Undecided choice of drugs for Osteoporosis

@normahorn did you come across calcium and phosphorus ratio or balance? It's surprising that dairy and high calcium containing bone-in fish like sardines have such a high amount of phosphorus. Maybe that's what's "wrong" about dairy... In the end, op patients are just having too much metabolic inadequacies in this complex bone matrix

The endocrinologist I see would advise against medication for borderline osteoporosis. I, on the other hand (with no particular knowlege of anything) would be alarmed at the suggestion of Prolia. And would advise against reclast. But would suggest you look at Forteo.
It is just that if you fracture your life will change in ways you can't imagine. I've read that more fractures occur in osteopenic women than in osteoporotic women.
Trabecular bone structure is poorly depicted on dxa. Have you had a TBS. That is where we lose bone the fastest because there is more surface area to this type of bone.
Some people never fracture. I'm not taking the risk and have been on Forteo since April without negative effect.
70% of women 80 or older have osteoporosis. Congratualtions.

Forgot to ask- any recommendations on calcium/d/magnesium supplements? Every time I settle on one I find criticism on the ratios, amounts etc. I just purchased New Chapter Bone strength (which is criticized for ratios of Magnesium to Calcium). I am also am strongly considering Algae Cal (which my doctor did not approve of but I think she may be misinformed). That too doesn't have the 2:1 calcium magnesium ratio that seems to be the recommended ratio. If a company that does nothing but manufacture bone supplements doesn't use that ratio, surely there's a rationale. I think I should dive into McCormick's book before asking any more questions. I have a feeling I will get a lot of them answered.

I just read a study on the difference between taking a bone builder before Prolia and bisphosphonates or after. The difference was shocking: in some cases the latter had half the effectiveness. It is much much better to take Eventity, Tymlos or Forteo before a bisphosphonate or Prolia!

Hi,
I'm new to the board. I was just diagnosed with osteoporosis (left femoral neck -3.5, L1-L4: -3.0). I'm only 54yo, no symptoms, and very strong and healthy (weight lifting regularly for the past year and a half). I'm stronger than I have ever been in my life. I haven't broken a bone since I was 13. I actually asked my primary to order the Bone DEXA on a whim, fully expecting her to come back and tell me I had the bones of a 20 yo. I was devastated to see the results. I had an appt with a rheumatologist yesterday and her recommendation was Reclast infusion. (She wanted to start me on an oral medication but when she learned that I had a hx of ulcerative colitis (many years in remission) she was excited to tell me that insurance would approve skipping the pills and going straight to the Reclast. This is all brand new to me. I have always leaned towards Naturopathic approaches. Even with the UC, I chose to forego all traditional treatments and managed to stay symptoms free for 8 years now. Her advice was that my T-scores were too low to "play around with natural treatments". I asked her abut the AlgaeCal program and she said the Strontium element in it was ill-advised and gave misleading DEXA improvements. Reading these posts, it seems traditional medicines may be my best option. However, the general consensus seems to be that Forteo would be the place to start rather than Reclast. There's a part of me that wishes I never got the DEXA scan and could go forward feeling strong and healthy. Instead, I feel like I stumbled into a world of contradicting evidence, side effects, risks and confusion. Any input or advice is so welcome.

Gently, what is a TBS? TY

Hi,
I'm new to the board. I was just diagnosed with osteoporosis (left femoral neck -3.5, L1-L4: -3.0). I'm only 54yo, no symptoms, and very strong and healthy (weight lifting regularly for the past year and a half). I'm stronger than I have ever been in my life. I haven't broken a bone since I was 13. I actually asked my primary to order the Bone DEXA on a whim, fully expecting her to come back and tell me I had the bones of a 20 yo. I was devastated to see the results. I had an appt with a rheumatologist yesterday and her recommendation was Reclast infusion. (She wanted to start me on an oral medication but when she learned that I had a hx of ulcerative colitis (many years in remission) she was excited to tell me that insurance would approve skipping the pills and going straight to the Reclast. This is all brand new to me. I have always leaned towards Naturopathic approaches. Even with the UC, I chose to forego all traditional treatments and managed to stay symptoms free for 8 years now. Her advice was that my T-scores were too low to "play around with natural treatments". I asked her abut the AlgaeCal program and she said the Strontium element in it was ill-advised and gave misleading DEXA improvements. Reading these posts, it seems traditional medicines may be my best option. However, the general consensus seems to be that Forteo would be the place to start rather than Reclast. There's a part of me that wishes I never got the DEXA scan and could go forward feeling strong and healthy. Instead, I feel like I stumbled into a world of contradicting evidence, side effects, risks and confusion. Any input or advice is so welcome.

wilkenl and Chris,
Thank you both so much for your replies. I really want to figure this out . Before I knew anything about my bone health, I started lifting because I got a late start with kids (I have 15yo twin girls) and I figured if I want to be an active grandma, I better get off my keister and start building muscle. wilkenl, I just got that book in the mail today! I ordered that and
Lies My Doctor Told Me: Osteoporosis: How the Latest Medical Research on Bone Drugs and Calcium Could Save Your Bones, Your Heart, and Your Life. Either of you familiar with that one?
I would love to find a good naturopath. Unfortunately, S. Florida is a bit of a wasteland for alternative medicine. I wonder if telehealth is an option. The west coast seems to be housing some of the best docs. Also, when you say "its too late for me" to manage naturally, is that based on your DEXA score? At -3.0 and -3.5, my rheumatologist felt that it was too late for me to explore that route. I'm not sure yet.
Chris, Thank you for all the advice. I'm curious what made you choose the Tymlos? If I am indeed going to start one of the bone building meds, my biggest concern is hair loss. I know strong bones are more important than a head of hair but I spent five years growing it in after losing much of it as a combined result of an overzealous hormone doc and his testosterone pellets combined with the stress of a uc flare.
Thank you again- its nice not to navigate this alone. I love smart women. There's nothing we can't do 🙂
Amy

@ahmeyers I chose Tymlos because the dose pen is adjustable so I could ramp up slowly. I never took the full dose (I am small) and still had excellent gains. It is otherwise very similar to Forteo.

The other reason was that I was told I could do Evenity after Tymlos but not the other way around. I will do a 20% test dose of Reclast to "lock in" gains after the other meds.

Osteoporosis does not have symptoms. We feel strong. I was doing sword tai chi for several months. I still fractured three lumbar vertebrae with one wrong movement. My Tymlos was delayed by COVID unfortunately. You do not want to be me, and have the pain and disability from fractures. Side effects of meds, if they happen, are, in my view, worth it. But the lack of symptoms from osteoporosis makes it hard to be motivated!