Has this happened to you? BMD declines with both Prolia and Evenity

I don't recall where I read regardless of whether or not the medication caused hyperactivity, it adversely affected bone density. When I researched osteoporosis, whatever I read motivated me to make an appointment with an endocrinologist to supervise me while discontinuing it. A GP said just to stop taking it. (Hmm.)

In my experience, I've found it helpful to seek medical opinions from a few specialists when it is for something important. This has made a huge difference for me, and I once decided against surgery because of a third doctor's diagnosis.

I quickly searched on Google Scholar and found these:

"In postmenopausal women TSH suppressive therapy is associated with a decrease of bone mineral density, deterioration of bone architecture (quantitative CT, QCT; trabecular bone score, TBS), and, possibly, an increased risk of fractures." (Not in premenopausal women. My prescriptions suppressed my thyroid activity.)
https://ec.bioscientifica.com/view/journals/ec/9/7/EC-20-0167.xml
Old paper:
https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/620592
"Conclusions The lack of association between fracture and levothyroxine prescription in the whole cohort is reassuring, although an independent association between levothyroxine prescription and fracture occurrence in male patients suggests that levothyroxine may contribute to fracture risk in this specific group."
https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/211045
https://www.thyroid.org/warning-too-much-thyroid-hormone-increases-bone-fractures-in-the-elderly/
"Main outcome measure Primary outcome was fracture (wrist or forearm, shoulder or upper arm, thoracic spine, lumbar spine and pelvis, hip or femur, or lower leg or ankle) in relation to levothyroxine use (current, recent past, remote). Risk among current users was compared between those prescribed high, medium, and low cumulative levothyroxine doses in the year before fracture."
https://pmc.ncbi.nlm.nih.gov/articles/PMC3084377/
Another viewpoint:
https://www.ncbi.nlm.nih.gov/books/NBK585648/
"Of 798 770 subjects fulfilling the inclusion criteria, 11.7% took thyroxine regularly and belong to the exposure group. The final cox regression showed that subjects taking thyroxine have a 6.3% higher risk (HR 1.063; CI 1.046–1.080, p = < .0001) than members of the control group."
https://www.sciencedirect.com/science/article/abs/pii/S8756328216300564
Happy reading and I hope you find the answers you're seeking!

Here is a review article regarding the influence of thyroid pathology (hyper or hypo) on osteoporosis and fracture risk:
https://pmc.ncbi.nlm.nih.gov/articles/PMC7151086/
In hypothyroidism, over treatment with levothyroxine is the main negative factor for bone health as this paper suggests.

Thanks @mayblin for this very interesting article. I don't know if I'm being over treated. It's something to discuss with my endocrinologist.

I have been taking thyroid meds my entire adult life. Currently my TSH is 2.5 and I feel tired, no stamina most of the time (i have hashimoto's thyroiditis). Would like to decrease meds because of osteoporosis, but don't want to feel even more tired. My endo says my TSH should be between a 4 and a 6 (even though 6 is considered hypo) because of my age (73) and having osteoporosis. I have resisted decreasing the thyroid meds. I have always read that the thyroid meds don't affect your bones unless you are taking too much and it is making you hyper thyroid.
Aren't you afraid to decrease meds and then have hypo symptoms?

Yes, I'm afraid too, because I'm tired all the time. I'm thinking that the Forteo makes me more tired. I have also gained weight in Tymlos and Forteo. I'm afraid that I might gain weight on less Thyroid med. But I have broken 5 bines in 18 months so really need to take care of my osteoporosis. It is interesting that your endo wants your TSH higher because of your age. I am 74 and none of my endoscsaid anything. I think they are motivated to do as little as possible. On Thursday, my endo said no more tests, come back in 6 months, and he was out the door!

Thank you so much for this article. I have been over treated with Armour thyroid for years. My doctor was trying to bring my free T3 and Free T4 up but it suppressed my tsh. I reduced my dose by half at the beginning of the year and may need to reduce again after tests. I’ll show her this article. This is very helpful.

I just got my Bone density and Evenoity did nothing for me either. Doctor says try Prolia, but I am scared of Prolia becasue of rebound fratures. Not sure what to do next. This is very upsetting.

Qué otro efecto tuviste. Thanks

@bluebonnet242
It is normal for the tsh to lower when upping t3 or t4; the pituitary gland senses the higher T3 levels, etc. and reduces its TSH production; this is part of the normal feedback loop. A normal TSH doesn't automatically mean low T3/T4 levels are fine.
Priorities are usually the t3 and t4 levels not the tsh, but there is a balancing act which your doctor will be trying to reach. Remember that the tsh reflects the action of the pituitary in response to the ups and downs of your t3 and t4.
T3s can especially be a problem because a low t3 is tied to depression.
In my case, I prefer a higher t3 and though we ck the tsh it is not as important to me. But I am prone to t3 depression levels so my case may be entirely different from yours.
I have taken thyroid meds for years, and I have gone from osteoporosis to normal bone readings, DEXA, with normal bone microarchitecture, TBS.

@kathleen1314 thanks for the comment. I’ve been taking NDT since 2008. I was also told TSH would be suppressed because of the t3. My tsh has been suppressed below 1 since starting it while trying to get my free T3 and free T4 in the right range. What would a good level of suppression be? If you have any articles handy, I would love to see any recent articles or trials you may have regarding overly suppressed TSH and the effect it may or may not have on bones.

Unfortunately, my osteoporosis continued to get worse and I had a hip fracture 2 years ago. I am now on Tymlos. Of course, we all have different health issues that may contribute to osteoporosis.

May I ask how suppressed your tsh is? I’m happy that your thyroid meds are working for you and that you have been able to improve from osteoporosis to normal! Not an easy feat.