Osteoporosis treatments: What did you choose?

Posted by tdawnandrews @tdawnandrews, Jun 6, 2019

I was recently scheduled to have back surgery but was cancelled when my dexa scan showed osteoporosis in my spine. The recommendation is that I begin Forteo treatment. Wondering if I need to get a second opinion or if this is common. Are there any other alternatives?

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@mint

Forteo vs. Prolia vs. Reclast?
At my recent DEXA, my lowest T-score was -3.3 (at lumbar spine). I previously took oral Alendronate for four years, and stopped in 2016. I haven’t taken any medication since then for the last six years. I’ve never had a fracture and I’m generally active and healthy and practice yoga almost daily. I have had ulcerative colitis in the past, but not active for many years. My endocrinologist recommended starting osteoporosis medication and gave me a choice between three options:
1) Forteo daily injections (followed by Reclast infusion)
2) Prolia every six months for 2-4 years, with re-assessment, and followed by Reclast infusion
3) Reclast infusion once a year for three years.
My understanding is that Forteo is the only one of these drugs that actually builds bone, so that may be best but I’m not keen on the daily injection. With Prolia, the bone density is likely to drop rapidly after stopping, requiring a course of Reclast immediately following. That leaves Reclast as my choice, but I’m still not sure if that’s the best option.
I’d be grateful for any information to help with this decision.
Thank you!

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Welcome @mint. With all the choices out there, it can be hard to choose the right treatment for you. For this reason, I moved your question about Forteo vs. Prolia vs. Reclast to this existing discussion:
- Osteoporosis treatments: What did you choose?: https://connect.mayoclinic.org/discussion/osteoporosis-treatments-1/

I did this so you can read the previous posts and easily connect with members like @notmoff @d1076g @sue225 @suze317 @mj20 @bee1950 and more. As @windyshores points out, there are more options than the 3 you listed as well.

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@sue225

Not video but vit d!

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I’m new here and I would like to know if anyone has issues with prolia. I’ve be getting prolia shots twice a year for 8 years. My dexa scan showed improvement. I have developed neuropathy gradually over about 3 years. Could that be a side effect of prolia?

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@jennyseven

I’m new here and I would like to know if anyone has issues with prolia. I’ve be getting prolia shots twice a year for 8 years. My dexa scan showed improvement. I have developed neuropathy gradually over about 3 years. Could that be a side effect of prolia?

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@jennyseven my doc is mainly concerned with the rapid drop in bone density and rise in fracture risk when Prolia is stopped, even for a break in treatment. Check with your doctor and the pharmacist on side effects, and maybe call Amgen, the manufacturer, to report it. I googled "prolia neuropathy" and here are some results, which suggest that low calcium might be the culprit while you are on Prolia, not the drug itself:

https://www.drugs.com/sfx/prolia-side-effects.html
List of side effects includes numbness and tingling.

https://www.ehealthme.com/ds/prolia/peripheral-neuropathy/ Study showed no peripheral neuropathy with Prolia.

https://www.inspire.com/groups/bone-health-and-osteoporosis/discussion/prolia-and-neuropathy/
Post on forum regarding Prolia side effect.

Another google result:
Is tingling a side effect of Prolia?
Tingling wasn’t specifically reported as a side effect of Prolia in clinical studies. But tingling may be a symptom of side effects such as sciatica and hypocalcemia. Sciatica is described as a shooting pain that travels from the lower back down a leg. Weakness and tingling can also occur.

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