I was diagnosed with osteoporosis in July 2020. I am confused as to which doctor I should consult for treatment. My primary care doctor wants me to take Fosomax. I want to wait until my heartburn issues are resolved before starting Fosomax, since heartburn is one of its side effects.
My primary care doctor recommended that I see an endocrinologist. My gynecologist said I should talk to a rheumatologist and she thought my T-scores were not that bad. My gastroenterologist told me I should go for the injections (Prolia) instead of Fosomax because he thought given my history with heartburn I would very likely have heartburn problems with Fosomax. My hip surgeon who did my right hip replacement in 2019 thought that I should start Fosomax now because I am only 54 and have time to build up my bones. Every doctor has their opinion, but first I need to schedule an appointment with a specialist to help me decide. I don't know which doctor to see, an endocrinologist or a rheumatologist?
Right now, I am taking calcium and D supplements and trying to exercise, follow the COMB study protocol, and see if my scores will improve. I know eventually I will have to go on Fosomax or some medication. My T-scores were: lumbar spine -3.0, femoral neck -2.3, hip -1.9, and 10-year fracture risks were: major osteoporotic fracture 5.6%, hip fracture 1.1%.
I would appreciate any advice as to which doctor to see and what your experiences were. I'm just not sure where to begin or if my scores are that bad. Thank you!
Periodontal disease, bone loss and osteoporosis 
Very nervous about taking Reclast
Diagnosed with osteoporosis.
Can you really reverse osteoporosis naturally? 
I have read that taking a medication which is associated with GI side effects is not advisable when one has an existing similar condition. According to a presentation by Dr. Dan Solomon compliance with any medication that has GI side effects is only 50%.
In this presentation Dr. Susan Ott cites a study which concluded HRT is more effective than Fosamax. Has this option been discussed?
uwmedicine.org/provider-res...
Have tests been done to rule out secondary causes of bone loss? The experts says that 50% of postmenopausal women have an underlying condition which contributes to bone loss.
Are you petite, small-boned by any chance? If so, one's DXA may be skewed - that has been my personal experience.
Your fracture risk is not high - as 90-95% of fractures result from falls even at a young age of 54 it is never too early to take precautions to avoid them! Learning proper movement patterns and form such as a hip hinge instead of spinal flexion would be helpful. Dr. Paul Miller notes most vertebral fractures occur from ADLs - Activities of Daily Living.
Hil lilo, Thank you for the link to the presentation! The information is very helpful. I am small-boned and on the petite side. My primary care doctor reviewed my bone density scan results and went right into recommending Fosomax. She did not ask me any questions or checked for secondary causes for bone loss. I will definitely bring that up when I see a specialist. Thank you!
Please watch this presentation by American Bone Health and listen to their comment at the 27.04 mark. vimeo.com/455293430
lilo, this link doesn't work. Can you tell me which video you're referring to so I can find a working link? thanks
Thank you for your assistance, Mark! From the screenshots it appears the presentation discussed ABH's previous Fracture Risk Calculator. My notes from the presentation: "Osteoporosis is one of the risk factors for breaking a bone but it only accounts for a portion of the overall risk." 18:10 mark. Cortisol blocks absorption of calcium at which decreases bone cell growth. 27:04 mark "Bone density is a volumetric measure and will underestimate the bone strength of someone of small stature."
Thank you! I'll try to figure out which video that is and post a link.
This article explains how we small-boned individuals have skewed DXA scans. rienstraclinic.com/newslett...
You are a wealth of information! Thanks!
You're most welcome!
I was interested in your reply when you said, “Are you petite, small-boned by any chance? If so, one's DXA may be skewed - that has been my personal experience.”
I know that small-boned, slight built women do have tendency to get osteoporosis ski was not surprised that I was diagnosed with it recently but I haven’t heard anything about diagnoses being skewed. Can you tell me more what that meant for you? Thanks.
Sorry, I see a conversation continues in this issue and I’ll read that. Sure it will be informative.