What a difficult decision, especially for the elderly. My mom is 86 and just finished a 12 month course of Evinity. Fortunately no side effects but no real change in density. Her Doc wants her to start Prolia. The potential side effects are SO awful she is extremely hesitant. Im no medical denier (im a dentist by trade) but looked into it and shes right. Some people have terrible side effects in trade for minimal benefit. She may do nothing further and honestly i support that. Seems many of these drugs benefit 60 year olds the most.
Seem to miss a key point that although these drugs increase bone density, it’s not the flexible type bone that is desired but rather brittle bone. Why not promote things that actually build healthy bone such as D, K2, protein (collagen) rich foods?
After suffering a wedge fracture of my T12 vertebra I was diagnosed with osteoporosis. I did a lot of research and I'm not susceptible to the "what doctors won't tell you"type of information. One thing that surprise me when I started reading pubmed, JAMA and other such journals was that results of bisphosphonate studies such as the FIT study (one of the largest osteoporosis studies) the results are expressed in relative risk reduction rather than absolute risk reduction. If for example you gave 100 people a drug and two people in the placebo group still suffered a broken bone while only one person in the experimental bisphosphonate group suffered a broken bone you would have a relative risk reduction of 50% but an absolute risk reduction of one. In the FIT trial for example with over 2000 post menopausal women with existing vertebral fractures for clinically apparent vertebral fractures followed up over 36 months, 23 (2.3%) in the alendronate group and 50 (5.0%) in the placebo group experienced a further fracture. This is roughly a 50% relative risk reduction but an actual reduction of only 27 people out of 2000. In hip fractures there were approximately 44 hip fractures in the placebo group and 22 hip fractures in the Bisphosphonate group. in that study ages range from 55 to 81. That means you may have a tennis playing active 55 year-old woman in the study and also an 81 year-old overweight under exercised woman living in a home for the elderly all mixed up into one big statistic. And of course an 81-year-old having a hip fracture is more likely to suffer complications then a 51-year-old. The problem with a study like this is that so many other factors are hidden by the statistical nature of the study. I don't think it's right to assume this means any individual should or shouldn't take bisphosphonates but rather you have to consider your situation compared to the statistics both for prevention and complications and make up your own mind. It has been suggested that for hip fractures it would be more effective for people to practice balance exercises on a regular basis which would have a greater effect than medication as a vast majority of hip fractures are the result of falls from losing one’s balance. Another issue I question is that frequently drugs are measured in their effect on bone mineral density BMD. A bisphosphonate may stop bone mineral density loss, but that is not the same as bone integrity. Bisphosphonates work by slowing down the production of osteoclasts which normally reabsorb micro fractures in bones so that when osteoblasts come along and build bone they are building bone on a healthy substrate. If the osteoclasts aren't doing their job then you are building new bone over microfractures. Each person must seriously consider their own situation and understand the variables involved, it’s not so simple as to say take this medicine and you will be okay.
I’m 60, my t score of the femoral neck was -2.4 in 2019, it’s now -2.0. Doctor said I have osteopenia, I have celiac disease that wasn’t detected til I was 47 and my vitamin D level was 11 back then. The report says my risk of hip fracture in 10 years is 7% 🤷♂️
Missed opportunity to mention denosumab as compared to traditional bisphosphonates. And also, the use of these compounds in the bone cancer/metastasis setting when lytic lesions are also impacting the integrity of skeletal structures (particularly load baring).
Low levels of testosterone and estrogen decrease bone density substantially. Even as a young man in my 30’s, low testosterone gave me osteopenia (almost osteoporosis). My doctor told me that natural hormone therapy (which I’m now on) would be the most effective treatment. I wonder why this isn’t offered to women? I realize there was a concern about cancer with artificial steroids. But these days you can get natural hormones from compounding pharmacies. That’s worth considering for post-menopausal women (100% of whom have both low estrogen and low testosterone).
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I have osteoporosis, after 5 years of treatment there was no improvement on my bone density. Now my health ins no longer covers Prolia. My Dr recommends I take 6 calcium tablets a day and Vit D3. That doesn’t seem right to me. Where do I go for help?
Forteo may help. I was on it for two years and my bone density got better estrogen for one year now at 65. I’m doing another bone density scan after some time. I was severe osteoporosis maybe 5 yrs ago. Forteo was great. I am going to be seeing a doctor tomorrow about the osteoporosis I have and I really don’t want to take any of the other medication‘s like Fosamax and some of the others have a lot of side effects. I want to go back on the Forteo and stay on it, there was a two year limit before but I believe now that has been lifted. I’m just don’t know if they’ll offer it.
June 26 broke my femur behind the Greater Trochanter stem 6/27 did a anterior hip replacement. Almost 9weeks out on cane now. Was in good shape going in. Osteoporosis taking Atendonate. 81 years female . Diet recommendations? I am Carnivore but I mean supplements?
At 52 I've got osteoporosis. As a male who has lifted weights for 30 years, doesnt smoke or drink and eats well I dont want to take bisphosphates. After using them for a few years then what happens?
What a difficult decision, especially for the elderly. My mom is 86 and just finished a 12 month course of Evinity. Fortunately no side effects but no real change in density. Her Doc wants her to start Prolia. The potential side effects are SO awful she is extremely hesitant. Im no medical denier (im a dentist by trade) but looked into it and shes right. Some people have terrible side effects in trade for minimal benefit. She may do nothing further and honestly i support that. Seems many of these drugs benefit 60 year olds the most.
It's a very good point. Yes, you understand the problem well; it's not “medical denial” to see the real challenges here.
Seem to miss a key point that although these drugs increase bone density, it’s not the flexible type bone that is desired but rather brittle bone. Why not promote things that actually build healthy bone such as D, K2, protein (collagen) rich foods?
After suffering a wedge fracture of my T12 vertebra I was diagnosed with osteoporosis. I did a lot of research and I'm not susceptible to the "what doctors won't tell you"type of information. One thing that surprise me when I started reading pubmed, JAMA and other such journals was that results of bisphosphonate studies such as the FIT study (one of the largest osteoporosis studies) the results are expressed in relative risk reduction rather than absolute risk reduction. If for example you gave 100 people a drug and two people in the placebo group still suffered a broken bone while only one person in the experimental bisphosphonate group suffered a broken bone you would have a relative risk reduction of 50% but an absolute risk reduction of one. In the FIT trial for example with over 2000 post menopausal women with existing vertebral fractures for clinically apparent vertebral fractures followed up over 36 months, 23 (2.3%) in the alendronate group and 50 (5.0%) in the placebo group experienced a further fracture. This is roughly a 50% relative risk reduction but an actual reduction of only 27 people out of 2000. In hip fractures there were approximately 44 hip fractures in the placebo group and 22 hip fractures in the Bisphosphonate group. in that study ages range from 55 to 81. That means you may have a tennis playing active 55 year-old woman in the study and also an 81 year-old overweight under exercised woman living in a home for the elderly all mixed up into one big statistic. And of course an 81-year-old having a hip fracture is more likely to suffer complications then a 51-year-old. The problem with a study like this is that so many other factors are hidden by the statistical nature of the study. I don't think it's right to assume this means any individual should or shouldn't take bisphosphonates but rather you have to consider your situation compared to the statistics both for prevention and complications and make up your own mind. It has been suggested that for hip fractures it would be more effective for people to practice balance exercises on a regular basis which would have a greater effect than medication as a vast majority of hip fractures are the result of falls from losing one’s balance. Another issue I question is that frequently drugs are measured in their effect on bone mineral density BMD. A bisphosphonate may stop bone mineral density loss, but that is not the same as bone integrity. Bisphosphonates work by slowing down the production of osteoclasts which normally reabsorb micro fractures in bones so that when osteoblasts come along and build bone they are building bone on a healthy substrate. If the osteoclasts aren't doing their job then you are building new bone over microfractures. Each person must seriously consider their own situation and understand the variables involved, it’s not so simple as to say take this medicine and you will be okay.
It’s important to note that bisphosphonates can reduce bone loss a little, but will not reverse it
Yes. Thanks
I’m 60, my t score of the femoral neck was -2.4 in 2019, it’s now -2.0. Doctor said I have osteopenia, I have celiac disease that wasn’t detected til I was 47 and my vitamin D level was 11 back then. The report says my risk of hip fracture in 10 years is 7% 🤷♂️
Thanks for sharing. Good luck on next steps.
Missed opportunity to mention denosumab as compared to traditional bisphosphonates. And also, the use of these compounds in the bone cancer/metastasis setting when lytic lesions are also impacting the integrity of skeletal structures (particularly load baring).
Low levels of testosterone and estrogen decrease bone density substantially. Even as a young man in my 30’s, low testosterone gave me osteopenia (almost osteoporosis). My doctor told me that natural hormone therapy (which I’m now on) would be the most effective treatment. I wonder why this isn’t offered to women? I realize there was a concern about cancer with artificial steroids. But these days you can get natural hormones from compounding pharmacies. That’s worth considering for post-menopausal women (100% of whom have both low estrogen and low testosterone).
You're Very Welcome! Join Our Live Broadcast Every Wednesday! @11am EST. For more information please visit our website prevmedhealth.com/ & www.jubilee.health/. To learn more watch our videos on UA-cam ua-cam.com/channels/moEsq6a6ePXxgZeA4CVrUw.html
I have osteoporosis, after 5 years of treatment there was no improvement on my bone density. Now my health ins no longer covers Prolia. My Dr recommends I take 6 calcium tablets a day and Vit D3. That doesn’t seem right to me. Where do I go for help?
There is actually a lot of evidence that shows you don’t get further benefit beyond 4 or 5 years.
Forteo may help. I was on it for two years and my bone density got better estrogen for one year now at 65. I’m doing another bone density scan after some time. I was severe osteoporosis maybe 5 yrs ago. Forteo was great. I am going to be seeing a doctor tomorrow about the osteoporosis I have and I really don’t want to take any of the other medication‘s like Fosamax and some of the others have a lot of side effects. I want to go back on the Forteo and stay on it, there was a two year limit before but I believe now that has been lifted. I’m just don’t know if they’ll offer it.
so ...what are you saying about bisphosphonate ?what is the optimal duration of treatment ?
It isn’t clear yet. But 4 years is looking good at this point.
Thank you very much for the very helpfull information
Thanks. I hope you are well.
June 26 broke my femur behind the Greater Trochanter stem 6/27 did a anterior hip replacement. Almost 9weeks out on cane now. Was in good shape going in. Osteoporosis taking Atendonate. 81 years female . Diet recommendations? I am Carnivore but I mean supplements?
At 52 I've got osteoporosis. As a male who has lifted weights for 30 years, doesnt smoke or drink and eats well I dont want to take bisphosphates. After using them for a few years then what happens?
Once you start any osteoporosis medication you can never stop
@@gate-gate6863 That's not true - 4 to 5 years on a bisphosphonate then you stop. As he said, the drug remains in your bones.
I don´t understand a Word of what you tell….. could you tell it more understandabel…?
Sorry. We have done a lot of work in that space over the past couple of years.