Why no bone marker tests before starting alendronate?

I agree that these tests should be standard before starting meds - if only to confirm that the right meds are being prescribed. I know someone who was prescribed Bisphosphonates and insisted they check first. Turned out these were totally the wrong meds so Dr switched the prescription.

My dexa was 3.3 so they want me to start fosamax...what is an hrt

@gently I agree. At the time, I was not as educated about osteoporosis so I didn’t bother to question it. It’s great that we have forums like this where people who are newly diagnosed can be made aware that they should be seeing a specialist right from the start.

@richandjanice Hormonal Replacement Therapy

@gently You are correct that more people should appeal insurance denials. I watched an online presentation on this subject about a year ago and the figure of those who appeal is low and the number of those who win on appeal is high.

Insurance counts on people not feeling well enough or having the time to make an appeal. The onus is on us. Clinicians will have to be involved to provide backup for our claim to coverage but we are often the ones who initiate the process.

If anyone is interested, there is an organization called Triage which does outstanding work on health insurance and other financial issues facing cancer patients but others as well. Here is a link to one of their resources on Appeals:
https://triagecancer.org/quick-guides/health-insurance-appeals
I believe Triage has its annual online presentation of various financial issues coming up in the next week or soon:
https://triagecancer.org/conferences

@sueinthelou I also agree that it makes sense to test the bone markers before starting meds. When I asked my doctor about this he said no, that's not the standard protocol (not much of answer!) and that they would test after I'd been on the bisphosphonates for a period of time. Since my DEXA was -.25 I'm holding off for now and continuing with strength training, supplements and impact training (jumps etc).

@jodywell
I am also holding of off the meds for now. My endocrinologist has agreed to the bone marker tests. I did them Monday and waiting for the results. She is suggesting Reclast for me but I’m not 100% on board as of now. I have ramped up my exercises and jump squats and heel drops are now part of my daily routine (along with a bunch of other stuff, diet and supplements). I plan to retest in 3mo and 6mo using OsteoIQ because Medicare only pays for them once a year. I will then see if my interventions are working and make a decision. I think my dr thinks I’m stupid but she goes along with me which is good.

@sueinthelou Wishing you all the best! It seems meds are the default for most doctors and, like you, I’m not ruling them out forever, just for now, I’ve asked for and received a referral to an endocrinologist and now waiting for an appointment. Keep up those jump squats! 🙂

@sueinthelou, I hadn't heard of https://osteoiq.com/. The two markers CTX and P1NP are less pricy at https://www.jasonhealth.com/ $148 for both tests. But then you wouldn't have access to the osteoiq interpretation. If you go through osteoiq, let us know how they interpret the bone markers. We'd love to see your marker numbers if you are comfortable telling.
Medicare only paying for one set per year defeats the best use of the markers which is to determine if a medication is working for the patient. It will be good to know if your routine is effective. Very informative post for me, thanks. But my favorite part "I think my dr thinks I'm stupid but she goes along with me which is good."

@gently
Thanks for the heads up about JasonHealth. I was not aware of that company. I will definitely bear in mind when I repeat the tests in 3mo. I’ll let you know how I get on with the diet/exercise routine. 🤞🤞.