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Struggling with making an osteoporosis treatment decision
I am just struggling to make a decision about my treatment. I had my first bone density test and found I have osteoporosis. I have a couple of -3.2 vertebrae. My hip bones less problematic. I'm 60, active and fit. I've seen an endocrinologist and a rheumatologist who were both highly recommended. Both said "Evenity" before I barely sat down. But there is so little known about Evenity, and nothing known about its long term effectiveness or risk. I've read heart breaking posts from women who were advised to take Prolia with the same assurance and then had multiple debilitating fractures because so little was known/admitted about rebound risk. I am tearful and anxious and sleepless. I've been so healthy my body has carried me through so much life and adventure. I just don't know what to do , whether I'm putting me/my body at risk. Both doctors are paid consultants for Amgen. I feel hopeless and distressed. One of the doctors, although I said I wanted to consider my options, went ahead and got pre authorization for Evenity from my insurance "to show me how easy it would be". I feel cornered. My general doctor also has concerns about me being put on a relatively unknown drug when I haven't tried something like Forteo with a long track record.
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My Dexa testing was done at two different hospitals. They didn't give the same results. I am going by the one that is assoiciated with my spine surgeon. However, he can't fix my problem until my bones get stronger. That is why I am taking Evenity.
Hello @dianestanley. Thanks for clarifying your situation. Interesting that you did not have the same results, but then I have always been told that you should use the same machine for DEXA tests. Fortunately, I have been able to do that for many tests, over many years. I do hope Evenity will make your bones stronger, and quickly, so that you can take care of your spine. I'm sure it has been a painful experience. Take care.
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1 ReactionWhat did you scan in 2021 show after using AlgaeCal and Strontium?
@kathleenin texas, strontium will make bone density on the DEXA seem better than it is, because strontium replaces calcium in the bones and is heavier.
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1 ReactionExactly.. that is the reason I skip it. Same as Fosomax.. just adds poor bone quality. If it’s too good to be true……
Strontium affects the way the DEXA sees bone density. There seems to be some disagreement on its effect on bone quality. I wish there was more consistent info!
First, on the ranelate form, which says it builds bone as well as inhibiting resorption, so bone quality would be better than with Fosamax presumably : "Strontium ranelate acts through dual mechanisms of inhibiting resorption by osteoclasts and maintaining or stimulating bone formation by osteoblasts. It has shown only a modest effect in preventing recurrent vertebral fractures. " https://americanbonehealth.org/medications-bone-health/why-strontium-is-not-advised-for-bone-health/
Then there is this:
But doesn’t supplemental strontium strengthen weak bone? The jury is in: and the answer is, it does not!. In a 2016 clinical trial in Osteoporosis International of elderly patients with wrist fractures, supplemental strontium (alongside calcium and vitamin D) did not significantly improve healing within a few months of injury. However, most research indicating that strontium strengthens bones has referenced its positive effect on bone mineral density in patients with osteoporosis, not a single fracture.
Consider that quantity does not guarantee quality. Bone naturally contains minerals such as calcium, magnesium, and phosphorus. The mineral strontium has a similar electric charge to calcium and can take its place in bone. The more mineral in bone matrix, the more dense the bone. Strontium increases bone density, especially the thickness of the outer, or cortical, layer of bone. While this increases bone’s compressive strength, it does not improve and can actually lower bone’s tensile strength- the ability to elongate and flex under pressure. Lacking elasticity, bone becomes brittle like a dried up tree branch. Your fracture risk is higher with more brittle bone. Moreover, strontium is heavier than calcium, so lots of strontium in bone artificially increases your score on a bone mineral density test without improving tensile strength. https://caltonnutrition.com/strontium-does-not-strengthen-your-bones/#:~:text=Strontium%20increases%20bone%20density%2C%20especially%20the%20thickness%20of,becomes%20brittle%20like%20a%20dried%20up%20tree%20branch.
Aside from this issue, it was determined to increase cardiovascular risks and clots.
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1 ReactionI had not heard about cardiac issues, but makes perfect sense. Studies are few on the subject and take years to complete..so we do what we can with what we have.
Thank you for the follow up
Has anyone had a kidney transplant and taken any medication for osteo? Had an appoint with dr and he wanted to put me on Prolia which scares the dickens out of me because of the anti rejection medication I am taking on top of the already side effects I am experiencing. I hope side effects lesson up.
I understand people who have had a kidney transplant are faced with compound side effects. In 2023 It was my hope there would be a safe medication for osteoporosis for post kidney transplant or other. transplants. My diet is excellent I walk with weights on ankles and hips for at least an hour at least 3x weeks, take Vit D 7K. have normal weight and my kidneys are working with normal GFR (filtration rate ) numbers. Any suggestions? I am 73 years old, have no heart issues, normal weight for my height and age. Thank you.
Cecilia... What doctor(s) have you seen at Yale? I live in CT and am struggling to find a good osteoporosis specialist.
When all other meds made no difference, my primary referred me to CT Enterology in Branford. I didn't know that enterologists were osteoporosis specialists. I actually saw Karen Moriarty, an APRN, who prescribed Evenity which was new in 2021 and I was the first patient in the group on it. She, of course, worked with the MDs and they were pleased with my final results. I would recommend them.