Which specialist is best-Rheumatologist, Endocrinology, or Physiology?

Posted by ladydi22 @ladydi22, Jun 19, 2023

I am beginning this Osteoporosis journey. 2 yrs ago the Rheumatologist had some labwork done and a couple x-rays and said that Evenity would be the only choice for me in order to build bone mass. However I noticed it has a "black box" warning. I left her office stating I did not want to take any meds. In the last couple yrs my PCP ran a Vit-D which was low. I have been on prescription Vit D and my numbers are a fraction better except for my spine which has an old compression fraction from a fall at L1 and advanced degenerative disc disease.
Frankly, I am overwhelmed. I eat ok and do get out to walk, but I am thinking of seeing an Endocrinologist this time and a Physiologist who would prescribe an exercise regimen for me.
I don't want to take meds but I guess hormones (if needed) might be okay? Looking for anyone's feedback. THANK YOU
Also I read and research a lot which only confuses me more BUT I READ THAT THE AVERAGE WOMAN WITH NORMAL BONE DENSITY LOSES ABOUT 13% OF HER BONE DENSITY IN 10 YEARS OR ABOUT 1.3% A YEAR.... SO AREN'T WE FIGHTING AN UPHILL BATTLE??
LADYDI22

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Yes after menopause it is an uphill battle!
If you don't want to take Evenity due to cardiovascular risk, you could ask your doc about Forteo or Tymlos. I chose Tymlos instead of Evenity and had excellent results. Tymlos has an adjustable pen, so you can start at a low dose if you like and ramp up so that side effects are eased. You inject it yourself every day. It becomes like brushing your teeth.

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@ladydi22 I was diagnosed with osteoporosis about 15 years ago. I had been in the osteopenia range since my mid-40’s despite all the hiking, cross-country skiing, and weightlifting I had been doing for many years. I resisted taking any of the medications. My Vitamin D level was low so my doctor put my high doses of Vitamin D and I kept up with Vitamin D3, calcium, and magnesium. Since my mother had osteoporosis and by age 65 had compression fractures, was frail, and in a lot of pain I decided it was time for medication. I took the first line trial of Fosamax and did well with it. I figured it was a cost-benefit ratio. By the time I finished the Fosamax at 5 years of taking it my bone density score was back in the osteopenia range.

Here is how I look at alln. Once the tmedications are approved by the FDA the pharma company is to those present during the clinical trials and approval process. Notused the word “all”, thus resulting in the so-called “black box warnings”. If you read all of that information on every medication you could assume or believe that you will experience all of the side effects. In fact, that is rarely true.

Whatever specialist you do see you can discuss what side effects the specialist has seen in his/her practice and what you can expect. Taking medication isn’t a “get out of jail free card” and you have to do all the other lifestyle work to support your bone density including diet and exercise.

Whatever you choose to do may be different than what I chose. Do you have a referral to a specialist?

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Overwhelm is stifling and very important to deal with as osteoporosis is so multifaceted in approaches on how to deal with it. I would suggest if you could tap into Margie Bissinger , PT and Certified Health Coach it would be good. She focuses on the overwhelm, but additionally has hosted symposiums related to NaturalApproaches to osteoporosis and bone health. Excellent person to tap into to at least begin to deal with overwhelm to get your head in a better place.

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I’m traveling, I may be able to give you more direct info on tapping into her when I get home.

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@windyshores

Yes after menopause it is an uphill battle!
If you don't want to take Evenity due to cardiovascular risk, you could ask your doc about Forteo or Tymlos. I chose Tymlos instead of Evenity and had excellent results. Tymlos has an adjustable pen, so you can start at a low dose if you like and ramp up so that side effects are eased. You inject it yourself every day. It becomes like brushing your teeth.

Jump to this post

Thank you so much for replying with this info... I never heard of this med.

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@naturegirl5

@ladydi22 I was diagnosed with osteoporosis about 15 years ago. I had been in the osteopenia range since my mid-40’s despite all the hiking, cross-country skiing, and weightlifting I had been doing for many years. I resisted taking any of the medications. My Vitamin D level was low so my doctor put my high doses of Vitamin D and I kept up with Vitamin D3, calcium, and magnesium. Since my mother had osteoporosis and by age 65 had compression fractures, was frail, and in a lot of pain I decided it was time for medication. I took the first line trial of Fosamax and did well with it. I figured it was a cost-benefit ratio. By the time I finished the Fosamax at 5 years of taking it my bone density score was back in the osteopenia range.

Here is how I look at alln. Once the tmedications are approved by the FDA the pharma company is to those present during the clinical trials and approval process. Notused the word “all”, thus resulting in the so-called “black box warnings”. If you read all of that information on every medication you could assume or believe that you will experience all of the side effects. In fact, that is rarely true.

Whatever specialist you do see you can discuss what side effects the specialist has seen in his/her practice and what you can expect. Taking medication isn’t a “get out of jail free card” and you have to do all the other lifestyle work to support your bone density including diet and exercise.

Whatever you choose to do may be different than what I chose. Do you have a referral to a specialist?

Jump to this post

Thank you for taking the time to respond. I will definitely ask lots of
questions. I decided to see an endocrinologist and see what he has to say.
I know there is not a magical way to grt back to par but I want to explore
my options this time, and you gave me a new option to consider.

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@ladydi22

Thank you so much for replying with this info... I never heard of this med.

Jump to this post

@ladydi22 even at less than a full dose of Tymlos, I had a 20% gain in spine, going from severe osteoporosis to borderline, and 9% in the hip. Hope you can try it!

Many are doing Evenity after Tymlos but you apparently cannot do Tymlos after Evenity fyi.

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@ans

Overwhelm is stifling and very important to deal with as osteoporosis is so multifaceted in approaches on how to deal with it. I would suggest if you could tap into Margie Bissinger , PT and Certified Health Coach it would be good. She focuses on the overwhelm, but additionally has hosted symposiums related to NaturalApproaches to osteoporosis and bone health. Excellent person to tap into to at least begin to deal with overwhelm to get your head in a better place.

Jump to this post

Thank you for this new idea! How would I connect with Margie Bissinger? I
live in PA - would I call, email, or does she have aoots on zoom?

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@ans

I’m traveling, I may be able to give you more direct info on tapping into her when I get home.

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I would greatly appreciate it!

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@windyshores

@ladydi22 even at less than a full dose of Tymlos, I had a 20% gain in spine, going from severe osteoporosis to borderline, and 9% in the hip. Hope you can try it!

Many are doing Evenity after Tymlos but you apparently cannot do Tymlos after Evenity fyi.

Jump to this post

Thanks for the tip. I will talk to the Endocrinologist about this!!

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