Finding Experts to Help?

Perhaps a functional medicine practice. I have found the best guidance with a whole person approach. They were the ones who helped me start bhrt at 78.

This is an overwhelming diagnosis and even the experts have wildly varying opinions on how to address OP. You'll find a lot of good information and support here. though.

I will share what I did anyway. I think we have all forged our own paths with MDs and/or functional medicine providers:

I was diagnosed in 2023 with OP. The worst score was my hip at a -3.5 with a subsequent DXA 2 years later which reported a -2.5. The MD thinks the -3.5 was an incorrect reading b/c it was kind of an outlier from the other scores.

I found an endocrinologist who scared the hell out of me so I started shopping.
I found another who wanted to prescribe Prolia right out of the gate so I left.
II found another really good MD who subsequently retired.
Finally, I did a google search for various endocrinologists in my area and got on waiting lists (sheesh). I finally landed with a good MD and I feel like we are a good team. She is always prepared, listens to me and is willing to let me experiment a little. So far, I have avoided medication, but my TBS was not great so we'll see. I don't want to take meds, but I don't want to fracture even more than that.

I am 70 years old and started HRT and progesterone on June 1st (so far, so good - sleeping like a baby). I started to eat a lot more protein, take K2, MK7 and D3 supplements and I get my calcium from food. I am in an Onero weight lifting class 2x a week. Here's a link to maneuver to see if there is anything near you: https://onero.academy/locations/

I also watched a lot of webinars, most of which are available on youtube.

Margie Bissinger: https://www.youtube.com/@margiebissinger6980
Osteoboston: https://www.youtube.com/@osteoboston
International Osteoporosis Foundation IOF: https://www.youtube.com/user/iofbonehealth
Lisa Moore, DPT for exercise: https://www.youtube.com/watch
Irma Jennings - recipes: https://www.youtube.com/channel/UC7EIG9je_itwaNq-t1y6M5g

Maybe you'll be fortunate enough to find an all in one provider, but I had to piece it together and it took me 2.5 years to feel somewhat settled.

I wish you all the best.

Are you close to Mayo Clinic in Rochester? If so, it might be best to get a second opinion from a bone specialist there, as the initial treatment choice is highly consequential. Many specialists now favor an 'anabolic-first' strategy. One piece of good news is that the lumbar bone mineral density (BMD) is generally the most responsive to therapeutic intervention with bone-building (anabolic) agents.

Because your diagnostic scores meet the threshold for osteoporosis, an endocrinologist likely won't rely on HRT as your sole therapeutic option. Many members here have used an OB/GYN, or a functional medicine practitioner, or specialized telehealth clinics like Midi to get their HRT prescribed. No matter how or where we get our HRT prescribed, it is prudent to get a thorough risk assessment regarding cardiovascular disease and breast cancer beforehand.

babs10 has shared many great links above. It will take some time to put all these pieces together to tailor them to your personal needs, but it is well worth it. Good luck!

@babs10 I cheered aloud when I read in your post, “I am 70 and started HRT and progesterone”. It is my hope to be saying the same in a month if I can find a doc that will listen and prescribe. I saw that you belong to OsteoBoston as do I. Any chance you’re in the greater Boston area? I’d like to start a coffee meet up and perhaps you are interested.
Thanks
Ann

@sassysaveur

I used a functional medicine provider for bhrt at 77.

Hello, I have been successful bringing my scores up with natural supplements, HRT, and weightlifting. I started the HRT at 64 after getting a good evaluation from a functional medicine group. My regular MD did not want to start HRT due to my age as well. My numbers were similar to yours. I had a T spine of -3.4 now -2.5 After 1 year. Everyone has a different situation so I encourage you to fully educate yourself on all possible options before starting medication. It still might be the better choice for you but it was not for me. Best of luck!

I am 71. I was dx with osteoporosis when I was 69. My DEXA scores were -2.6 right femoral neck, -2.4 left FN, -2.5 lumbar. PCP wanted to start fosamax. I said I wanted to wait. I researched and found myself also overwhelmed with all the information. I found Dr lisa Moore on Facebook, her group is Brick house bones. She offers free exercise programs on youtube and paid programs. She also has a program to purchase that helps work you way through the information. I also started HRT but finding a Dr in the menopause society. I walk 3.5 miles 4 days a week and weight, impact and balance training at the gym 3 days a week. I also track my calcium protein, magnesium, etc from food. My DEXA in May 2026 show my lowest score is now -2.1. so I am officially now osteopenia. Start slowly do what feels ok for your body.

Thank you everyone for the info, links, and personal stories. They are most helpful. I'm starting to distill out the key points and you have helped emmensely. I'll tackle the supplements and nutrition first and adjust my exercise routine while I search for the right medical provider to test for and discuss HRT options. I'm cautiously optimistic that starting HRT might also help with a number of other symptoms that I previously chalked up to getting old or being too late -- now that I'm digging into all the menopause info that's changed since the WHI, I may still have a fighting chance to get rid of my brain fog while fixing my bones. And the fosamax can just sit on my shelf while I think this all through.

@babs10
This is great. Thanks so much for sharing all of this with us.

@smc25, @maryandnans
Wonderful gains!!

If you are open to sharing, what dose and form of estrogen are you using? Also, do you monitor bone turnover markers? If so, how has your CTX changed over time? Thanks!