1. < Osteoporosis & Bone Health
Profile picture for newenglandtransplant

Evenity Results and Next Steps

Posted by newenglandtransplant @newenglandtransplant, Sep 2 9:23pm

After being diagnosed with post menopausal osteoporosis last year at the age of 52, I started Evenity last October. In addition to Evenity, I started the .05 estradiol patch plus progesterone, continued lifting weights, increased my walking, and supplemented calcium and vitamin d.

Just received my 12th set of Evenity injections today after meeting with my endocrinologist last week to review progress and next steps. I am very relieved to have gotten good gains.

Dexa results from August 2024 and August 2025 are:

Lumbar Spine: from -2.7 to -1.2 T score, BMD +20%
Left Total Hip: from -2.1 to -1.6 T score, BMD +9%
Right Total Hip: from -2 to -1.4 T score, BMD +11%

Next step will be reclast in October. My doc will monitor CTX annually to determine timing on future reclast infusions. The thinking is these will likely be some number of years apart rather than an annual infusion.

We also talked a bit about the longer term. The hope is that periodic reclast infusions will maintain my BMD well into the future, particularly for as long as I am able to continue with MHT. If/when I need another anabolic, we will try to time for two years past my last reclast infusion to reduce the blunting effect. Though Evenity is FDA approved for just 12 months, we will consider another round of Evenity if/when needed, particularly since we know I’ve had good response to Evenity.

Thank you so much to each person who continues to share their experience with me, either directly or through your posts. I’ve really needed the encouragement this group provides. I’m feeling a bit nervous about the reclast, and I’m appreciating the wealth of experience shared here.

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

Profile picture for dvargo
dvargo | @dvargo | Sep 4 4:59pm
In reply to @mayblin "@tillymack, CTX (C-terminal telopeptide) is a bone turnover marker that reflects how much bone is being..." + (show)
Profile picture for mayblin @mayblin

@tillymack, CTX (C-terminal telopeptide) is a bone turnover marker that reflects how much bone is being broken down (resorbed), so it indirectly measures how active osteoclasts are.

When you are on antiresorptives like Evista or Reclast, your CTX levels usually goes down. Because Reclast is a stronger antiresorptive than Evista, the drop in CTX is typically much greater with Reclast.

Measuring bone turnover markers isn't standard practice everywhere yet, but some endos do them to help guide treatment.

Jump to this post

My CTX was 85 then went down to 35 on HRT. Is that good? These doctors do not really explain.

REPLY
1 reply
Profile picture for mayblin
mayblin | @mayblin | Sep 5 8:58am
In reply to @dvargo "My CTX was 85 then went down to 35 on HRT. Is that good? These doctors..." + (show)
Profile picture for dvargo @dvargo

My CTX was 85 then went down to 35 on HRT. Is that good? These doctors do not really explain.

Jump to this post

Hi @dvargo, Your CTX change shows that HRT is definitely reducing bone breakdown, which is the goal. However, the current value looks quite low - below the lower end of the typical reference range for premenopausal women. It's good idea to double check the reference range and units on your lab report, and discuss with your doctor to make sure it's within a safe range, since long-term oversupprssion can affect normal bone remodeling.

REPLY
1 reply
Profile picture for dvargo
dvargo | @dvargo | Sep 5 9:42am
In reply to @mayblin "Hi @dvargo, Your CTX change shows that HRT is definitely reducing bone breakdown, which is the..." + (show)
Profile picture for mayblin @mayblin

Hi @dvargo, Your CTX change shows that HRT is definitely reducing bone breakdown, which is the goal. However, the current value looks quite low - below the lower end of the typical reference range for premenopausal women. It's good idea to double check the reference range and units on your lab report, and discuss with your doctor to make sure it's within a safe range, since long-term oversupprssion can affect normal bone remodeling.

Jump to this post

I am not on any pharma drugs for bone suppression. Just the HRT, so my doctor is probably not worried. HRT does not hold onto old bone like the drugs (osteoclast). I have it done every year because I ask for it. My doctor said it is really not needed because I am not on a drug. The whole thing is confusing to me when I receive the lap results from Quest.

REPLY
1 reply
Profile picture for mayblin
mayblin | @mayblin | Sep 5 3:11pm
In reply to @dvargo "I am not on any pharma drugs for bone suppression. Just the HRT, so my doctor..." + (show)
Profile picture for dvargo @dvargo

I am not on any pharma drugs for bone suppression. Just the HRT, so my doctor is probably not worried. HRT does not hold onto old bone like the drugs (osteoclast). I have it done every year because I ask for it. My doctor said it is really not needed because I am not on a drug. The whole thing is confusing to me when I receive the lap results from Quest.

Jump to this post

That's one nice thing about HRT.

Have you had your P1NP checked with CTX? If so, what's the result(s) while on HRT?

May I ask what dose and form of estrogen you are taking, and how long have you been on HRT? Thanks

REPLY
Profile picture for newenglandtransplant
newenglandtransplant | @newenglandtransplant | Sep 6 4:01pm

Thank you for sharing this paper, @mayblin I’ve read everything I’ve been able to find on evenity’s impact on bone micro architecture and strength, but I had not seen this before. It’s really quite interesting.

As far as what CTX level we’ll be shooting for between doses of reclast, I don’t know at this time. I expect we’ll have that conversation at my appointment next year, which will be a year out from my first dose. Yes, if my CTX stays low enough after the first reclast dose, we’ll hold off on further infusions.

With that said, MHT may not be a long term plan for me as I have risk factors for breast cancer. I’m considering switching over from estradiol / progesterone to Duavee as there is evidence (PROMISE study) that Duavee is protective in breast tissue, and my endo believes either Duavee or estradiol will be beneficial for bone health. I just feel so improved since starting the estradiol that I’m hesitant to shake things up.

If I remember correctly, you were taking either Tymlos of Forteo - did you choose to follow up solely with MHT, or have you also taken a bisphosphonate?

REPLY
1 reply
Profile picture for mayblin
mayblin | @mayblin | Sep 7 9:49am
In reply to @newenglandtransplant "Thank you for sharing this paper, @mayblin I’ve read everything I’ve been able to find on..." + (show)
Profile picture for newenglandtransplant @newenglandtransplant

Thank you for sharing this paper, @mayblin I’ve read everything I’ve been able to find on evenity’s impact on bone micro architecture and strength, but I had not seen this before. It’s really quite interesting.

As far as what CTX level we’ll be shooting for between doses of reclast, I don’t know at this time. I expect we’ll have that conversation at my appointment next year, which will be a year out from my first dose. Yes, if my CTX stays low enough after the first reclast dose, we’ll hold off on further infusions.

With that said, MHT may not be a long term plan for me as I have risk factors for breast cancer. I’m considering switching over from estradiol / progesterone to Duavee as there is evidence (PROMISE study) that Duavee is protective in breast tissue, and my endo believes either Duavee or estradiol will be beneficial for bone health. I just feel so improved since starting the estradiol that I’m hesitant to shake things up.

If I remember correctly, you were taking either Tymlos of Forteo - did you choose to follow up solely with MHT, or have you also taken a bisphosphonate?

Jump to this post

I didn’t realize MHT might not be a long-term plan for you. I was thinking if your CTX stays low enough, MHT alone could potentially work without Reclast. That said, Duavee does seem like a smart option if breast cancer risk exists, and its two components likely support bone health better than a SERM alone.

I did Forteo for about 22 months, then transitioned to MHT alone (TD estradiol + oral micronized progesterone), an approach I picked up from an endo familiar with it and reinforced by member @teb success. Like you, I plan to reuse an anabolic if my DXA trends back toward –3.0; right now my lowest T-score is –2.3 at the spine.

It’ll be interesting to see how things unfold for all of us - I’ve learned so much from everyone’s experiences and am really grateful for it.

REPLY
View MoreView Less
Please sign in or register to post a reply.