DEXA scores: mild vs. severe

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.

i can only say since the prolia shot my life as i knew it ended and i was forced to create a new one. i can't say this will happen t you bit i have researched this to the limit and there were more women who had adverse side effects than not. have mine gone away maybe maybe not because the medication i am taking probably helps but the severe pain i experienced was awful.. i would try another approach and maybe your supplements are helping

i can only say since the prolia shot my life as i knew it ended and i was forced to create a new one. i can't say this will happen t you bit i have researched this to the limit and there were more women who had adverse side effects than not. have mine gone away maybe maybe not because the medication i am taking probably helps but the severe pain i experienced was awful.. i would try another approach and maybe your supplements are helping

prettyflower, fosamax was a decent choice at 55. That is when most of us start to lose the most estrogen and consequently the most bone. Even though your dxa shows -2.7, the fosamax probably saved you from greater bone loss.
I don't think of Prolia as a good choice. Partly because of the storied history of the drug, but mainly because it preserves older bone, essentially the same working mechanism as Fosamax, thought with different mechanism of action.
It isn't that -2.7 is severe osteoporosis. But consider that the bone you have is bisphosphonate-bone. Bone that has been preserved with all its little cracks and fissures that the the medication has prevented from self-repair.
You are living in a time when there are amazing drugs available for protection from fracture. And your primary has both made you aware and given you interum protection.
You could get a frax score, have another dexa, double up on your supplements, take alternate supplements, place an estrodial patch, and exercise.
At your level I'd "suggest" Forteo. I'd be happy if an overeager dxa (dxa over estimates bone loss in small bones) placed me in a position where I could get a prescription for this medication. I'd jump sooner than later because those vertebral fractures, unlike any other fracture, never heal into their original position.
Some people never fracture.
My order of choice would be Forteo, Tymlos, Evenity.
best wishes

Did the side effects happen after the first injection or after a few years?

Did the side effects happen after the first injection or after a few years?

I am 78 year old man with a dexa score of -2.7 was -2.4 for 12 years. Hip and back are -2.0 or better. Drs want me to take a once a year 15 minute infusion called reclast because I have bad acid reflux. I am afraid of the side effects. Any advise.

Gbrodnan 1945,

Yes. One of the bone experts who conducted the clinical trials and had a private practice at Stanford has developed a procedure for delivery that you should print and take to your physician so that he can prescribe the delivery and to the practitioner who will apply the injection.

"As I have substantial experience with bisphosphonates, having led the clinical development of three of them, I recommend the following improvements/modifications to the zoledronic [Reclast} acid label.

First, I always have the infusion nursed dilute the 5mg in 100ml DSW into 500mL of NS, so that the now 600mL infuses over 60 minutes Making the N-BP less concentrated and infusing it more slowly substantially improves renal safety, based on data.
Second, I always in struct the infusion nurses to administer 650mg of acetaminophen at the time of the infusion, and instruct thepatient to take that same dose of acetamino;hen with dinner and at bedtime the day of the infusion, with all three meals and at bedtime the day after the infusion and a final (7th) dose with breakfast the 2nd morning after the infusion This reduces the risk of a symptomatic acute phase reaction (APR) from 22% to < 1%
The 3rd thing I do is to repeat the BTMs (U, NTX, and serum BSAP 4-6 weeks after the infusion of zoledronic acid, to assess the maximal effect (nadir in the rate of bone turnover. This serves as a comparison when I repeat the BTMs 12 months after the infusion. In my extensive 32 years of experience with IV bisphosphonates, the average woman (not taking aromatase inhiitors) will show a weel-controlled rate of bone turnover (much lower than baseline, and not meaningfully higher then 4-6 week psot-infusion), and only needs a 2nd infusion after an average of 24 months. This is similar to the Phase 2 study conducted by Novartis, where the demonstrated in Pm{ treated with 4mg of zoledronic acid that all of them maintained a normal rateof turnover through at least the final visit at 18 months."
These instructions will likely be something your care providers have not heard. It will be a little extra effort to make on your behalf. You'll want to be sure that your prescription provider gets the information to whomever will be giving the IV so they can prepare to have you for the hour instead of the fifteen minutes.
Some individuals report reflux symptoms with the IV bisphosphonates. So take the extra care after eating not to exercise or bend over or lie down or wear constricting belts or pants.
I'm curious about how at 66, 12 years ago you decided to have a dxa.
Some people really do have intensely negative experience following the infusion, lasting for weeks. So don't let any jaded medical provider wave off these precautions as unnecessary.
Best wishes.