DEXA scores: mild vs. severe

Understood. I am skeptical of it all and yet these drugs seem to best that is available at this time. Ah, these frail
human bodies! Good luck to you on your path.

susanfalcon, your endocrinologist makes a good point. ( "After a 2-h intravenous infusion, plasma concentrations of alendronate decline rapidly to approximately 5% of initial values within 6 h. About 50% of a systemic dose is excreted unchanged in the urine in the 72 h following administration." ) about GERD. You can avoid some of the effect of acid reflux by taking great care after ingestion. Gerd is seen with IV and injectibles, so there is the potential GERD effect even with great care.
Alendronate is the bisphosphonate with the least persistence in the bone. It remains unevenly distributed in cortical and trabecular bone for a documented ten years . It doesn't actually leave the bone. You lose the alendronate when the bone leaves the body in the course of remodeling.
Without expertise, only in speculation, I wonder if an anabolic after Evenity might be a better choice, since the final nine months of Evenity are said to be antiresorptive.

I think you meant to say that the anabolic medications such as Forteo or Tymlos don't work as well if taken following and antiresorptive drug, not "followed by."

@imay Thanks so much for the catch! Yes, you are correct, my comment should have read:
Per "Great Bones" book (pp. 568-569), an anabolic, or bone-building, medication (i.e., Forteo, Tymlos, and Evenity) doesn't work as well after taking 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.

I have had an appt with Dr McCormick and I had some GERD issues in my distant past. He said to me after Forteo , as the anabolic he recommended for me , he would use Actonel instead of Fosamax. Food for thought. Maybe check that out . Ask your practitioners questions. Good luck!!

thank you. I am keeping careful documentation of any GERD which not ever problematic for me in my past. Maybe holiday eating though careful contributed. Found it unusual that symptoms were only at night and the next day not night of and
only for 2-3
nights. Some say side effects dissipate over time. Trying to hang in there. Powerful medicine even though poorly absorbed. Hoping that means I don’t need to take for a long time. I have a CTX in January and maybe that will help in deciding length of anti resorption treatment but next DXA isn’t til October 2024 so probably not going to be able to stop this med any time soon. Although I am working with 2 different endocrinologists I’ve considering adding Dr McCormick as I’m probably not terribly far away in CT. Throwing everything I have at this beastly disease!! Appreciate your input.

Just so you know. Most, if not “all” meet with him on a phone call. I’m in NY and made the trip , was going to be a bit late due to traffic and issues on 90 , met with him on phone a few miles away from his office. 🥴 2nd time I just stayed home and received a call. He doesn’t do zoom , just so you are aware. Good luck!!

Will check out the book. At age 77, already 3 spinal compression fractures, Afib and now a 12 mm typical neuroendocrine tumor in lung I’m a little “oh well, do my best.” I am actually relieved that the tumor is so slow growing, no sign of issue in lymph nodes. Meet with a surgeon at Mayo soon. Haven't had any Afib for a year. I’m at the Y exercising 5x a week, meet with a trainer. Looking forward to next cruise and a trip with RoadScholars.org

i am not sure what to tell you to take but i can warn you about prolia i had 1 shot and it changed my life forever be careful and make sure you research everything the drs know very little about these medications but yet give out freely. there are some medications that seem better than others but how do you know if your osteoprosis is not severe maybe try supplements and go to someone who can tell you the right ones to take they seem to help

I read about your Prolia experience on another comment page. My DEXA scores have remained consistent since 2017 at -2.4 hip, -2.5 femoral neck and -3.2 lumbar spine. My endo wants me to start Prolia, which I don't want to do. Of course, he minimizes any risk of side effects. I've had no fractures that I know of and am petite at 5'2", 112 lbs. I have my next DEXA in 4 months and am hoping my scores haven't gotten worse. Since 2017, I've been taking New Chapter calcium supplements and collagen powders. I don't do a lot of exercise other than walking.