62 yo diagnosed with lumbar spine osteoporosis

I would not choose Reclast as my first option for medication. If you want to build bone density, you need Evenity, Tymlos, or Forteo.

I didn't have a fracture until... well, until I had a fracture. Until that point, I felt fine. Don't go by your history.

Unless the natural approach includes lots of specific weight training, it probably won't help, and your T-score will likely be worse in a year's time. Tymlos and Forteo are probably the meds that are least likely to provoke a reaction, but unfortunately nobody knows until they try. Also, they require daily self-injections for 18-24 months.

@njx58 thank you for your insight. I appreciate any advice to consider best approach for me. Have a good night.

@marley169 It's such a personal decision. If I had those scores, I would try the natural approach for a year --- but that's me!

If you fracture, you'll be upset you didn't take meds. There are so many conflicting opinions that I find it hard to know who to trust.

@marley169 , I’m also 62 and was diagnosed with osteoporosis about 15 years ago. At the time, they put me on bisphosphenates, a decision I now regret, or at least I regret having gone on them without doing a lot of my own research first. So it’s great that you are asking questions and considering options before making a choice.

Everyone is different. And so is everyone’s health profile. What I would do today if I faced your set of DXA numbers is to first find a doc who is collaborative and open to working through the pros and cons of different approaches with me. Then I’d start with diet (adequate calcium, vitamin D, vitamin K2 and magnesium as much through diet a possible) and exercise ( supervised strength training along the lines of the LIFTMOR study), and I’d look into whether menopausal hormone replacement therapy would be a good fit. (I’m on that now and wish I’d started years ago as my first step.)

I’d try that for a year or two and see what happens before starting meds. If I were still losing bone, then I’d consider meds.

These decisions are best made working with a doc who you trust based on your own specific profile.

There usually isn’t a huge rush to making a decision, so do your research. Lots of good info in this forum. Another good place for info is OsteoBoston’s website. They gather some really good speakers. Dr Keith McCormick’s book Great Bones is a great resource for detailed understanding of osteoporosis.

Good luck and wishing you the best!

@wondering1

My story is so similar. If only we'd known sooner!

There is so much free information out on YouTube. I know there is a lot of misinformation there too, but you will be able to spot the legitimate ones, I think. Just don’t look for miracle cures…there aren’t any. I would research before starting a drug to know if it is your first line of action, and is another one required after a time that you might not ever want to take. I would get the whole story up front, then make the decision on what suits you.
Also, wondering if you are small boned. I understand that that can make your numbers worse.
Are you taking any other meds that can lead to bone loss, i.e. prednisone or synthroid or have hyperthyroidism. Any of these may contribute to further bone loss.
Good luck in you decision,

Reclast is a bisphosphonate medication. After reading about the severe side effects some people have experienced with it, if I were going to take a bisphosphonate, I would take an oral form first and see how I reacted to it. But, in the long rung, studies show that bisphosphonates don't offer much benefit in preventing fractures. They retain old bone and slow growth of new bone, so maybe the BMD you are gaining is not strong? Here are a couple of articles on bisphosphonates that might be of interest to you.
https://www.amjmed.com/article/S0002-9343(24)00101-3/fulltext
https://www.consumerreports.org/cro/2012/04/popular-osteoporosis-drugs-come-with-mounting-concerns/index.htm
Bones change very slowly, so take time to research so you are comfortable with your decision. In the meantime, check out Brick House Bones in Facebook by Dr Lisa Moore, a PT specializing in osteoporosis. She has free exercise videos and information, although drugs are not discussed. The Better Bones website also has great information. Here is one of their articles: https://betterbones.com/bone-drugs/anabolic-treatment/

I am 63 years old. Was diagnosed with osteoporosis in the severe category a year ago. I had my first dexa scan due to hip pain and started bioidentical hormone therapy at that time. I then did walking, some weight-bearing exercise, resistance training and started eating much better, increasing my protein and calcium through food along with supplements of vitamin D3, calcium and a multivitamin with lower amounts of vitamin A. Apparently vitamin A inhibits the absorption of calcium. My nurse practitioner/"bone specialist" recommended tymlos due to how bad my low back is. I was a -5.4 t score in the lumbar spine. I did not start the tymlos but after a year of the hormone therapy and exercise and vitamins, and pushing for another Dexa, I actually had a 17% increase in bone density in that time frame. Which was more than what the average tymlos increase is in a year's time. My nurse practitioner was shocked and didn't even really know what to say other than if he had taken a bet on me he would have lost. I'm still considering doing the tymlos but I'm waiting another 3 months to decide what I want to do because I had such a good increase with the bioidentical hormone therapy and exercise and eating right. My hormone specialist doesn't want me to do the Tymlos. I'm still very bad in the lumbar spine (-4.3) but my hips have almost come back into the osteopenia stage so I feel much better about not doing the tymlos at this time. I just feel like they push meds on you rather than a natural type of healing with your body.

If I had it to do over again, I would have home for the Tymlos way sooner. I stubbornly refused any medication for the first 10 years. Then reluctantly took risedronate for 5 years. Then Tymlos when the risedronate ran out and I was at -3.6 lumbar spine. I was not offered HRT of any kind.

@susyt

Hi,
Can I ask your age? If you've been on mayo connect for awhile you've probably noticed that many women are not offered hormone replacement. Like many I was not successful getting them from any of my docs until I decided on using a functional medicine provider. I started at 77. I went through early nonsurgical menopause at 38.
So glad you are taking bone meds now and if you still want hrt then it is out there depending on your medical history.
Just to be clear, my primary motivation was getting my long list libido back not bone health. But I also knew that the bhrt would be helpful for my bones. Good luck.