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66 and DXA shows Osteoporosis w/High Fracture Risk
Two years ago osteopenia. Last week DXA Osteoporosis with High Fracture Risk. No HRT since 1995 when I had a total hysterectomy. Premarin for about 9 months then quit because of the risks of heart attack. Fast forward, been taking Fosamax and Vit-D for about a year. DXA 1/2024 showed osteopenia. Now Osteoporosis w/High Fracture Risk. Primary wanted to start me on Evenity, but because of the black label box warnings I am too scared to take it. I do have a history of abnormal EKG’s and heart palpitations for which my cardiologist has me on Metoprolol twice a day. I asked for a referral for PT with Phoenix as they have therapists that specialize with osteoporosis, balance etc. My doctor sent the referral today. I’m so confused as to what to take. They all have side effects, Prolia is for life and Reclast can cause severe kidney problems. I’m going to try and find an endocrinologist that treats osteoporosis. Any suggestions or recommendations?
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Starting medications for osteoporosis is a tough choice, due to side effects of all the medications. At some point, you just have to "pick your poison." My rheumatologist has been on me for years to "do something" but I was fearful of the side effects: osteonecrosis of the jaw, heart attacks, strokes, osteosarcoma, etc. My doctor finally scared me into taking medication. He told me that I would never recover from a broken hip and that it could actually kill me. I just finished two years of Forteo and my spine improved dramatically. I am getting ready to have surgery for a slipped disc and stenosis. I would be unable to have the TOPS surgery without the improvement in my spine. My hips are still needing improvement so I am now on Evenity for a year. The important thing to remember is once you start these drugs, you have to continue with a maintenance drug, like Reclast or Prolia, or your bones will rebound and become as bad or worse than when you started. Good luck with whatever you choose. I am glad I finally made the choice to improve my bones.
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1 ReactionRe: discussion about getting a DEXA scan yearly other than every other year, as my doctor says (and Medicare for screening purposes). I got the information from my Medicare program that I can certainly get a yearly DEXA; as it is a medical necessity; monitors pharma treatment. The doc just has to code it correctly. He gave me a referral for private pay as he doesn't believe a DEXA is appropriate through my insurance at this time. He said CTX score shows medication is working (went from 52 after a year of Fosamax; currently at 78 after a year of Reclast, no P1NP). Don't know what those numbers mean. Therefor he doesn't feel a DEXA is necessary and he said it would not change my treatment anyway. So at my appointment in early August, I will once again ask for a DEXA; if the answer still no I will begin the uphill battle of finding another doctor. If as I was told the Reclast infusion is the best fastest way to improve BMD numbers in my case, then I need to see those numbers. If Reclast isn't working as well as expected wouldn't there be at least a discussion of another drug/class of drug?