Medication efforts:

@cloud60 are your bones bad enough that you could get coverage for Tymlos, Forteo or Evenity? I could not tolerate bisphosphonates and insurance may cover the other meds if you try one or two bisphosphonates (that you listed) and cannot tolerate them. Prolia may be a possibility but eventually you would have to switch to a bisphosphonate after Prolia.

My bones are bad enough but it would take a special letter I guess from my endo to the insurance. So far the endo I’ve had hasn’t advocated for me well enough. Maybe there is a special form I have to get for exceptions from the insurance but my insurance called me and said I have to do what they say is a step program where you try each of their medications in steps. ( which is their list of cheapest to most expensive) The first was daily fosamax. The next is Boniva tablet. Which I don’t want bc it’s 30 days in your body and I can’t tolerate weeks if side effects. I only want to try a daily anything pill or shots. Because I need to be able to stop if it’s bad.
I would never take Prolia bc my Endocrin said it’s the only one you are permanently on medication from

I hope your doctor advocates for you, if your DEXA's are seriously low. Does your insurance still have the step program if osteoporosis is severe? Your doc should be able to explain the need for bone builders like Forteo, Tymlos or Evenity rather than the bisphosphonates. In fact the bone builders have been shown to work better when used first.

Prolia is not permanent. You just can't stop it without going on a bisphosphonate like Reclast, Fosamax etc. for a time. One poster here is doing one dose of Reclast OR a year of alendronate, after Prolia and posted a study n this in another thread.

When you stop Prolia, there is a rebound drop in bone density and increase in spinal fractures unless you do another med, possibly just short term. But you have to be careful about the timing of that switch- not too early and not too late.

Windyshores, I appreciate all your informative responses. I've ready many on different threads. What I have not found yet is: what DEXA score range is considered severe. Doctors lump all "osteoporosis' scores together, yet it is clear that there is a range and med decisions should take this into account.

I was told recently that (bone-building) meds are definitely needed below -3.5. But if they are trending down, start earlier. Most of us are trending down! I would, personally, consider meds at -3.0. Specifically Forteo, Tymlos or Evenity.

There is a diference between treatment and prevention strategies. I think most docs have stopped medicating osteopenia.

The real problem is that insurance wants us to "fail" one or two bisphosphonates or Prolia before allowing the bone builders. And I have read that those meds can affect the effectiveness of the bone-builders to some extent.

Thank you. One other question: any studies that indicate whether osteoporosis can stop progressing at a certain point. That is what seems to have happened with me: -3.1 same after 6 years according to DEXA. I am 80 now.

You might be doing medicine,
Supplements or weight bearing exercise?

If you are asking me about my apparently stable DEXA results, I should have said I have not taken any meds despite constant advice from PCP--standard insistence on need for meds. In addition to diet, I take calcium, D3, K2 (recently only) in amounts to supplement what I can't eat (not great appetite and chewing problems). I exercise in gym 2-3 times a week for strength bearing work.

in reply to vabird
I think that your experience is precious. It can be of help to many others, and it is interesting to understand what makes you so special. It almost impossible to do it without a study with other participants like you, and this is possible only of clinicians would be interested.
I would like to ask you, how many years before you were diagnosed with osteoporosis ?

I was diagnosed at age 69 with osteoporosis score of 2.8. 5 years earlier it was osteopenia. 5 years later is was 3.2, and 6 years later 3.1 (I consider this the same.) All on same machine.
These ages seem to be older than some women I am seeing, and I am seeing much worse scores at times.
Yes, no research being done--just lump everyone together, even if risk vs benefit of meds can be quite different.