← Return to Mild osteoporosis DEXA scores: what would you do?

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@teb

I agree with @ans that good integrative docs are hard to find and very expensive. Even the ones that are not great will charge you around $650 for the first appt. I've had many integrative docs over the years and most have had a similar approach. They put you through a battery of expensive blood, stool, mold, food sensitivity, heavy metal and toxin tests. I think some of these tests are valid but I'm not sure we all need all of them so if you do pursue this route, start small and targeted with your testing. The validity of food sensitivity tests have been called into question. A better and cheaper approach is to do an elimination diet of a single food of category like gluten or dairy for 4 days to a week and see how you feel. Then reintroduce for a couple of days and see how you feel. Almost all integrative docs will tell you to eliminate gluten if you have any type of inflammatory issue. Secondarily, they will advise you to eliminate dairy. In my case, after doing much research on my own, I eliminated those two things in my diet and my alopecia went into remission. So, it is helpful to figure out if any foods are causing malabsorption issues or inflammation.

Most integrative docs are not experts in osteoporosis so I think you're best bet is an appt with Dr McCormick. The fact that your bone density was stable after meds and then dropped might be a good thing to explore with him. He is knowledgeable enough to have a perspective on what tests to do to potentially determine a root cause, and recommend which medication might be best for you and at what point in time. And he's half the cost of an integrative doc.

My most recent appt with an integrative doc was with Felice Gersh who is an MD specializing in menopause, with extensive experience prescribing hormones. Since I've been on HRT for 5 years, I thought it would be a good idea to speak with someone knowledgeable to discuss dose and long term use. She charged $650 for the initial appt and $350 for the second appt (1/2 hour). I felt those two appts provided a valuable perspective and I agreed that a dose adjustment might be helpful. Of course, she tried to hook me in to becoming a regular patient with ongoing follow up as many of them do but I didn't feel it was necessary other than a check-in every few years perhaps. And commonly, she tried to sell me lots of supplements so I had to exercise discretion.

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Replies to "I agree with @ans that good integrative docs are hard to find and very expensive. Even..."

@teb thank you so much. I've seen a lot of posts recommending a McCormick consult but after reading yours I'm so much closer. I have his smaller book. I want to read more of it before deciding to call. I also think the idea of inflammation could be on target, as over the last year I've developed what my PCP thinks may be fibromyalgia (I'm not sure about it), and the muscle and joint discomfort is affecting my motivation to exercise.

I have dealt with food sensitivities for more than 40 years. There are legitimate tests for lactose intolerance and celiac disease, but your best bet on anything else is an elimination diet. Just because you have inflammation does not mean you have to stop eating gluten. I would read what Dr. Andrew Weil has to say. Some of the tests you mention are not credible.