Treating Osteoporosis: What works for you?

Good afternoon @toni7. Your concerns are legitimate. And the basket of options can be extremely confusing. There are three rather new medications that require injections and have been developed to build bone. The one with the longest medical history is Forteo. The next one is Tymlos. Both are taken for two years. The newest one is Evenity which not only builds bones but also protects the bone from reabsorption during the one year schedule.

Because of uncomfortable side effects with bisphosphonates, I chose two years of Tymlos. My scores for hips returned to the osteopenia level and the other scores remained stationary which means they held their own. I had no side effects except for the first few days. They were unspectacular.....and disappeared in a couple of weeks.

Then came the hard part. What next? Moving to Evenity would mean a rapid building of more bone and a less active effort at protecting as the research begins to show. Since my unfortunate reaction with Boniva, it appeared that I only had one choice and that would be Prolia.

I did finish a year on Prolia with concerning side effects and unimpressive Dexa scores. I secured periodontist exam reports indicating that so far there was no damage to my jaw and that my teeth would probably not need any surgery or implant treatments.

Nothing felt right to me so I asked for a consult in Endocrinology at Mayo Clinic. Here is what I discovered. At the age of 77, when I was told that I needed to begin the osteoporosis medications, that recommendation was way too aggressive. I did not need any bone-building or bone protection at that point based on my scores. There seems to be some anxiety among endocrinologists and other clinicians to make sure everyone gets going on something.

So......now I was in a "pickle". Evenity was too new without enough research for me and only possible for a year. Again....then what? The Mayo endocrinologist went back to look at the once-a-month biphosphonate dosage which resulted in side effects. What if you took the bone-protecting biphosphonate, alendronate, weekly instead of monthly? The dosage of one infusion a month was just too heavy for me.

So.....four weeks ago I began to take one tablet, not an injection, every Monday morning. And as you might be beginning to realize......it is working. No side effects, no joint pain, no jaw or teeth or gum pain. No nausea or injection soreness.

So just backing off from the more infrequent heavy doses is the answer for me. It might also be worth discussing with your clinician. Questions??????

May you be safe, protected, and free from inner and outer harm.
And thanks Mayo Clinic.

Chris

For what it's worth, I tossed out all tummy acid drugs and relied on my grandmother's old cure after first learning about the PPI osteoporosis risk.

When I have an upset stomach of any kind, I drank 6-8 oz. of water with 1/4 tspn of baking soda. And it works for me 100% of the time. I don't have high blood pressure so the sodium from the baking soda isn't a problem.

My gastroenterologist said a lot of his patients have done the same thing successfully. It might be worth a try.

Here's a link to an article about the meds and osteoporosis.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6540255/#:~:text=Long%2Dterm%20PPI%20therapy%20is,metabolic%20bone%20disease%20%5B17%5D

If you don't have any issues with sodium, try the baking soda. A lot of my gastroenterologist's patients gave up on the meds and have done well. I hope that your gastroenterologist informed you of the effect of PPIs on bones. (Mine did not, by the way.) PPIs are tricky drugs. They have odd side effects, none of which I knew much about when first prescribed to me.

Had you been on Prolia and gone off it without a relay drug? I'm sorry to read that you're dealing with this as I'm sure that we all are...

Maybe this is just me but I'd be very careful about risking any other part of my body just to strengthen my wrists. Push-ups and the plank require near perfect stability and strength of the spine and hips. Any slip out of the posture can stress both while the load-bearing responsibility falls on already-vulnerable wrists. There are myriad ways to use safer resistance trainer that just isolates the wrists. You could start with something safe and work your way up to push-ups, etc., if and when the wrist bones show gains. Again, this is just my thinking and I tend to be risk-averse about things not easily fixed. Slow and steady seems a good mantra for osteoporosis-prevention strategies in my mind at least.

Hi. Chris. I am new to the group. I am 74. I had osteoporosis in my wrists with a score of -2.9 several years ago and then had two infusions of recast in 2016 and 2017 which I tolerated well and now last week my latest scan shows -3.3 for my wrists and continued osteopenia in my hips but not my spine. I know I am lucky that my spine is holding up well so far.

I now I need to start doing planks and pushups again. I stopped going to the gym when Covid started but did some weight work for a while but I stopped about six months ago.

Do you do anything special about your wrists?

Pat

So interesting. Yes, my new gastroenterologist upped my Omeprazole and added famotidine. She also wants me to have an endoscopy and a procedure where they put a probe in your nose, down to your stomach and you keep it in overnight and then you go back to the hospital the next day. It's supposed to measure the acid in your stomach. It sounds torturous to me, so I am very nervous about it. I'd rather use the baking soda! 🙂

Just went back to prolia..
Have done calcitonin and forteo. Have 7 fractured vertebrae in back. T-8 and t-12 more than 90%.
After prolia last Wednesday I am weaker in back and more severe pain. Could prolia have caused this? It hurts to breathe.