Finishing Evenity, now what?

Had blood work and 24 urine test done. Blood work was all normal, but urine calcium was slightly elevated 306. Dr office just called to say the Dr wanted my ok to contact infusion center for my first Evenity shot. I asked what Dr typically recommends afterwards. They said Reclast or Prolia. Told them I understand you need to “lock in the gains” but do you ever get to stop the Prolia? How do you take it for a year or two then stop. I said then you have to take something else correct? She said it all depends on your scans and bloodwork. At Dr visit she said she doesn’t recommend Prolia but how do they then recommend it for locking in gains? It’s all confusing and I just started crying again on the phone. She said she’d talk to Dr about my concerns and call me back. I was diagnosed in February and just this last week I was starting to get my head wrapped around all of it. Then they called and reality just set in.

@rudysmom - I reluctantly agreed to take Evenity - no fractures/severe OP - and am almost finished. The dr will order bone turnover markers following Evenity, but I'd like to order them again a few months out from the end of the Evenity course to see what impact HRT and nutrition and high-impact exercises will have had when some of the Evenity effects have lessened. The exercise class is for OP given at a medical facility.

I've been intrigued by the Japanese recommended treatment for OP: Vit K2-MK-4 and am considering that to follow Evenity for a few months. After that I will pay for a REMS scan to see if bone density gains have been maintained. My dr is ordering a DEXA scan at the end of the Evenity course, so I will have a recent comparison in order to make a future decision.

@singingbones
I’ve gone to 2 Endo’s for opinions. First one was useless, this one I really like. I asked both of them about K2-MK4 MK7 and both of them didn’t recommend it. First Dr said it was a waste of money and that Japan was only country to use it. He then said if I had money to waste I could donate to his website for research! Umm, hard pass. The other Dr said no to it too. I can’t remember her reasoning. Quite a few people on this forum use it and claim it helps. I’m just so overwhelmed right now I can’t even think about it. I need to look into it more. So many conflicting sources saying how much to take and when. Right now I’m tracking everything I eat and exercising everyday. All the while trying to tell myself I’ve got this. I always thought I was a strong person, but this has pulled the rug out from underneath me.

I'm sure you already know the things you can do alongside medication: balanced diet, calcium, vitamin D, weight-bearing exercise. Regarding the latter, you would be best off with a bone-health educated strength trainer (check out BHOF BoneFit registry). There are remote providers too, but make sure the program is based on progressive loading regimen (=increasingly more demanding workouts) to keep the osteogenesis going.

@rudysmom
Feeling overwhelmed after first learning about an osteoporosis is quite understandable and common. Probably best to take the time to understand what is going on unless your treating doctor tells you your situation needs urgent attention. This is a cite to a very useful guide in plain English to understanding the whole osteoporosis universe. https://my.bone-guide.workers.dev/

We know nothing about you....age, DEXA score, fracture history, other medical issues and medication to be able to discuss the Evenity recommendation. But many people have posted here that they are referred for a cardiology assessment before beginning Evenity.

@rjd
I was just diagnosed is February. I’m 61 my Spine score is -2.7 and hips are -2.0. I’ve never fractured and I don’t take any medications. The 1st Endo I seen said that’s probably my problem why I’m so stressed because I don’t take anything. Maybe he’s right. In fall of 2023 I was diagnosed with osteopenia and I tried Fosomax. After pill 2 I was having severe pain in my lower right back. I thought it was my sciatic nerve. Took me to pill 3 or 4 before I realized what was causing it. I couldn’t even roll over in bed. So Dr had me stop and just told me to increase my calcium. Dr ran some blood tests and 24 hour urine calcium test. Results for urine test was slightly elevated 306 and 300 is the max. Dr office called yesterday about setting up Evenity. I had asked about Evista but she didn’t seem to keen on it. I’m assuming because my scores aren’t that severe maybe she’s thinking Evenity will put my back in osteopenia? I’m hoping she calls me back today. I asked the person who called me with results about HRT and she said Dr doesn’t prescribe that. I don’t know. It’s all so confusing. 🫤

@rudysmom My T-scores are about like yours. I am trying LIFTMOR type exercise, plus HRT as my primary response. ONERO is one program that uses it.

If I had bad enough T-scores then I would take the meds, but I am trying the proven heavy-for-you weight lifting therapy first. It is easy to find the scientific papers which you can print out and take to your doctor.

This delightful presentation & interview done by OsteoBoston with the primary researcher in LIFTMOR explains more.
"ONERO Builds Bone without Medication-How's and Why's" with Professor Belinda Beck

@kfhoz
Thanks I’ll research that this weekend. I have a telehealth appointment Monday with my Dr. so I can talk about all my concerns.

@rudysmom Got the same response from my rheumatologist and her PA. I still think its a good idea to take the K2...MK4 and 7. I don't see why a study in Japan would not be reliable. What is wrong with Japanese research? Why aren't we in the US researching it?...or are we?

@wizdum
I did read that the US is studying it but the studies are showing conflicting results. Figure it’s just one more tool in our toolbox. I asked both Dr’s about prunes and neither were on board with them. But the Dr I’m seeing did say they’re definitely not going to be bad for me. So I worked myself up to 6 a day. I’m just getting into that routine. Once I make that a habit then I’ll start the K2. Just need to read more on it to figure out how much and when to take it. Also want to look into collagen. There’s a lot of mixed opinions on that too. Again, one thing at a time.