Looking ahead after Tymlos: Reclast, Evenity or HRT?

Posted by psmnonna @psmnonna, May 29 8:39am

Sorry this may be a bit long, but here is some backstory:

I am on month 5 of 24 of Tymlos. I'm not loving it much, but tolerating it so far. Side effects of rapid heart rate and sometimes shoulder, chest or back pain for about 30-45 mins following injection. Doc said not to worry, so ignoring it for now. Anyone know of damage to the heart from chemically induced rapid heart rate daily over a 2 yr period? I work out, run, bike, walk, hike, yoga and do weights. As I have for over 40 years. Along with healthy mostly veggie diet, fresh veggies, fresh fruit, high protein from nuts, beans, tofu, etc. My calcium intake easily surpasses the 1200mg daily recommendation so I take no extra calcium other than what is in my daily multivitamin. For about 3 years I've added a D3, K2 as MK-7, magnesium and fish oil. Where the osteoporosis came from is anyone's guess. No family history, and at 66 I am younger than both of my sisters who are 72 and 77 with no osteoporosis. Mom passed at 93 with only 2 years of Reclast before that as she had no osteo either, just osteopenia.....but she was in her 90s before she started. So here I am young, active and healthy (I like to think, anyway) with a spine Dexa of -3.6. Since I already do everything that is recommended and have for years before my diagnosis I decided to go the drug route, which makes me cringe. But seeing as my lifestyle didn't prevent a low dexa score I saw few alternatives.

My main question for those of you out there in the know is where do I go after my 2 years of Tymlos?
~I have recently seen some things about HRT for people over 10 years past menopause. Apparently new research points to this being an OK alternative since past studies were not correct?? So basically a whole generation told that HRT was dangerous and caused increased risk of stroke and heart attack was incorrect (which is why I never started it)? But does that mean that it would be OK to start HRT at 68, the age I will be after Tymlos?
~Evenity....is this similar to HRT?
~Reclast...am I correct in thinking that this is a super-sized yearly dose of a bisphosphonate? What does this do to osteonecrosis of the jaw and spontaneous femur fractures over time? How many years can you take it and if it has a limitation, then what?
Thanks for any and all insights. 🙂

Interested in more discussions like this? Go to the Osteoporosis & Bone Health Support Group.

@psmnonna I have a few thoughts. I’ve been taking Kim Millman’s “100 days to Healthier Bones “course based on functional medicine . When I started down my path of inquiry after a fragile spine fracture- as a very active person , seemingly told meds were the only way, I did not want to jump in till I did some research. I’ve learned a significant amount of info that’s pertinent to the drug options , which this forum has certainly been beneficial. I’ve read McCormicks book , consulted with him and have been a part of Margie Bissinger’s “Healthy Bones Heathly Life “ community, that meets 4x /month , and soon finishing The Millman course which helps you identify root causes of osteo with ideas and natural supplements to address these issues. I am technically suppose to start Forteo very soon , Ive been saying that for a while now. Called Dr to have nurse training on how to do the injection and it’s now almost 2 weeks and no appt yet!!!! But I will tell you all on this forum that we may be missing the boat if we don’t know and try to address the underlying root causes, or at least consider them and attempt to use them in conjunction with other things we’re doing . Some are - 3 top things that should be limited in our diets or considered to be suspect of creating issues are: gluten, dairy, sugar. It’s stated by the Osteoporosis Foundation that all with osteoporosis or osteopenia should have testing for gluten sensitivity / celiac disease. Other things to be aware of include- as stated get blood markers done using guidelines specified so follow up tests are comparable. Be aware of your supplement intake , inflammation , blood sugar levels, hormone status, stress and sleep can’t be overstated , of course exercise including weight bearing/resistance strength training /cardio , gut health . That’s a lot I know , and how are you to know where to start. It’s certainly a process and a journey cause a lot of testing is involved depending on how much you truly want to dig and understand where you are. Many of us have felt like very healthy individuals and others not so much , but even us healthy feeling people do have underlying issues and often in a few areas. I know this was a lot , but felt compelled to share this morning and had time - cause taking this course is intense and time consuming and not cheap - so you’re trying to really get out as much as you can from it. NOW do more research in these areas and maximize your ability to have the best bone quality you can have !!! Good luck to all!!!

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I have written in the past about how Evenity (very new at the time) helped me greatly in improving my bone density scores. I was advised by my ENT to then move on to Reclast infusions. I don't like the idea of taking yearly infusions. I had a bad reaction to Prolia after just one injection and I quit. I'd taken weekly Actonel (residronate) for many years prior and it didn't seem to help, but possibly kept me from getting worse. When I refused Reclast, I was instead told to go back on the Actonel. Now, two years later, I again had a bone density test and it shows some decline. Still, I'm not back in the negative 3s. Again, I'm told to go on Reclast. I don't want to. Does anyone know if Reclast has chemo in it? My husband who had severe Prostate cancer for years, was given an infusion for the first time. We weren't told the name. Two weeks later, he suffered a slight fall, broke his femur in 3 places and he died days later. I've pretty much made up my mind to refuse it. Any opinion?

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I took 3 months of Evenity shots for low bone density because I have not had any prior stroke or heart incidents. After 3 months I developed severe heart arrhythmias that were occurring several times a day. I went to see my cardiologist and it happened while I was on an EKG machine, so they recorded the whole thing. My heart went to 230 beats per minute for a minute and then dropped back down to 120, then went back to 230. I was oscillating like that for quite a few minutes as I sat on a chair, after getting off the EKG machine. I suspect that if I had any vascular blockages in my system, I would have had a stroke right then and there. I think the Evenity shots caused the arrhythmia episodes. I had to have an ablation heart surgery within 2 weeks. So in order to prevent a POSSIBLE bone issue later in life, I ended having heart surgery immediately. This is NOT a good tradeoff.

Since getting off the Evenity shots, all the arrhythmia episodes went away, thank goodness.

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@kmp88

I took 3 months of Evenity shots for low bone density because I have not had any prior stroke or heart incidents. After 3 months I developed severe heart arrhythmias that were occurring several times a day. I went to see my cardiologist and it happened while I was on an EKG machine, so they recorded the whole thing. My heart went to 230 beats per minute for a minute and then dropped back down to 120, then went back to 230. I was oscillating like that for quite a few minutes as I sat on a chair, after getting off the EKG machine. I suspect that if I had any vascular blockages in my system, I would have had a stroke right then and there. I think the Evenity shots caused the arrhythmia episodes. I had to have an ablation heart surgery within 2 weeks. So in order to prevent a POSSIBLE bone issue later in life, I ended having heart surgery immediately. This is NOT a good tradeoff.

Since getting off the Evenity shots, all the arrhythmia episodes went away, thank goodness.

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Wow...that was definitely NOT a good trade-off. I'm so glad your arrythmia episodes are gone, but that ablation surgery was not on your radar before the Evenity. Thank you for sharing this. This is what I am afraid of going forward with any other meds....starting down the cycle of taking one thing to fix a problem, which causes another issue leading to another med and on and on. Every day I take the Tymlos shot I question if I'm really doing the right thing in the long run. Yes, anabolics build bone, but what kind of bone? Is it just dexa test passable, reaching some arbitrary magic t score number creating bone with no substance, or is the bone truly strong? Again thank you for sharing your experience with Evenity.
Cheers!

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@ceciliamarypatriciafrancis

I have written in the past about how Evenity (very new at the time) helped me greatly in improving my bone density scores. I was advised by my ENT to then move on to Reclast infusions. I don't like the idea of taking yearly infusions. I had a bad reaction to Prolia after just one injection and I quit. I'd taken weekly Actonel (residronate) for many years prior and it didn't seem to help, but possibly kept me from getting worse. When I refused Reclast, I was instead told to go back on the Actonel. Now, two years later, I again had a bone density test and it shows some decline. Still, I'm not back in the negative 3s. Again, I'm told to go on Reclast. I don't want to. Does anyone know if Reclast has chemo in it? My husband who had severe Prostate cancer for years, was given an infusion for the first time. We weren't told the name. Two weeks later, he suffered a slight fall, broke his femur in 3 places and he died days later. I've pretty much made up my mind to refuse it. Any opinion?

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You have my sympathies on your loss. I totally understand your refusing Reclast after your husband's experience. I would as well in that situation. I'm not sure if I will take a bisphosphonate of any sort after Tymlos, but still undecided as to which way I'll end up going.
I don't think that Reclast is a chemo med. I think it is used in conjunction with chemo to help strengthen bones which are weakened by cancer therapies and steroids taken for cancer.
Take care

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Thanks, I just wish I had a clear understanding what Reclast really is in layman's terms.

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@ceciliamarypatriciafrancis Reclast is an anti-resorptive which means it reduces bone turnover, which leads to denser bone. If taken too long, that means the bone is denser but of lower quality, since new bone is not being made. It coats the bones after Tymlos or Forteo (or Evenity) locking in the gains from those meds.

Reclast does NOT contain chemo. It is use to prevent bone loss during hormonal breast cancer treatment, and is thought to also have preventative qualities against metastasis to bones.

@ans I have been gluten and dairy free for decades. It does help with inflammation. However, my simplistic view of causes of osteoporosis for many of us (barring steroid use, or parathyroid issues) is loss of estrogen at menopause and living much longer than people used to 100 years ago!

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@windyshores

@ceciliamarypatriciafrancis Reclast is an anti-resorptive which means it reduces bone turnover, which leads to denser bone. If taken too long, that means the bone is denser but of lower quality, since new bone is not being made. It coats the bones after Tymlos or Forteo (or Evenity) locking in the gains from those meds.

Reclast does NOT contain chemo. It is use to prevent bone loss during hormonal breast cancer treatment, and is thought to also have preventative qualities against metastasis to bones.

@ans I have been gluten and dairy free for decades. It does help with inflammation. However, my simplistic view of causes of osteoporosis for many of us (barring steroid use, or parathyroid issues) is loss of estrogen at menopause and living much longer than people used to 100 years ago!

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@windyshores- Absolutely agree !! As it’s at that time in our life that many lose up to 20% of their bone density. As women APPROACH menopause that would be the time to
1- get a base line DEXA for comparison layer as needed
2- explore the potential for some hormone treatment , based on your individual history

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@windyshores

@ceciliamarypatriciafrancis Reclast is an anti-resorptive which means it reduces bone turnover, which leads to denser bone. If taken too long, that means the bone is denser but of lower quality, since new bone is not being made. It coats the bones after Tymlos or Forteo (or Evenity) locking in the gains from those meds.

Reclast does NOT contain chemo. It is use to prevent bone loss during hormonal breast cancer treatment, and is thought to also have preventative qualities against metastasis to bones.

@ans I have been gluten and dairy free for decades. It does help with inflammation. However, my simplistic view of causes of osteoporosis for many of us (barring steroid use, or parathyroid issues) is loss of estrogen at menopause and living much longer than people used to 100 years ago!

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windyshores,
I have been a vegetarian for 39 years. I’m now experimenting with being Gluten and dairy free.
My friend was just visiting from Chicago where she is a nutritionist. She hasn’t consumed dairy or gluten for many years. While she was here - in a city known for food - we had several dinners out together. Observing her ordering meals was disheartening and encouraging at the same time.

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@susanfalcon52

windyshores,
I have been a vegetarian for 39 years. I’m now experimenting with being Gluten and dairy free.
My friend was just visiting from Chicago where she is a nutritionist. She hasn’t consumed dairy or gluten for many years. While she was here - in a city known for food - we had several dinners out together. Observing her ordering meals was disheartening and encouraging at the same time.

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@susanfalcon I don't feel limited at all. The only issues arise when friends invite me to dinner and get all nervous. Eventually they learn to just put the veggies aside without butter. If they make pasta, I just don't eat it. Etc. But restaurants work fine. I cannot have dairy, gluten, salmon, avocado, nuts of any kind, chocolate and some citrus is dicey. I don't even think about it except at a meal made by friends. And...gluten free products are good these days...just expensive. Canyon Bakehouse is the best.

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