Should I take Reclast?

[cigarbox]

I am concerned about taking Reclast. Any thoughts from anyone ? My bone density is in the -2. range. Is it more extreme than Fososmax? Just can't make up my mind about it because of the side affects. And Dr, thinks I definitely should.

[Met00]

Have you tried Fosomax? Your bone density doesn't sound too bad (although it depends which end of the -2 range it is, for example -2.9 (osteoporosis) is quite different from -2.0 (osteopenia). Have you had any fragility fractures? If your bone density is close to -2.5/-2.6 (just osteoporosis) or between that and -2.0, then if you haven't had any fractures I'd wonder why you're being prescribed meds.

[cigarbox in reply to Met00]

I have had two compression fractures due to pretty bizarre incidents falling very hard on concrete about 15 years or more ago and no problem with fractures since. My lumbar spine is -2., hip is-1.9 and neck is -2.3 I took fosamax about 5 years ago for a couple years and will not put me on it now because of occasional acid reflux. I am told it is the factoring in of my age of 71, fractures, and being slender. Appreciated your reply.

[Met00 in reply to cigarbox]

Those are amazingly good scores at age 71! If they're counting your fractures from so long ago, I can understand them wanting to prescribe, but if those weren't fragility fractures then I can't see that you have any real risk factors that would suggest the need for meds. Do you have a copy of your DEXA scan report? In the UK we're giving a fracture risk score as part of that (eg 10% risk of fracture in the next 10 years). I'm not sure whether that happens automatically in the US, but if not, or you don't have your report, you could check it out for yourself (make sure you change the country to North America/US on the Calculation Tool drop down link at the top of the page): sheffield.ac.uk/FRAX/tool.aspx

[Mark_ABH in reply to Met00]

Cigarbox, you can also use the American Bone Health Fracture Risk Calculator. It's validated specifically for U.S. people ... americanbonehealth.org/calc...

[Augustine1951]

Having been a victim of prolia rebound I have done a lot of research on all these drugs. Reclast is a strong suppressor of bone turnover which means suppression of remodeling. Including bone formation. They are useful drugs for those at high risk of fracture. However once you start them your body is no longer remodeling bone in a normal way and the lag effect of the bp drug extends beyond the prescribed period. You can also make progress in maintaining bone density with exercise and proper diet and supplementation. I would get more than one opinion at your scores. I am unclear if you lumbar spine is - 2.0 or -.2. There are also anabolic options which make new bone rather than suppressing turnover but some must be followed by a bisphosphonate. You can also take the FRAX fracture risk test on line to see your risk. Not sure how t would address a traumatic fracture of the spine v a fragility fracture. Whatever you do read up on these drugs and their mechanism of action and ask questions. Good luck.

[cigarbox in reply to Augustine1951]

Thank you so much for your input and experience . Will keep asking questions.

[Mark_ABH]

Hi Cigarbox, thank you for sharing your story. All the responses so far are very sound and helpful.

I would add something that popped up this week in the literature and applies to you. Traditionally, traumatic fractures were considered not to be predictive of future osteoporotic fractures. However, a new study says both traumatic and nontraumatic (low-impact) fractures should be considered in treatment: healio.com/news/endocrinolo...

Your scores do seem pretty good for someone of your age and slight build. As I said above, you should use a risk assessment tool to get a full picture of your fracture factors.

Good luck!

[Met00 in reply to Mark_ABH]

That's an interesting study, although it would worry me if that approach led to anyone who has a fracture, no matter what the cause, being considered at high risk for future fracture and therefore being prescribed medication. Most of the examples of fracture due to trauma suggest higher risks of fracture due to the activities being undertaken. For example if you go skiing, you'll be at much higher risk of fracture than someone who enjoys a walk round their local park! Even something like falling down the stairs may suggest that the individual's sense of balance and/or co-ordination is not as good as it may be and therefore, once it's happened once, that may raise the risk of it happening again. On the other hand, something like a car accident that wasn't your fault surely can't raise the risk of future fracture?

I assume that, should a post-menopausal woman have a fracture due to trauma, they would first be given a DEXA scan to check their bone density before prescribing medication. However, most post-menopausal women are likely to have osteopenia, rather than the bone density of a 30 year old. Combining that with a fracture, under the current system, would then sound warning bells and almost certainly lead to prescribing medication. I think this would be entirely wrong. It's one thing to be concerned about fragility fractures, which are a good indication of weak bones, but to be concerned about traumatic fractures, that would occur regardless of your age or bone density, would lead to an irresponsible level of prescribing.

[cigarbox in reply to Met00]

I completely understand....that is the dilemma. I earlier stated that I had fallen 15 years ago and did not mention the second fall. Really didn't think it was significant but as I am hearing from several people beginning to think it IS significant. The first fracture was in 2004 and was caused by literally running into a garage door coming down and it threw me to the ground(cement) with tremendous force! ( I hopped out of car to run in at the last minute and husband didn't know I had to go back inside before we left and started to put the door down and I didn't see the door.....hit my head which threw me down.......you had to be there). Second time was retrieving something in our large sized Ford pickup truck and as I was stepping down out of the back of the bed (the wrong way my husband tells me later) I slipped and fell again on concrete....both times were landing on my bottom. That fracture was in 2012 I think. I suppose the last fall is debatable as to trauma. I do have a sore back now. Was on Fosomax for about 7 years after the first fall even though I was osteopenia. Went off of it when they decided you should not take it that long. Took s break and then was talked into taking it again about 5 years later for a couple of years. Then stopped that. I am pretty sure this is too much information but wanted to clarify. You are so kind to respond. According to the link Mark_ABH sent I might indeed be in need of medication. Wish my endocrinologist would at least ponder more than a minute and discuss more with me. Maybe to him it is a no brainer. sigh.

[Elsa1056 in reply to Mark_ABH]

Thank you for posting this study. I am just in the osteoporosis range at -2.5. I sustained a traumatic right wrist fracture requiring surgery 4 years ago. I recently fell and fractured my left wrist also requiring surgery. I am not on medication but have been diligent with exercise, nutrition and supplements. While I’m not keen on starting a bone med it certainly will be discussed when I next see my endocrinologist.

[cigarbox]

Wow! That is really a new outlook on traumatic versus non traumatic fractures. I very much appreciate you sending the link to the article.

[CincyCello]

I am a slender, 64 yr old Caucasian female with osteoporosis. I am on Reclast therapy and have had 3 infusions so far with no side effects; it's an easy treatment. I tried the oral Fosamax 13 years ago and could not tolerate the painful stomach issues. I'm hopeful the Reclast will slow the progression of bone loss.

[cigarbox]

Thank you for your reply! So glad to hear a good report. Since you’ve had three infusions have you had a bone density scan somewhere along the line that could give you an idea how it is working? Thanks.

[Bet117]

Hi Foreyes,

I have had 6 successful doses of Re-Clast. My most recent was in May after a 4 year gap. To date I have had no side effects.

I made sure to drink plenty of water prior to the infusion, take my calcium and drink 50-60 oz of water daily since.

My doctor ordered the infusion be given slow drip over an hour as opposed to the regular 15 minutes to enter my system more evenly.

If you have any doubt or other conditions that concern you, have a talk with your doctor about them any possible side effects and if he/ she will be willing to order follow up labs to keep check.

Hope this helps. I know that it is a difficult decision, but for my needs, I have found this to be the best solution.

Please reach back and let me know how you are doing and know that you are not alone.

Bet

[FearFracture]

-2 is osteopenia. I recently took my first dose of zoledronic acid. My lumbar spine T-score was -3.9 in 2019 and my doctor put me on alendronate (alendronate, reclast, zoldronic acid are all bisphosphonates). In July 2021, I had my 2nd DEXA scan and my lumbar spine T-score was -3.7 so really not an improvement although my Dr. didn't present the info that way until today. I had and appt earlier and after having done a bunch of my own research I discovered that going from -3.9 to -3.7 is not significant and might be the machine (so not even real). I have never had any fractures. If I had been diagnosed with osteopenia, I would never have taken meds right away, I definitely would have tried a natural solution. And unless you have digestive tract issue (heartburn or acid reflux) you should try alendronate before jumping in and getting an infusion of reclast (zoledronic acid) or prolia. Additionally, although not approved in the US (but NASA funded part of the research) you should check out LIV (low intensity vibration) therapy marodyne.btt-health.com/ I just discovered this yesterday, and when I went to my endocrinologist this a.m. I asked him about it and he said, yes, there is evidence that it works. Wanted to clock him because why didn't he volunteer that info 2 years ago. LIV is approved in Europe to treat osteoporosis/osteopenia and from the studies I've read, it seems to be very promising and have no negative side effects. LIV actually stimulates new bone growth. All bisphosphonates do is stop bone loss and therefore taking bisphosphonates can actually lead to brittle bones.

Things I have recently added to my routine to try to naturally reverse bone loss:

- eatting 5 - 10 prunes per day (studies show this can help)

- eatting a handful of almonds a day (studies show almonds inhibit osteoclasts)

- pushups

- back extension exercises

- lunges

- squats

- balance exercises

I haven't purchased a LIV system, they are expensive but not really in comparison to infusion therapy. The Marodyne LIV system is $2500ish, and my zoledronic acid infusion cost around $5000/yr, fortunately I have health insurance so I did have to pay all of it.

healtheuropa.eu/preventing-....

[Muscle7 in reply to FearFracture]

How much did you end up paying for the request in fusion out-of-pocket?

[FearFracture in reply to Muscle7]

My insurance changed from 2021 to 2022 😂 same insurance company different premiums, deductibles, and out of pocket max. I’m laughing because my doctors and insurance change so often, it’s hard to keep up.

I’m pretty sure in 2021, my out of pocket max was around $1,200.00. I had a cyst removed from my wrist and a colonoscopy and an endoscopy in 2021, so those 3 things along with my portion of my doctor appts were partially covered by my hlth insurance. By the time I had my zoledronic acid infusion in mid-November 2021, I had already paid approximately $650, of my out of pocket max, so I was only billed approximately $550 for the infusion. If I hadn’t had the cyst removed, the colonoscopy and endoscopy, etc., I would have been billed the full out of pocket max of $1200.