drug of choice for osteoporosis

[Happy DSr]

Hello All

please tell me about your drug of choice for osteoporosis

I am a 10 year successful vet, IMHO. Labs are all good, weight loss maintained, good health. But annual bone mineral density scans have shown a slow but continual decline. I just had my most recent scan and my PCP has called me in for an appointment. I think she want to talk medication.

I have been doing a version of Major Mom's recommendation - strontium, boron, K-2, mag citrate, and I take 150,000 D plus 3000 calcium citrate daily.

So if it is time for osteoporosis medications, what are the pros and cons of the options for those of us with malabsorption. What are your experiences and advice?

Happy



this thread was helpful, but an update would be great
http://bariatricfacts.org/threads/i-have-osteoperosis-now.906/

 

[southernlady]

My PCP went straight to the ones that can be infused, my choice was Reclast but the side effects can be wicked for a few days. Others are doing Prolia but that is twice a year. Then there is a version of Boniva that can be infused. Avoid oral meds.

 

[Clematis]

My friend's doc put her on Forteo as soon as she was DXed with osteoporosis. It has to be injected daily but only for 1.5-2 years. And it has to be refrigerated but can be packed in a soft sided cooler to travel... to a hotel with a fridge so forget about going on camping trips during treatment time. Yes it was a PITA but it turned her osteoporosis around far far better than other friends who took the other stuff. I don't know the cost but assume it's astronomical without insurance.

I fear I am heading in that direction as I have a very strong family history of severe osteoporosis, but so far I just have osteopenia.

Good luck!

 

[DianaCox]

"so forget about going on camping trips during treatment time."
RVs have fridges ... just sayin' ....

 

[Clematis]

Ha. Well, there's camping and then there's house-sized trailers with two bathroom RV-ing @DianaCox.

Actually my friend was most annoyed that she couldn't go to Europe as they never have hotel room fridges (at least none that I've seen). She did risk it in the last two months of treatment after calling ahead to the hotel in France as to whether she could store it in the hotel restaurant refrigerator... and whether it would in fact still be there when she went for it every day.

I believe she told me that if something happened and she couldn't take it (i.e. someone threw out her syringes or refrigeration failed) treatment was over, FOREVER. No "oh well I'll just start up again next week when I get back." You have to take it straight through the treatment and then you can never take it again.

 

[southernlady]

My friend's doc put her on Forteo as soon as she was DXed with osteoporosis. It has to be injected daily but only for 1.5-2 years. And it has to be refrigerated but can be packed in a soft sided cooler to travel... to a hotel with a fridge so forget about going on camping trips during treatment time. Yes it was a PITA but it turned her osteoporosis around far far better than other friends who took the other stuff. I don't know the cost but assume it's astronomical without insurance.

I fear I am heading in that direction as I have a very strong family history of severe osteoporosis, but so far I just have osteopenia.

Good luck!

Unfortunately Forteo is off the table for MOST insurance companies (esp Medicare based) cause they want you to try the cheaper options first.

 

[k9ophile]

My friend's doc put her on Forteo as soon as she was DXed with osteoporosis. It has to be injected daily but only for 1.5-2 years. And it has to be refrigerated but can be packed in a soft sided cooler to travel... to a hotel with a fridge so forget about going on camping trips during treatment time. Yes it was a PITA but it turned her osteoporosis around far far better than other friends who took the other stuff. I don't know the cost but assume it's astronomical without insurance.

I fear I am heading in that direction as I have a very strong family history of severe osteoporosis, but so far I just have osteopenia.

Good luck!

Yes, it is expensive. I used it after Boniva. I've had good results with both. I've been on a treatment sabbatical this year. I see the doc in September to see what's next. Southern Lady is right about orals. My doc hasn't wanted to use the once a year injections or even the twice a year due to the fact that if there is a bad reaction, it's going to be in your system for a while.

I hope you find something that works for you.

 

[k9ophile]

"so forget about going on camping trips during treatment time."
RVs have fridges ... just sayin' ....

Some people do the hiking and tent thing. My parents had an Airstream trailer. It was nice, but the fridge didn't work. Yours is much more inviting. Having done both, I'll skip the tent if I ever get an uncontrollable urge to give up hotels.

 

[Happy DSr]

not sure if like any of these solutions
- lose jaw bone while not absorbing the Bisphosphonates
- take daily shots of Forteo for two years, with refrigeration logistics to be managed, and hope it takes
- take annual shots/infusions and potentially deal with side effects for long time while drug works out of my system

It will be an interesting discussion with my doctor

 

[k9ophile]

It is fraught with risk. In that way, it is similar to choosing to have WLS. I don't regret choosing Boniva and Forteo. I approached it like my DS: with tons of research, careful consideration, and seeking informed professionals.

Best wishes for the option you choose. Sadly, the older we get the harder it is to make sure we're doing the right thing. Sometimes, I long for the days when my only problem was deciding what to wear for the day with the knowledge I could make any changes I wanted in five minutes.

FWIW, the refrigeration logistics weren't difficult. My doctor gave me a cooler bag designed just for Forteo. I always checked a hotel for a refrigerator. We stayed on the Biltmore Estate after confirming that we'd have that in place. The rooms do not have refrigerators, yet there was a nice mini-fridge tucked in the room unobtrusively. The bag had instructions for the cooling packs on when to use them after cooling in the fridge or freezing them depending on the time you'd be transporting. There also was literature to show to airport screeners.

 

[DSRIGGS]

So I guess I should probably get a Dexascan with all my issues that I have had with absorption and I will be 4 years post Virgin DS in September. I am assuming I can just ask my PCP to schedule one of these, or do I have to go to a specialist? I am wondering if because I am male that the insurance company will try to deny?

My wife fell and hit her head a good 6 months ago and she is still having these sharp pains that only last for a few seconds and then go away. They have
increased in frequency so she went to a Neuro who wanted an MRI. Insurance denied saying that she needed a CT before they would approve. That pisses me off as they did that with Cameron's initial PET scan when his cancer was found. Why order a fu**ing CT and more radiation when not necessary?? So her Dr is now fighting with BCBS to approve that the MRI that she wants, not a damn CT that she did not order for a reason.

Anyway, just wondering if simply ask my PCP and how expensive of a test it is so if I should expect a fight? Thanks

 

[k9ophile]

@DSRIGGS Shop around. I was surprised to learn my local physician has a dexa-scanner in his office. I can't remember what he charges, but I was amazed to learn it was under $100.00. I wish the same could be said for CT scans and MRIs.

 

[DSRIGGS]

Yeah, I know he doesn't have one as his office is old but I have two hospitals locally that have all the technology in the world. It will cost $150 max for an outpatient procedure. Just wasn't sure how hard it is to get approved, but sounds cheap so shouldn't be too much of a fight, I wouldn't think.

Thanks

 

[Petunia]

I had three injections of Prolia when BCBS wanted a Bone Density to see if I improved any. There was no significant improvement so they won't approve any more. I go back in September to see the endo to see what our next step is.

 

[DSRIGGS]

Is an Endocrinologist who one sees for bone osteoporosis? I would have thought a PCP or Orthopedic Doc.