Would Fosomax be your first choice of drugs to treat osteoporosis?

Newer thinking is to start with an anabolic medication like Tymlos, Forteo, or Evenity before a bisphosphonate like Fosamax. This is because a bisphosphonate can minimize the efficacy of an anabolic if taken first.

Also, your primary care physician is likely not knowledgeable enough to treat osteoporosis. Can you get a referral to an endocrinologist specializing in bone metabolism diseases?

Check out one of the many YouTube videos featuring Dr. Ben Leder on sequencing of osteoporosis medications.

Also, I was on Fosamax for over five years as my first osteoporosis medication. I fractured my spine anyways, even with a T-score in the osteopenia range.

I was also relying on hormone replacement therapy, weight lifting and exercise, nutrition, and supplements (calcium, vitamins D & K).

My PCP treated me for over five years. I am now seeing an endocrinologist and the standard of care provided is much higher.

This is a complicated disease. You want an expert overseeing your treatment.

I took Fosamax for about a year and a half in 2015, and during that time I developed persistent pain in both thighs. Unfortunately, the pain has never gone away and has gradually worsened over the years. Despite seeing multiple doctors, I haven’t been able to find relief or answers.

A friend of mine, who used to jog and hike regularly, was diagnosed with severe osteoporosis and later found to have celiac disease. After changing her diet—going completely gluten-free and alcohol-free—her bone density improved significantly, and she has now been reclassified from osteoporosis to osteopenia.

I was diagnosed in 2023 with osteoporosis with a spine of -1.2 and a left hip of -2.7, right hip -2.5 and my primary immediately put me on Fosomax. Within five months I started experiencing severe leg cramps. this was baffling because I take liquid magnesium and liquid electrolytes and have for years. In the next two months I developed severe heart palpitations. Since the meds I was taking was the Fosomax, I suspected that the drug caused these symptoms. My primary admitted that Fosomax can raise your calcium levels and upset your electrolyte balance. I knew then that the cause was the Fosomax. I stopped the drug and added twice the liquid magnesium to my daily intake. The symptoms started relieving within the next two weeks but it took months to build my magnesium stores back up. When I started seeing symptoms of too much magnesium (diarrhea) I went back to my regular dose. As others have stated, I shouldn't have been put on drugs with the low numbers I had and I realized my primary doesn't know what he doesn't know. I now read everything on this forum, and have educated myself. I will not take any drugs until or if I reach -3.5. I have a REMS ultrasound of my bones in November and a DEXA next February so will see where I am. I do weight training and take all the vitamins and Dr McKormick's fortibone collagen powder.

I would do what my physician says. Many internists and GOs are knowledgeable about bone density and treatment.