Am I the only one that’s in denial?

I wanted to be in denial, but PC, endocrinologist, and orthopedic all said absolutely not when I asked about delaying meds. (-3.9 spine) I am hoping I can choose no meds after two years on Tymlos, or a new vaccine or meds come out by then. I am showing gains on Tymlos. I have side effects, but they are bearable. I do take a reduced dose. Was 4 clicks, but now 5, going to start 6 soon. Full dose is eight clicks. Before starting meds, I did weight lifting for a month and there was no improvement in P1NP or CTX. (I am not stopping weight lifting and hope that I will be able stop all meds in two years.) After three months on 4 clicks of Tymlos, I saw 90% improvement on P1NP. While a hip fracture would be unpleasant, a spine fracture and possible spinal cord injury terrifies me, so I took the meds. Do not take bisophates as the first drug. There is an order to take. https://www.youtube.com/watch Avoid Prolia. This woman reversed hers, but my doctor will not agree to HRT. https://www.youtube.com/watch

Treadmill is not very effective, but going as fast as possible for thirty minutes is great cardio. https://www.youtube.com/watch

If you are really lucky, you won't fall and break a hip.

If you are less lucky, you'll break a hip and get a hip replacement. It's not a fun process.

If you are old enough and unlucky enough, you'll fracture a spine and be crippled. Or, you'll break a hip and die in a nursing home. That happens all the time. A broken hip for an elderly person is usually a death sentence.

Don't stick your head in the sand. -3.8 is a really bad score. Don't be scared of all the talk of side effects. Here's what I am doing. I took Tymlos for two years and made great gains. I don't even have osteoporosis anymore. I'm now taking Fosamax. The plan is to take it for a while (as yet undetermined), then take a "drug holiday." Then, we'll play it by ear. BYW, I agree that meds like Prolia and Reclast can be daunting. I'm much more comfortable with the path I've chosen.

P.S. Although it is helpful, all those things you are doing aren't going to make a big dent in a -3.8 score, not by a long shot. Calcium + vitamins + walking will not make a big difference, I promise you.

indenial, I was so eager to start teriparatide for osteoporosis. I was so much more afraid of the fractures.
But I know how you feel. With athersclerosis, I should be more afraid of myocardial infarction than the medications. I've reluctantly, taken statin a PCSK9 inhibitor with intolerable side effects.
It is basic wisdom to be afraid of these medications that no one calculates all the side effects of.
Luckily, I've had no side effects with teriparatide.
You are actually at the perfect age to start an osteoporosis medication. In the first ten years after menopause we lose the most bone, due to loss of estrogen. We have to do all the exercise, supplements with close attention to the problems exercise can cause when your bones are weak. Preserving bone is easier than recovering it.
For each of these medications there are patients without side effects.
I enthusiastically can recommend Forteo. Some cannot tolerate the drug. But with Forteo or Tymlos you can stop at any time without negatively affecting your body. The period of time for side effect is usually four hours.
If it's unbearable you just stop taking it.
When you finish the two year course, it's best to follow with another medication or with HRT, but these two drugs leave you with stronger bones. Dexa returns to baseline within a year or two, but some fracture protection can be seen for seven years following.
I so like Forteo that I'm on extended use, extended use for my lifetime the endocrinologist says.
It is a very personal decision and I wish you the best luck.

Have you thought about HRT?

I would not say I am in denial. My lowest score was -2.6 two years ago. So I looked at my diet, added weight, balance and impact training. My lowest score now is - 2.1. I also started HRT. I know this is what helped. Will it continue to improve, hopefully yes, but I have to continue this routine.

I was in denial, then my worst area, L-4 got to a -4.1. That scared me. I tried no drugs, and about 15 hours a week of exercise (heavy weightlifting and pickleball), and added protein to my diet and the supplements I already take. I improved that to a -3.3 in 13 months, but my femoral neck wasn't changing, so my Dr said I had to start something. I refused the Fosamax type drugs (thank goodness) and started Tymlos 11 months ago.

Three things I think you should consider to help make your decision. First, you do not have osteoporosis in just one area. You have it everywhere! So your hips might be bad, but so are your wrists, ankles, ribs, etc. Heaven forbid, you break a bone, many times surgery can't be done until your bone density improves, so then they will put you on the drug that you don't want to take, and because of your broken bone, you won't be able to exercise to get the full benefit of the drug, then you'll be on it longer, have worse results from the surgery, and it can be a vicious downward spiral...
Second, for every person who comments about a bad reaction here, I'd guess there are probably 90 women taking the drug with no side effects. So don't be so scared. Like others have said, you can titrate your dose and start out slowly on Tymlos and I think Forteo too, to lessen any side effects. I'm only on 5 clicks after 11 months, but still getting great results, and I do a Dexa every 6 months.

Third, if you are 62, you probably have private medical insurance. I've heard that women on Medicare have to fight harder to get a bone builder drug approved. My Tymlos is free because the company gives a coupon to those with private insurance, so no copay.

I wish, wish, wish I could go backward in time and tell myself to start Tymlos earlier. (sigh) Watch the video about drug proper drug sequencing (you need a bone builder like Tymlos or Forteo first- do not start with bisphosphonates). Do your research and choose a drug and start it, do the exercises and supplements. Your future self will thank you....

@indenial I am 65 and just diagnosed with osteoporosis. My L4 is also -4, left hip -3.6. I am absolutely with you on concerns with these medications. Your post yielded very helpful responses. I am so grateful for Mayo Connect! I have to agree with others that no medication with these scores is riskier than the side effects. I am doing my research and taking my time to find the treatment that I think best fits my circumstances. Then when I sit down with my doctor again I will be better informed and we can hopefully agree on a treatment plan. It's definitely not an easy decision! Please take your time and continue to research and read others experiences. I wish you the best.

I am in denial as well. Was diagnosed with osteoporosis in spine years ago and osteoponea in hip. My last Dexa scan was 2015 and I was only offered foxamax. I refused to take it so no more Dexa scans. I went the route of strength training and diet and supplements. I have been very active since that time with no problems, but just had a T9 fracture a few months ago and apparently had other spinal fractures that I was not aware of. I am recovering and getting back to walking and PT. I am scheduled for a Dexa scan and Endocrinologist appt. next month. I'm sure it will look bad and they will want to put me on Evenity. I think my biggest mistake was not taking HRT because of all the scares at that time. I am 79, so probably don't have a lot of options so not sure what Dr. will prescribe but I don't want to spend the years I have left have miserable side effects. I also don't want a fractured hip so not sure what to do.
So glad I found this forum to share with others having the same issues.

The only thing that has really stopped me from starting treatment is the rebound, after gains are lost within a few years. Have also read many reports about bones being even more brittle and more prone to fractures after gains are lost. These are the things that keep me up at night. That, and my T12 compression fracture from 10 months ago that isn’t healing properly because of my osteoporosis, of course.

@summera1
I hear ya. I can’t do HRT either. Missed the boat on that one, now they say it’s too dangerous because of blood clots. I really wish my doctor had talked to me about the importance of HRT. Not one conversation about it. probably wouldn’t be in the shape. I’m in now, had I been educated regarding bone health and HRT. I’m assuming your Dr will have you pick a second medication after Tymlos, to lock in your gains. Mine was going to be Tymlos, followed by Reclast.