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How do you ever choose which med?
I already have anxiety and trying to decided which med to choose is giving me even more anxiety. Ugh To summarize my previous posts I’m 61 and was diagnosed in February with OP. My spine is -2.7 and hips -2.0.
My Gyno diagnosed me and gave me the news over the phone while I was driving in my car. He gave me choice of Prolia or Evista. Gave me a very brief description and asked which one I wanted to do. I said I wanted to see an Endocrinologist.
Made appointments with 2 different Endo’s. First one suggested Reclast, Alendronate or Evista. I did tell him when I was diagnosed with Osteopenia I tried Fosomax. Had severe pain in lower back after a couple of pills. Told him I was told to stop meds and increase calcium. When he gave me choice of the 3 meds he also skated over the side effects told me to look them up on bone health website and choose. Had God complex so I moved on. Next Dr I really liked but she came at me with Evenity and I inquired about Evista. She said I could do that too. Ordered bloodwork and 24 hour urine test. Office called me after getting results and said she wanted to set up me up with Evenity shot. I started to panic. Mainly because after that is Reclast or Prolia. I asked if she ever prescribed HRT. They said no. I feel like starting out with Evenity is basically hard core. Like I said in 61, and after Evenity is then Prolia or Reclast, which I can’t handle biophosonates and I read that odds are I will have reaction to Reclast as well.
I know I have to do something I don’t want to fracture. Maybe Evenity would really increase my scores since I’m not that far over the line, but I keep hitting the wall with Prolia or Reclast. I’d like to try Evista first or HRT, but the whole blood clot thing with Evista worries me. I read that if you’re going to be sedentary for a long period of time for instance surgery or travel you should stop it at least 3 days in advance. She doesn’t prescribe HRT so I’m guessing I’d have to find another Endo who would prescribe it. Or if Endo doesn’t prescribe that what Dr does? PCP? Gynecologist?
I have a telehealth appointment tomorrow with the Dr about Evenity, to basically talk me off the ledge.
So how do you choose? I just feel like once I make the decision my life will never be the same. It just all seems like a roll of the dice.
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I started HRT all topical about a year ago. I found an integrative DR near me not covered by Insurance.
They ran blood work and DUTCH test to evaluate my current hormone levels and started me on topical estradiol, estriol and progesterone. I have family history of breast cancer as well, so pursuing the topical creams seemsed to be the least risk.
My spine TScore was -3.5 and only area with osteoporosis and no fractures.
I wasn't ready to start the osteoporosis meds so pursued the HRT.
So far it is helping.
Spinal bone is the quickest to remodel and get positive results.
I also didn't feel like I had to rush and took my time to explore options and find the DRs I felt comfortable with. Again Ive not had any factures either so I didn't feel like i had to jump in right away.
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1 Reaction@rudysmom
These videos helped me understand meds better.
Osteoporosis
Prolia
But ultimately decided to go HRT route.
@oknowwhatpixie
Thank you! I’ll watch them tonight. Can I ask how HRT is working for you and what is your age? Did Endo prescribe that for you?
@rudysmom
The HRT is working, had to adjust the dosage but am using compounded creams so was easier to make adjustments.
Not Endo DR, found an Integrative Doctor in my area that deals with HRT options. Started when I was 58.
HRT has also helped with my sleep and no more hot flashes. Bone density has also improved, my Blood bone markers are also in a good place, CTX has dropped and shows less bone loss, stabilized at this point.
I feel your anxiety, I felt the same way.
Search for hormone therapy doctors in your area or you can use this search from Menopause society.
https://portal.menopause.org/NAMS/NAMS/Directory/Menopause-Practitioner.aspx
I would avoid pellets, cause if your having any issues its hard to address.
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1 Reaction@oknowwhatpixie
I read that if you still have your uterus you have to also take progesterone. I was thinking about the patches? I’m 60 (just realized in post I said I was 61. Will be in a couple months. Nothing like aging myself. lol)
@rudysmom
Yes need progesterone, am also using a cream for that.
I use compounded creams, my choice over patches and oral options and pellets.
With the compounded creams more control over the amounts.
With family breast cancer history the compounding creams seems the best option and keeping my risks lower.
Some will state not FDA approved, but I trust my componding pharmacy knows what they are doing. And my results so far show its working for me.
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1 ReactionHave you had a fracture that was related to bone loss yet?
If you decide to pursue hrt/bhrt further and live in the u.s. you might try looking for a functional medicine provider. That is what I finally did.
@gravity3
No I haven’t had any fractures. You’ve had good results?
rudysmom, I looked at it like this. There aren't that many medications in two classes. Medications that build bone Forteo and Tymlos
Mcdications that stop the loss of bone: all the bisphosphonates (Reclast and Fosamax) and Prolia.
Then Evenity--thought to do both.
I'm partial to the drugs that build bone. Tymlos and Forteo stimulate the natural process of bone renewal--getting rid of old fissured bone and repairing with new bone.
The second consideration is side effects. This is where the dice really rolls because you don't know how your body will react. Again, Forteo and Tymlos head the list for me because the effects are short-lived, usually 4 hours sometimes 24.
Your doctor will have a preference, which may not align with yours.
I hope your appointment is helpful today.
Best wishes
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1 ReactionIf my spine were at -2.7, I'd forego the meds and get serious about lifting weights. It seems to be the lever that best guarantees bone building, so they say. Best wishes to all.
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