New to osteoporosis and overwhelmed

Your spine scores are what some of us have after treatment! 🙂 Just to reassure you, not minimize your concerns. Your hip is more concerning but not horrible. You definitely need an evaluation and treatment but it doesn't have to be lifelong.

First, has your parathyroid been tested? Estrogen levels?

Second, most docs will tell you that it is better to do bone builders first. Those are Forteo, Tymlos (both of which work through the parathyroid) and Evenity (which inhibits sclerostin). Insurance is the problem. Insurance and often PCP's want you on anti-resorptives first, meaning bisphosphonates like Fosamax and another med, Prolia. Prolia is very difficult and risky to get off, I have been told.

Dr. Keith McCormick has a new book out entitled "Great Bones," which is a great resource. You can get it at the library or online. His other book is "A Whole Body Approach to Osteoporosis." He also does consults by phone.

Dr. Ben Leder from MGH has an excellent video online about Sequencing and Combinations.

I know it is a shock but you can do fine. You have time so take it to research and decide. Your bones are not made of dust! You can learn how to move through PT if that makes you feel safer. I went 17 years with osteoporosis before a fracture. And again make sure there aren't other causes, like high PTH because you are just now menopausal. My bone density dropped sharply at menopause but then the rate of loss eased considerably.

Thank you so much Windyshores for your reassuring comments. Yes, tested my PTH and it is normal. My OB/Gyn doc said no point in checking estrogen levels b/c we already know they will be low since I am (finally) in menopause. Re: HRT, she said if someone is already on it for post-menopausal reasons, then they will keep the patient on it. But they would never initiate HRT to another osteoporosis drug for dual therapy. That doesn't really make sense to me as the mechanisms should be additive instead of opposing. But I will bring that question to my Endo appt. I will look into all the resources you've listed. Thanks!

zingsong, welcome
WHO estimates the percentage of women with osteoporosis in your young age at 14%. You'll feel more ordinary in the endocrine office.
What I gather from reliable and less reliable sources, you'll lose the most estrogen in the next two years. Your consideration of estrogen replacement is wise provided you have no personal or genetic cancer risks. My understanding is that a low dose estrodial patch is the safest application.
I second the recommendation of an anabolic, except not Prolia and not Evenity. Tymlos or Forteo.
Your exercise routine sounds safe. Always good to have a PT, though. Your risk is from cooking and shopping.
Save the iron pots until your bones get stronger. Don't bend over those deep boxes to pick up a watermelon,
ever. And you can't pick up those babies until they are born. You have time to get ready. With a good endocrinologist, your bones will be strong again.
There aren't that many pharmaceuticals, so that part will be easy.
The endocrinologist I see would say that peace of mind makes it reasonable to ask for another dxa. Your endocrinologist may have to sign the "necessity" form.
I think you should test the estrogen levels and recheck parathyroid because your calcium is on the low side. Your Ds are low for treating osteoporosis.
Tell us about your bone expert.
You were smart to get that dxa. This will be easy for you.

MY D3 is 52. I take 3,000 units daily and one gummy has 45mcg K2. If you do Tymlos I read that it "eats" D3 and my level has stayed the same for two years despite the relatively high intake. Just a small bit of info!

Re: Ca, the normal range is 8.8-10.5 on my lab report, and my level is 9.4 so I feel like it's a decent value, no? I understand that Ca is one mineral where you can't have too much (cardiovascular risks) or too little (bone loss). Also even with an adequate Ca level, my T-scores are still so bad. Part of me is thinking what difference would it make even if I boost it up? But, I am taking 500mg Ca Citrate twice a day per doc's orders. And I will continue to eat a lot of Ca rich foods.
Re: Vit D, I agree my level of 25 is on the low side. I will ask Endo what my goal is. Currently my primary doc told me to take 4000iu daily x 3 months, then 2000 iu daily. Interestingly, the day after my doc told me to max the Vit D, I saw an article on Scientific American - "The healing powers of vitamin D may be overhyped". And to complicate things further, I was reading another article where they say African Americans women have more fractures when their Vit D level is >20 while White women have less fractures when their Vit D level is >20. I asked my primary then where do Asian women fit in? How do we know our response to Vit D is not closer to African Americans than White women? She says she doesn't know the answer and no one knows and she is following the treatment guidelines developed by Endo/bone specialists.

It sounds like you CA is just fine. I had never heard that Vitamin D less than 25 made fracture risk worse for black women. My doc says Vitamin D needs to be adequate to help calcium get to bones, but as we all know most studies are with white women. Not sure about Asian women. I hope your doc knows.

The research is out there to support taking vitamin K2, either in the form of MK4 or MK7.
Dr Doug Lucas is also a good doctor to listen to . He’s a retired orthopedic surgeon.

I commiserate with your feelings. This site is so helpful. Also check out OsteoBoston on YouTube

Hi @zingsong, I felt overwhelmed by my diagnosis as well.
For exercise options, check out Dr. Loren Fishman's(Columbia University School of Medicine), "Twelve Poses vs Osteoporosis." You can google that, find his series of yoga poses on line that have been studied and found to improve bone density. Also, you will find some interviews with him.
Physical therapists that specialize in osteoporosis are Sara Meeks and Margaret Martin. They are on YouTube as well.
I'm soon to be 73. My numbers were similar to yours. Two years on alendronate my spine improved out of osteoporosis, but my hips got a little worse. At the same time, I was taking high dosages of prednisone (not good for the bones) for over a year and a half for an autoimmune disorder. It took a year to get diagnosed and I did not exercise other than walking as it was extremely painful to move. I've been off prednisone for nearly a year and regained mobility.
My PCP suggested I get a minitrampoline to improve my hips. I've used it for about four months and my pelvic floor muscles have really tightened up. If you're interested in rebounding, speak with your doctor to get clearance. Earth and Owl has many good, free, instructional videos on You Tube.
The advice is to be cautious with lifting, use proper lifting techniques (these too can be Googled), do not curve or bend the back forward.
I wish you the best.

Oops!! Newbie mistake - I should have posted at the Osteoporosis & Bones support group! I didn’t even see it until just now. Should I move the discussion to over there?