Major osteoporosis treatment centers

Any recommendations for options in Iowa? I have gone to the University of Iowa in Iowa City and seen 3 endos there. All just follow standards and don't really listen. See you as a statistic and not a person.

Hi @2024tymloshelp. I understand your concern! Osteoporosis treatment is incredibly complicated and nuanced. Would you say you dread the decision- making process or the potential side-effects of the medications more?

I think your best option is to do a search on this site specific to your needs. That way you will discover much more than I alone can provide. I don't know if Tymlos is the first osteoporosis medication you've done, what your DEXA, TBS and bone markers were prior, and what your comorbidities are. Has your doctor prescribed Reclast after Tymlos?

Tbh, by the time I made the choice to go on Reclast I had already read up on my options extensively. My doctor wanted me to go on Prolia, and I'd read enough to know that I didn't want that. I was open to listening to her opinion as I trust her. She had demonstrated that she is well-versed in the medications and up-to-date on recent research. I came into the conversation having studied up extensively myself, and I felt confident and empowered. I chose Reclast based on what I'd read, conversations with my medical team and my subjective knowledge about my own body.

The reality is that all of these medications are very powerful, and no one knows how an individual will respond. I was definitely overwhelmed in the beginning, but I realized that stressing out was really affecting me negatively. I made the decision to eliminate that. I know that I can handle whatever comes my way. One of the best things I've done on this site is to do a search for positive outcomes. Most of the time, we come here to search for or report problems, and we're fed those results. We forget that there are many success stories as well. You could be one of them.
Best wishes to you moving forward!

Neil Gonter, MD at Rheumatology Associates of New Jersey in Teaneck. They have the same DEXA technician for many years (so consistent readings) and their DEXA scan has TBS as well.

I go there for my DEXA scan. Dr. Gonter recommended meds but I'm going to hold off until my next DEXA in 2026. That said, if I do decide to go that route, I'll go to HSS in NYC for a second opinion.

My pcp in Littleton CO, recommend to ask University of Colorado Hospital radiology department if they do TBS at the time of a DEXA scan. They do a TBS, and I am scheduled for those tests. She did not inform me of the TBS until I found out about it here and brought it up.

hollygs: just curious, what side effect/effects specifically made you wary of going on Prolia

Hi Maryann @mkoch.
My *primary* reason for not wanting to go on Prolia is that I have an autoimmune disorder. Prolia may be more likely than Reclast to negatively impact the immune system. The rebound effect is also of concern as I have had multiple fractures including spinal. I appreciate that with Reclast, the likelihood of rapid bone loss after discontinuation is much lower, so further treatment is more flexible. The potentially higher risk of osteonecrosis of the jaw is concerning - my brother has a history of that (albeit not from medication). When I spoke with the medical team at the infusion center regarding my choice of Reclast, they said that they have seen fewer side effects with that vs Prolia.

All that being said, you never know how an individual will respond to any medication. There are many people who have done very well on Prolia, and many people who aren't happy with Reclast. For reference, so far I've been on Fosamax followed by one year of Evenity, one year of Tymlos and did my first Reclast infusion in May 2025. So far, so good!
Best wishes to you!

Thank you for your reply. As you stated, given Prolia's negative impact on one's immune system, I think that explains 3 UTIs/bladder inflammation in 5 months. I've been taking it for 5 years. But my husband may be on the right track suggesting that I'm older now (74) and my immune system is most likely not as robust as it once was and I can no longer stave off infections I once was able to. I've never had a history of uti infections until recently. The one in May landed me in the hospital with sepsis.

I'm so sorry to hear that you've had such a rough time recently.

Yes, Prolia is associated with an increased risk of infection including UTIs - it simultaneously inhibits bone loss and immune function. I think your husband's assessment is spot-on in regards to your immune system not being as robust as it previously was. So you have a double whammy! I'm older too - almost 70 - and everything seems to be slowing down.

Do you intend to remain on Prolia, or are you considering other options?
Best wishes to you moving forward.