Evenity worked for me: Why I chose medication for osteoporosis
I just completed a year of Evenity and had my f/u Dexa. My first Dexa was in 2015 when I was in my 50s. My OB/GYN suggested it as I had broken a bone in my 40s. That Dexa showed osteopenia in my lumbar spine with a score of -2.4. At that point, I was adamant that I would not take any medication. I increased my calcium and kept up my running and weightlifting. I also decided that since I wasn’t going to take any meds, I wouldn’t bother with f/u Dexas. I started seeing a new NP who convinced me that I should see what my scores were in 2023. I was shocked to see that my lumbar spine was now-3.4. That was a real wake up call! Severe osteoporosis.
So I was still set on not taking medication, especially after reading a lot of the discussions on this site. I spent most of 2023 running more, lifting heavier, yoga, Algae Cal and Strontium (yes I know Strontium shows false strengthening). I hiked in NC that summer with a heavy backpack. But in the meantime, I read all of the books recommended, researched the medications, and made an apt with the osteoporosis center at our large teaching hospital. My plan was to see if I could improve my results naturally. I would pay for another Dexa out of pocket to see if anything changed.
In Oct I went to see the provider that runs a large osteoporosis clinic. I told her my plan. She was very honest with me. She said I would be wasting my time and money. She felt that my osteoporosis was genetic. I was already doing everything I could including bio identical hormones and my score was worse. She said to stop the Strontium which I did. She said that osteoporosis was a chronic condition. You can improve it with medication but once you stop, you will begin losing bone again and go back down. I would have to be on something for the rest of my life. I elected to start with Evenity. My labs were good and remained good. I had no side effects from the medication. I chose Evenity due to my Medicare coverage. I have Medicare A/B, plus a D plan and a gap plan. Tymlos and Forteo had large monthly deductibles. Evenity was covered at 100% because I went to an infusion center and it was covered under Part B and my gap plan. Also Evenity targets the lumbar spine and that was my biggest problem. Even though I had a lot of hesitation, I decided to trust my provider who follows a large patient population of osteoporosis. I was concerned about side effects but I pulled up the actual clinical trials and read them. The # of severe side effects were actually very low and were almost equal in the placebo and medication group. My provider confirmed that and said that my chances of a severe side effect would be very low but my risk of a fx was very high and that would change my life. She said that the serious side effects were not showing up in the general population of people taking the medication.
My latest Dexa showed improvement in my lumbar spine to -1.8 (from -3.4). I will switch to Prolia next month. I would encourage anyone hesitant to start medication to read as much as you can and discuss with your provider. I also chatted with the infusion center nurses and other patients that I met at the center about Evenity and Prolia to see what their experiences were. Everyone said the same thing, that most patients do very well. Occasionally, someone needs to change their medication but that was rare. Also, I’m pretty healthy. There are some patients with multiple comorbidities and they might have more issues.
Interested in more discussions like this? Go to the Osteoporosis & Bone Health Support Group.
Was there a reply to your question? If so, I missed it.
I think she meant that there are no *further* gains from Evenity after taking it for a year? Even the FDA says the effect wanes after 12 months.
However, this study followed people who took it for two years, followed by a biphosphonate, with good results.
https://pubmed.ncbi.nlm.nih.gov/29694685/
I also did very well on Evenity went from -4.6 to -3.3. I have now been on Prolia and after 1 year no significant change my T score is -3.2 Theses are in my spine.
Could I ask you what bhrt refers to? I'm interested in starting HRT after decades of evista then 4 years of Reclast. I have scoliosis with worsening curve.
Bioidentical hormone replacement therapy. In my case I have a estradiol/testosterone pellet inserted in my hip. It lasts 12 weeks. I also take progesterone and have an estradiol vaginal cream that I insert twice a week.
Thanks for your reply! I have asked and asked about hormone replacement therapy without success, even though I have no contraindications other than my age. Did you say you are 76? That's about my age! I'd welcome any tips for making this happen!
I tried with pcp, endocrinologist and a gyn. No luck even with no contraindications. Kept coming up against the age stuff. Finally went to functional medicine. My medicare and supplemental take care of the blood tests and office visit but doesnt cover the pellet.
Thanks so much for letting me know that a functional medicine doctor might be open to prescribing HRT!
The pellets can get pricey in the long term depending on one's budget. I also tried compounded testosterone cream and an estradiol patch. Went back to the pellet recently.
What is functional medicine?