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Reclast, Actonel or Evista?

Posted by rudysmom @rudysmom, Apr 7 5:31pm

Went to my first of two different Endocrinologists appointments today. A nice enough Dr but didn’t seem interested in what I had to say, made comment about how he was the Dr. I understand that, but told him how my Gynecologist kind of blew me off. I told him that the Dr gave me diagnosis while I was driving my car and I had made comment about how I had been crying all weekend prior when I seen results in patient portal and that the Dr’s was response was “oh” then gave me choice of Prolia or Evista. The Endo Dr said, this isn’t a life threatening diagnosis it’s a lifestyle change diagnosis. I said ok, but as I started crying again I said, it’s not right to dismiss me. I mentioned magnesium and he said it’s a hype, I mentioned how calcium is only absorbed at 500-600mg at a time. He said that’s not necessarily true. Said only need to take 2 servings of calcium a day, glass of milk and cup of yogurt. In my head I was like what?? Mentioned K2 and he said, no it’s waste of money only the Japanese treat with that no one else. Told him I can’t tolerate Fosomax tried it 2 years ago when I had osteopenia and had severe lower back pain, couldn’t even roll over in bed. He said, but the pain went away right? Yeah after a couple of days. So he gave me choice of Reclast, Actonel or Evista. Told me to get some blood work, gave me a website to look at and look at which drug I’d like to try. He doesn’t like Prolia and said I’m not a high fracture risk so he doesn’t recommend, Evenity, Forteo or Tylmos. He said he was switching a lot of his patients to Reclast. I have next appointment with different Endocrinologist the 21st this month. Hoping to have a better experience.

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jw9 | @jw9 | 2 days ago
In reply to @cat1203 "I think you are wise to consult another endo. I personally couldn't deal with someone with..." + (show)
Profile picture for cat1203 @cat1203

I think you are wise to consult another endo. I personally couldn't deal with someone with his dismissive GOD attitude. I have an appointment with a new rheum next month. In her bio she talks about how she encourages patients to bring in any info and questions they have from their own research, support groups, etc. I hope she lives up to that.

I too was just told to take Fosamax when first diagnosed with just a one-page cursory "explainer" about osteoporosis and no info about possible side effects. I somehow came up with the idea that I could be on it for 5 years then have a drug holiday which I hoped/expected to be long, maybe even permanent. Ha! Even though your diagnosis isn't "life-threatening" as your endo put it, it's still upsetting and disheartening when you realize this is something you're going to have to manage for the rest of your life. Especially when there are potentially serious side effects with all the drugs.

In my case, I was on Fosamax for 3.5 years (with no side effects whatsoever) before I had another DEXA. I had no gains in BMD at all. It was still considered a "win" because I at least stayed stable, but the new PCPrecommended I see a specialist for a bone-building drug, and I went on Forteo, with some gain in BMD but not as much as I had hoped. So now I'd like to try Evenity because I still have severe osteoporosis and am considered a high fracture risk.

It sounds like your osteoporosis is mild (do you have your T-scores?). Since you had trouble with Fosamax, you might also with Actonel or Reclast, which also are bisphosphonates, with Reclast being the strongest. Also, if you do need to take an anabolic, bone-building drug in the future, the effect will be blunted if you've taken a bisphosphonate first (which is why I think I didn't have as much gain from Forteo as I had hoped). Evista might be a good choice for you.

I think you'll find this article helpful. https://medshadow.org/conditions-treatments/osteopenia-osteoporosis/osteoporosis-treatment-screening-medications/

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@cat1203
Excellent article and in-depth. Thanks!

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