Treating Osteoporosis: What works for you?

Thank you so much for your advice. You seem to be so knowledgeable. I wish my primary doctor was aware of, or had recommended these other drugs. I think waiting a month to be seen by the specialist is too long. I may seek out another hospital. Thanks for your help.

@mj20 with scores like that, I would think you would qualify for bone-building drugs like Forteo, Tymlos and Evenity. Evenity builds bones very fast but cannot be followed by Forteo or Tymlos.

I chose Tymlos and will follow with Evenity if results aren't good enough. I also chose Tymlos because the delivery pen has 8 "clicks" and I could start at a low dose of two clicks and move up as my body adjusted. This minimized side effects.

With a spine score of -4.7 I would start with a bone-builder not an anti-resporptive like Fosamax. You need something stronger, I think. And I also would not do weight-bearing exercises, or I would be very careful with them. Seek advice on that. I do tai chi instead!

As @callalloo indicated, there are studies that indicate the bone-building drugs work better if you have not taken the anti-resorptives (Fosamax and other biphosphonates, or Prolia).

Hi everyone, I just joined this group and I think it is wonderful. I just had a dexascan for the first time and my numbers weren't good..... femoral neck, -3.8, total hip -3.7, lumbar spine, -4.7. My doctor wants to put me on Fosamax, but I'm afraid of the side effects. What would you do? I'm in my late 60s, tall and thin.

Good evening @catluvr999. I am back. By the way, are you one of the folks that finds it hard to go back to a previous post........I do. The "Bookmark" feature in your profile really helps. After posting a reply or comment.....just click on the three dots and then on Bookmark. It takes you to your profile so you can find the post without hunting around.

So.....you want my T-scores. I am not an expert on this subject so, please be gentle. I hope this is helpful and would appreciate your feedback. These are all from the same Hologic Discovery densitometry system. The baseline is 10/29/18. The next one is post-Tymlos on 11/18/20. The last scan was 7/9/22.

Hip: -1.5 baseline and -1.2. Bone mineral density has not significantly changed having increased 0.9% since the previous scan.
Wrist: -3.4 baseline and then -3.2. Bone mineral density is increased by 2.6% which is not statistically significant.

Does this tell you anything about my rather rough experience and the medical value of the current weekly pill format as opposed to monthly injections? I call it, "taking less more frequently".

May you have ease and contentment.
Chris

This forum really is helpful because there are so many experiences represented. Glad that it's helpful for you. I have osteopenia and devoutly hope to avoid osteoporosis so read the posts here to stay current about which drugs are being used so I can read the peer-reviewed studies about them in case I end up needing to plan ahead. And to read about what others are doing, in addition to drugs, to stop or even reverse osteoporosis.

Thank you so much , Callalloo, for your thoughtful reply. I made an appointment with a rheumatologist, but there are no openings for a month. I will try to do some weight bearing exercises until then. I was always very active until Dec., when I had to retire due to chronic lung issues. I'm used to taking all kinds of meds, but Fosamax was the most worrisome. I really appreciate your advice. This is such a great source of information. Thanks to everyone.

I personally would get a second opinion. Not because of any reason to distrust the doctor's suggestion, but because treating osteoporosis may require pre-thinking a long-term strategy over a number of years. And that means paying attention to which drugs, if taken, might make other good drugs not possible or work less well.

Fosamax, a biophosphate, doesn't preclude other possibly-better drugs later. But there are some newer drugs that work better if taken first. So treating osteoporosis is an evolving field as newer drugs have become available and a doctor with a specialty in treating it is most likely to know all of the options. Including when or if the somewhat-controversial estrogen therapy could help. (Being thin is associated with a lower general level of estrogen and possibly an earlier-than-average loss of the so-called estrogen-shield that protects bones.)

Or you could start on the Fosamax while looking for a second-opinion specialist. I just think, with those numbers, you might want an overall plan of action for comfort while you research other non-medical things you can do in addition to drugs. That way you'll know you're using all the tools currently available to address this and maybe reverse some of the numbers as well.

Hi everyone, I just joined this group and I think it is wonderful. I just had a dexascan for the first time and my numbers weren't good..... femoral neck, -3.8, total hip -3.7, lumbar spine, -4.7. My doctor wants to put me on Fosamax, but I'm afraid of the side effects. What would you do? I'm in my late 60s, tall and thin.

@callalloo not sure why you think the femur score is not important. Hip fractures are very disabling. I wonder if I "misspoke" awhile back. My report says the femur neck is not reliable to measure change. That may be particular to me, and it may not mean the femur neck score is unreliable. To be honest, I don't know what it means. But the femur score is different from the femur neck score anyway.

Wow, do I agree with you. My mother died after a hip fracture. Although they tried surgery to repair it...she never walked again and stopped talking or engaging in any way. I would drive two hours to see her on Friday, place her in a wheelchair and take her through the rose garden. She had no reaction........just stared straight ahead. For her, quite an active run-a-bout......this was the end.

Unfortunate and preventable???????
Chris