenity become more resorptive in the latter months, could this influence how long you need and anti resorptive before a drug holiday. i’ve not been able to turn up any info specific to this.