DEXA scores: mild vs. severe

Posted by prettyflower @prettyflower, Nov 26, 2023

My primary doctor started me on Fosamax when my DEXA showed -2.5 in the spine. After four years the DEXA was -2.7. A specialist then said to move on to Prolia, which I have delayed a bit. Is my DEXA "severe" enough to warrant that jump? What other meds would some of you suggest at this level? I am 59 and have never had a fracture, that I know of. Thank you.

Interested in more discussions like this? Go to the Osteoporosis & Bone Health Support Group.

@wakefield

Medicine is one way to go, but read what Dr. Keith McCormick has to say about diet and your bones. Acid reflex could be your body having a hard time with the calcium your taking.
My scan was -3.1, in the spine and my Dr. wanted me to start meds, I'm a 65 year old woman. I power walk 2-3 miles, three times a week, I started jumping lightly 10 times a day landing on my heals (2x's a day;) started taking zen basil seeds, I eat mostly a veg/vegan diet, I don't smoke and occasionally have a drink. One year after doing the above I had another scan and my number dropped to -2.8, I am going to continue with my bone plan and add a gym membership for lifting weights with a trainer to get started on the right foot. I'm treating my bone density not as a disease, but as a product of getting older and working to slow it down as much as possible.
Before going on meds. read up about the med. your Dr. wants to put you on.

Jump to this post

Thank you for mentioning zen basil seeds. I’ve never heard of them but they sound like a good addition to my diet too & can stop the magnesium supplements.

REPLY
@wakefield

Medicine is one way to go, but read what Dr. Keith McCormick has to say about diet and your bones. Acid reflex could be your body having a hard time with the calcium your taking.
My scan was -3.1, in the spine and my Dr. wanted me to start meds, I'm a 65 year old woman. I power walk 2-3 miles, three times a week, I started jumping lightly 10 times a day landing on my heals (2x's a day;) started taking zen basil seeds, I eat mostly a veg/vegan diet, I don't smoke and occasionally have a drink. One year after doing the above I had another scan and my number dropped to -2.8, I am going to continue with my bone plan and add a gym membership for lifting weights with a trainer to get started on the right foot. I'm treating my bone density not as a disease, but as a product of getting older and working to slow it down as much as possible.
Before going on meds. read up about the med. your Dr. wants to put you on.

Jump to this post

Thank you so much. I will take your advice. I try to walk everyday. They want me take an infusion once a year called Reclast. I have been resisting for a few years. I think I will try your plan.

REPLY
@proliamistake

the side effects happened after the first shot but some people have hd several shots before having reactions so there is really no way to know. i just think hat the prolia shot is dangerous and even though people have taken it for awhile with no problems the one that had problems were severe i a so sorry i ever got that shot it changed my life forever are the side effects gone maybe maybe not i probably will never know and no dr will ever say anything

Jump to this post


I agree with you. I thought the drug would be taken off the market, instead the FDA approved a generic.
The basic flaw is in the way the drug works.
Even now with the information about the hazard, the drug is being prescribed without awareness of the danger of missing or being late for a dose.
Without warnings from good-hearted people like you, proliamistake, many more women would be afflicted by the cascade of vertebral fractures Prolia can cause.
Now Amgen is providing us with another clinical trial hailed drug--Evenity. It will take a while before we understand if the risk of heartattack and stroke are realized in the female population.
https://www.aboutlawsuits.com/prolia/

REPLY
@gbrodnan1945

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.

Jump to this post

I would encourage you to read up on patient reviews of reclast. Your DEXA results are really not that bad, and
recast scared me when I read all the negative comments.
After I completed Evenity I researched Prolia and Recast, and decided to discontinue any treatment. My DEXA was -3.2 went to -3.0 in right femur, -2.9 went to
negative 2.8 in my left femur and spine went from -2.1 to -1.5 in my spine. I was disappointed in the results in my hips, where I actually have osteoporosis, but got the best results. in my spine, where I did not. I didn't feel like I got a good enough improvement in my hips to warrant continued medications, which all have awful side effects.

REPLY

susanjane77, I've asked the doctor for consent. I hope you are wrong about being laughed at and know they wouldn't kick you out. But I also know they might not be prepared to comply with this method. It is best to have the doctor request the extra effort. The method will make sense to anyone familiar with the drug.

REPLY
@rn40

I would encourage you to read up on patient reviews of reclast. Your DEXA results are really not that bad, and
recast scared me when I read all the negative comments.
After I completed Evenity I researched Prolia and Recast, and decided to discontinue any treatment. My DEXA was -3.2 went to -3.0 in right femur, -2.9 went to
negative 2.8 in my left femur and spine went from -2.1 to -1.5 in my spine. I was disappointed in the results in my hips, where I actually have osteoporosis, but got the best results. in my spine, where I did not. I didn't feel like I got a good enough improvement in my hips to warrant continued medications, which all have awful side effects.

Jump to this post

Thank you for your reply. I just can’t seem to make the decision to take Reclast. The dexa scores have been stable since 2010 in fact that year the femoral head was -2.3. Two years ago -2.6.

REPLY

I was struggling to make a decision until I read the patient comments about
Recast, then the decision was easy. I guess each of us must way the risks/rewards of any medications

REPLY
@gently

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.

Jump to this post

susanjane asked for more information about this recommendation about administering Reclast. I agree, it would be good to have more specifics about this provider, his rationale and any publications related to this acute side effect.
I also wonder if this provider also has a protocol for treating 'intractable pain' that has been documented by Novaris and the government (FDA I think) as a rare side effect.

REPLY
@wakefield

Medicine is one way to go, but read what Dr. Keith McCormick has to say about diet and your bones. Acid reflex could be your body having a hard time with the calcium your taking.
My scan was -3.1, in the spine and my Dr. wanted me to start meds, I'm a 65 year old woman. I power walk 2-3 miles, three times a week, I started jumping lightly 10 times a day landing on my heals (2x's a day;) started taking zen basil seeds, I eat mostly a veg/vegan diet, I don't smoke and occasionally have a drink. One year after doing the above I had another scan and my number dropped to -2.8, I am going to continue with my bone plan and add a gym membership for lifting weights with a trainer to get started on the right foot. I'm treating my bone density not as a disease, but as a product of getting older and working to slow it down as much as possible.
Before going on meds. read up about the med. your Dr. wants to put you on.

Jump to this post

i think you are doing the right thing

REPLY
@wakefield

Medicine is one way to go, but read what Dr. Keith McCormick has to say about diet and your bones. Acid reflex could be your body having a hard time with the calcium your taking.
My scan was -3.1, in the spine and my Dr. wanted me to start meds, I'm a 65 year old woman. I power walk 2-3 miles, three times a week, I started jumping lightly 10 times a day landing on my heals (2x's a day;) started taking zen basil seeds, I eat mostly a veg/vegan diet, I don't smoke and occasionally have a drink. One year after doing the above I had another scan and my number dropped to -2.8, I am going to continue with my bone plan and add a gym membership for lifting weights with a trainer to get started on the right foot. I'm treating my bone density not as a disease, but as a product of getting older and working to slow it down as much as possible.
Before going on meds. read up about the med. your Dr. wants to put you on.

Jump to this post

Congratulations on your progress!
One question - do you jump up and down on the floor from a standing position or are you jumping off something? I have a similar spinal score.

REPLY
Please sign in or register to post a reply.