Fosamax

[dao94566]

Hi, I was diagnosis with osteoporosis in 2022 and have been on Fosamax for about 1 year. I have been reading post on this site for almost a year and do not ever read any positive results about any of the osteo drugs showing improvement. Has anybody taken Fosamax for at least 3 to 5 years and now show improvement on there bone scan?

[Siamang]

I also have difficulty hearing positive outcomes re medications on these sites but expect those that are happy don't read these sites?

However I have a number of friends who have taken fosamax and have prolia injections without any complaints and follow up scans have remained stable or improved. They accept that's just what they have to do and follow Drs recommendation. Wish I could be like them but I question anything that goes into my body and need to have all the information!

[usr2022 in reply to Siamang]

How bisphosphonates work is explained in video below by a specialist endocrinologist boneresearch.ca/about

Full transcript about bisphosphonates from video is below

youtube.com/watch?v=_8tBXJV...(Not working as expected?)

(around minute 21)

"Bisphosphonates have long-term skeletal retention, they adhere to the hydroxyapatite crystal.

When the osteoclast comes and attaches to the surface of the bone, it will start to release acid and enzymes and dig out a hole in the bone, and when it does that, the bisphosphonate is released from the bone, and it is ingested by the osteoclast. And in the osteoclast it inhibits the mevalonic acid pathway and it prevents the osteoclast from forming its cytoskeleton, so the osteoclast dies.

And that's a good thing because after menopause, we have rises in RANK ligand (because of estrogen deficiency) and this causes many more osteoclasts to form.

So after menopause there is an imbalance - bone resorption is higher than bone formation. We are removing more bone than we are forming.

So we have to knock off these extra osteoclasts. And that's how bisphosphonates work: because they kill off the excess osteoclasts, they cause osteoclast apoptosis or death of the excess osteoclasts.

So what the bisphosphonate will do, is it will protect and preserve the skeleton. And we're still forming bone, and the bone that's there is going to become more heavily mineralized because it is not being removed rapidly and so the bone density will rise with bisphosphonate therapy even though bisphosphonates are not anabolic agents, but they're associated with rises in bone density and reductions in the fracture risk because they're inhibiting the excess osteoclasts.

Now if your patient has taken bisphosphonates for five years or longer, and they now have a moderate fracture risk and they've never had a fragility fracture and their femoral neck T-score is better than -2.5, we can give them a drug holiday.

Because the bisphosphonate remains in the skeleton for decades and it will still continue to be released, knocking off those excess osteoclasts. And gradually the level of bisphosphonate will go down and the effects on bone remodeling will decline, but for the next 5 years, even off bisphosphonate therapy, our patient is going to experience anti-resorptive effects from the bisphosphonates they took for the 5 years before. And it's still going to protect and preserve their skeleton. So we give them what we call a drug holiday. We take them off the bisphosphonate, and during the drug holiday we're going to watch them; we're going to see them every 2 years, we're going to monitor their bone density , we're going to check their height, we're going to ask them "did you break anything?" ....."

[LilEgg in reply to usr2022]

I have to relay off of prolia… Been on it for 10 years last couple years so many side effects. I’ve done enough research & seen doctors to know I just can’t walk away and myst have a bisphosphonate… the longer you are on it the stronger than medication you need plus I have a hiatal hernia and cannot take anything in a pill (Fosamax and Actonel have a tendency of irritating the stomach )form therefore I will be taking reclast… The explanation is great and hopefully that’s what happens. My biggest worry is any side effects you have with this type of medication it’s with you for a long time as well and thats the scary part.☹️ My suggestion to anyone who needs to go on medication is to be really careful with Prolia… you can’t walk away from it and I never knew that at least with the other medication you can have a drug holiday

[dao94566 in reply to usr2022]

Thank you for the information.

[Siamang in reply to usr2022]

Thanks for posting - I found the article very informative.

[Siamang in reply to Siamang]

The utube interview was excellent.

[Caseville20 in reply to usr2022]

Excellent article. Thank you for sharing.

[bonewarrior in reply to Siamang]

I hear you. I have osteoporosis and am not taking meds. The bisphosphonates I was prescribed immediately after the diagnosis, without further explanation, remain in my cupboard. I am taking bone health supplements and have a PT I work out with twice a week. My next scan is in May (after 1.5 years) but I seriously doubt the DXA scans. They are the only ones available in Germany, where I currently live, but from my research on osteoporosis in different countries I feel that may be the best option. QCT may be the better option but I cannot find this in Germany at the moment. Does anyone have any experience with QCT vs. DXA?

[Maverick2015]

I was diagnosed at 48 and took supplements and exercises and diet. My scores only got worse. I started prolia and my scores improved slightly but didn't get worse. I also had several bike wrecks and nothing was broken so i felt it was working. I unfortunately was going to gyn then np in the pcp office and neither really knew much about oseto or the meds etc. I had a 4 month lapse because they both left and I had to find new dr and I kept waiting for 6 weeks for insurance to pre approve meds which I ended up paying for out of pocket. During that time I has 6 compression Fractures. Now I know from listening and watching videos from special Dr's that prolia has a half life of 1 month. As of December I'm going to Dr who hopefully knows meds and osteoporosis. I'm taking tymlos with the prolia that I already had taken. She is trained to read dexa and she said they can vary a good bit by your body position. So if the tech puts you slightly different than tech for previous scan it can alter results. I've also since heard that from other people on another site so you could be gaining or losing and dexa not be accurate.

[maxkat22]

I have been on Alendronate (generic Fosamax) for 3 rounds with some drug holidays. I also take bone supplements (CA, Mg, Vit A D K2) and a healthy diet. It appears to have slowed my decreasing bone density and provided stable DEXA scores. My bone quality was assessed as “good”. That being said I have just recently had multiple bone fractures in my foot from a very simple non- traumatic fall. I’m working my way back to weight bearing and starting back into my osteoporosis exercise program. Had been using a vibration plate and will resume when cleared.