Certainly not in all cases, but in my case and some people I know….
A primary care doc or ob/gyn doc sees the dexa scan results and says “you’ve got ____ osteo” and prescribes meds or options of meds, often bisphosphonates often based just on the Dexa results.
An endocrinologist will deep deeper. Do more labs, ask more history, look for trends, keep more data, etc. Maybe customize the meds recommendations based on your personal profile of all of the above.
I resisted drugs for many years. When I finally connected with an endocrinologist he provided me with so much more info that I finally felt comfortable or at least NECESSARY to start a meds regimen.
I went to an endocrinologist when my DEXA showed Osteopenia. She did have me do other tests (blood and even urine collection over the course of a day), to make sure my body was processing calcium and vitamin D properly.
She also pushed for me to take drugs. On my second visit, she said your natural methods are not working and put on my chart “refused treatment”(we did not get along) . She never even went through my medical history with me (my mother never broke her hip, I had no history of broken bones, etc.) She was horrible and said stuff like you want to be that old lady with the hunched back in a few years.
My PCP at the time, whom specialized in geriatrics and I loved, was much more helpful. She recommended specific natural methods, taking calcium, etc.
I do think that everybody’s journey with this is different. There is no one size fits all as there are so many factors involved.
I had a year of Evenity followed by Reclast to lock in the gains. Evenity was very effective and I had no side effects. Despite hydrating like mad and taking ibuprofin and tylenol alternating as advised 24 hours later I felt like I’d been hit by a truck and was running a fever. Happily symptoms did improve. I believe the plan is to do another DEXA scan after my year is up and decide from there when next Reclast infusion should be.
I was not impressed by my experience with Dr. McCormick. I felt he just wanted to sell me his supplements. I don’t have any obvious reasons for osteoporosis besides generally small bones.
I combine walking with jumping and lifting weights. I don’t enjoy the weight work, but everything I’ve read indicates that walking just doesn’t do enough for the spine.
Thx, mathmom, very helpful. I felt off and on feverish yesterday too. It’s good to have CC friends to steer the way, when IRL, I know no one having this treatment.
I am very interested in future treatments that involve gene targeted strategies and regenerative & cell-based approaches. They aren’t on the horizon near-term, but they seem promising. I am not interested in the current osteoporosis meds (for myself), but I know that they may be necessary for me down the road. I would much prefer that there be a better option if/when that day comes.
This is exactly how I feel. Because I won’t take meds right now even if my osteopenia progresses to osteoporosis, I see little point in updating my Dexa scan. It would be great if there were ultimately better treatments.
You can also do plain old jumps (up & down) or heel drops (up on your toes & come down hard). Every PT who specializes in osteoporosis workouts recommends this. It’s super easy to do them before or after taking a walk, while working in the kitchen (you can hold onto the counter if needed), or whenever you are. I do them without shoes if I’m inside, with shoes outside.
Sadly most studies show no improvements from weighted vests and those that do are seriously flawed. (Too few subjects, too short time wise.) Generally walking is only of limited use, heavier weights are the only thing that work for sure, building bones.
Since many broken bones from osteoporosis are caused by falls, anything that improves your balance and overall fitness are still good things to do.
Tymlos, Forteo and the first months of Evenity build new quality bone. I went from severe ostoeporosis to ostepenia of the spine in one year of Tymlos and after several fractures, have not fractured in 5 years.
I sometimes think forums and threads on osteoporosis need to be split into mild and severe. I mean, gee, I cannot lift weights or jump!
And meds are just not optional for me. I have done two years Tymlos, 4 months Evenity, one year Reclast, another year Tymlos, another 3 months Evenity and now Reclast. Cancer did this to me. My spine is so much improved but it is very hard to get at the hip. Spine was 20% better after one year and hip was 9%.
The important thing with meds is the proper sequence and unfortunately insurance companies like bisphosphonates and Prolia.
It’s very disheartening that insurance often prevents the optimal medication sequence. I think getting to a good endocrinologist is critical to getting optimal treatment. Around here that means waiting 6 months for the first appointment.
And if one wanted to further progress, a person could do their lunges and squats with a weighted vest.
FWIW, I own one and run with it along with doing squats, pushups and pull-ups with it.
All studies have limitations but IMO adding weight vest to one’s body puts a little more pressure on the skeletal structure, which should be good for bone density.
I was going to reply with that caution. I’ve had one - 12 pounds - for about 2 years. When I asked for it for Xmas, my DIL fussed and me - and also her Mom who wanted one - to be very careful. Her Mom’s friend was skipping while wearing one, tripped, fell, and broke her leg bad enough to be in a full leg cast for 6 months. I laughed it off. I told her I certainly wouldn’t skip. I’d be fine.
I got it and can see how it would happen. Maybe for men whose center of gravity is in their chest, adding 12 pounds there isn’t a big deal. For women, it’s in their hips, and I can DEFINITELY tell a difference. I felt completely out of balance. If you have osteoporosis and not optimal posture, I’d be especially careful. No skipping, lol…
Interesting, I’m glad that they are finally doing better studies regarding weights and osteoporosis. I do a lot of hiking with a day pack which I figure must be at least somewhat like a weighted vest!
