1. < Osteoporosis & Bone Health

HRT Safety

Posted by debbie1956 @debbie1956, Jun 8 6:29pm

I wanted to share this Medscape article I received today about new study on HRT. I am considering HRT for my osteoporosis at age 67 and am so encouraged by this article: https://www.medscape.com/s/viewarticle/hormone-therapy-after-65-good-option-most-women-2024a10007b2?ecd=mkm_ret_240608_mscpmrk_obgyn_menopause_etid6577682&uac=36

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gently | @gently | Jun 12 11:38am
In reply to @debbie1956 "@windyshores I meant to ask you what side effects you experienced with Evenity? This is the..." + (show)
@debbie1956

@windyshores I meant to ask you what side effects you experienced with Evenity? This is the medication that was recommended for me. I would want an anabolic but this would not be my choice. I am wondering why it requires a follow up antiresorptive when it is a combined anabolic and antiresorptive medication. If anyone else knows the answer, please let me know.

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It wasn't known that Evenity was anabolic for the first three months and antiresorptive for the last nine when the medication was FDA approved. Because the last nine months are antiresorptive, you are right about following Evenity with an anabolic. But "protocol" is slow to change. Paul Miller suggests that eventually Evenity might be prescribed for three months only. Which is almost exactly what our clever windyshore's body dictated.

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1 reply
windyshores | @windyshores | Jun 12 3:05pm
In reply to @gently "It wasn't known that Evenity was anabolic for the first three months and antiresorptive for the..." + (show)
@gently

It wasn't known that Evenity was anabolic for the first three months and antiresorptive for the last nine when the medication was FDA approved. Because the last nine months are antiresorptive, you are right about following Evenity with an anabolic. But "protocol" is slow to change. Paul Miller suggests that eventually Evenity might be prescribed for three months only. Which is almost exactly what our clever windyshore's body dictated.

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@gently and the idea has been discussed and is being studied, of using Evenity for those "short bursts" between other meds.

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dianeelizabeth | @dianeelizabeth | Jun 13 8:10am
In reply to @debbie1956 "Thanks for recommending "Great Bones", Yes I have read the entire 700 page book which was..." + (show)
@debbie1956

Thanks for recommending "Great Bones", Yes I have read the entire 700 page book which was worth every page! That book has a vast amount of vitally important information I couldn't navigate this situation without. I know Keith McCormick doesn't promote HRT for women my age, with such low score and recommends it for prevention rather than regaining. There seems to be new information lately about the benefits and safety of HRT even for women long past menopause. I recently watched an interview with McCormick in which he states he has changed his position somewhat on HRT. I'm not hopeful the HRT can reverse my loss but hope it may stop the progression. My REMS Echolight fragility score showed incredibly that my bone quality was still on the border of green zone low fracture risk which may explain the mystery of why I haven't fractured yet with spine at -3.5! The REMS results were similar to DXA at -3 spine and -2.6 total hip compared to DXA at -3.5 spine and -2.5 total hip. I'm hoping with some quality of bone remaining and avoiding a fall I may be able to cope. I hope to start HRT in the near future with naturopath who specializes in it and menopause, but haven't consulted with her yet so not sure what she will recommend. I will have another DXA in 6 months, a year from my last. The internal medicine doctor from the Osteoporosis Clinic in Vancouver recommended Evenity which is at least an anabolic I would want. I would have wanted Tymlos if I chose a medication, but it appears Tymlos isn't available in Canada. I have read many of your posts on Tymlos which have been so informative and helpful for me. Thank you so much for sharing all your experience. The doctor said Forteo is available for a mere $12,000.00 a year! Evenity costs $8000.00. But even the cost is not my first reason for wanting to try all my options first. I may eventually book a video appointment with Keith McCormick if he still offers this. (Far less expensive than the medication costs!) Thank you again for responding.

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@debbie1956 What was the Dr. MacCormick interview that you listened to? I am also using his book as my guide..but books have the issue of not being able to update easily. I am hoping McCormick will issue updates as he sees fit. I am also in Canada (Ontario)...I believe there can be coverage for some of the meds esp if you have a fracture. I didn't think I had a fracture (no outward signs and my spine is not too bad at 2.0) until I asked my doctor for an x-ray and a subtle vertebral wedge fracture was found. Not happy about that but hoping it will qualify me for medical if needed. Alot of women don't get the xray after BMD tests..my doctor didn't suggest it so I assume it isn't protocol. I am waiting for an apptment with an endocrinologist so can confirm drug coverage then.

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1 reply
kisu | @kisu | Jun 13 11:24am

Someone posted the link to the raw data from the Medicare HRT study released in May 2024. Please post it again. I want to make a copy of it. I cannot find the actual data online. It seems that the original posting here has been deleted.

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1 reply
kisu | @kisu | Jun 13 11:53am
In reply to @kisu "Someone posted the link to the raw data from the Medicare HRT study released in May..." + (show)
@kisu

Someone posted the link to the raw data from the Medicare HRT study released in May 2024. Please post it again. I want to make a copy of it. I cannot find the actual data online. It seems that the original posting here has been deleted.

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found it and thank you to the person who originally posted it

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1 reply
ashash | @ashash | Jun 14 9:45am
In reply to @kisu "found it and thank you to the person who originally posted it" + (show)
@kisu

found it and thank you to the person who originally posted it

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Could you please re-post the Medicare HRT study of May 2024?
Thanks.

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1 reply
ashash | @ashash | Jun 14 1:12pm

Thank you so much!
I hope for you a wonderful summer.

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debbie1956 | @debbie1956 | Jun 14 10:51pm
In reply to @dianeelizabeth "@debbie1956 What was the Dr. MacCormick interview that you listened to? I am also using his..." + (show)
@dianeelizabeth

@debbie1956 What was the Dr. MacCormick interview that you listened to? I am also using his book as my guide..but books have the issue of not being able to update easily. I am hoping McCormick will issue updates as he sees fit. I am also in Canada (Ontario)...I believe there can be coverage for some of the meds esp if you have a fracture. I didn't think I had a fracture (no outward signs and my spine is not too bad at 2.0) until I asked my doctor for an x-ray and a subtle vertebral wedge fracture was found. Not happy about that but hoping it will qualify me for medical if needed. Alot of women don't get the xray after BMD tests..my doctor didn't suggest it so I assume it isn't protocol. I am waiting for an apptment with an endocrinologist so can confirm drug coverage then.

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@dianeelizabeth Here is the interview with Keith McCormick where he discusses his revised position on BHRT for women up to 15 years plus past menopause. He goes into most detail at 46:50 on video and also mentions it close to 24:00. https://www.youtube.com/watch?v=W--WWCwQczI Your spine sounds good still at -2.0. I wish I had this number! It's surprising you had a fracture. I'm glad you've had no pain so far. A physiotherapist advised me to ask for an X-ray after pain from a hip rotator stretch injury, but X-ray showed no fractures in that area. My GP never suggested the X-ray either when my numbers were far worse than yours. My regular PT says the pain is from inflammation in my SI joint and that I would be feeling horrendous pain if I had fractured there which I'm not. I've had decades of muscle back pain unrelated to OP. It sounds like Ontario's Ohip is similar to BC's coverage. My OP doctor said BC pharmacare would cover some OP medication only after a fracture! Isn't the idea to prevent fractures which would cost far more with nursing homes, care aides... The doctor said Evenity might cover partial costs depending on my circumstance if I decide to take it so I imagine they would offer this in Ontario as well.

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dianeelizabeth | @dianeelizabeth | Jun 23 4:45pm

@debbie1956 Thanks for the link to the McCormick interview...very helpful!
Nice to be able to confirm that you have no fractures in the hip. Yes, I think the coverage for some of the expensive bone building meds are for high risk, and fractures can put you into that category as they are an indication of poorer bone quality. I suspect this is what I have....either that or an incident that caused the fracture many years ago (car accident, serious falls, etc which I have had a few of over the years). This is just my own thinking.
My physio says I would be in great pain if I had an active vertebral fracture so at the very least it must be healed..but I have also heard that some fractures don't cause pain. She thinks I can run, play pickleball, etc but should avoid big impact/twisting sports like tennis, golf etc. and I am still not sure about weights but I think she will introduce small weights slowly (I have just seen her once) . I still am sticking to the safe exercises for now...I guess I want to err on the cautious side.
https://osteoporosis.ca/provincial-drug-coverage/

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