Osteoporosis - Are bisphosphonates worth it?

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Dr. Brewer started as an Emergency Doctor. After seeing too many preventable heart attacks, he went to Johns Hopkins to learn Preventive Medicine. While there, he went on the run the post-graduate training program (residency) in Preventive Medicine. From there, he made a career of practicing and managing preventive medicine and primary care clinics. His later role in this area was Chief Medical Officer for Premise, which has close to 1,000 primary care/prevention clinics. He was also the Chief Medical Officer for MDLIVE, the second largest telemedicine company. More recently, he founded PrevMed, a heart attack, and stroke prevention clinic.
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🤙🏼TRANSLATIONS *** Please help by providing a translation of video captions for those that speak your language. Not everyone understands English, especially with my Southern US drawl. Click this link to provide translation services - help save lives!! bit.ly/PrevMed...

[@Samlol23_drrich]

What a difficult decision, especially for the elderly. My mom is 86 and just finished a 12 month course of Evinity. Fortunately no side effects but no real change in density. Her Doc wants her to start Prolia. The potential side effects are SO awful she is extremely hesitant. Im no medical denier (im a dentist by trade) but looked into it and shes right. Some people have terrible side effects in trade for minimal benefit. She may do nothing further and honestly i support that. Seems many of these drugs benefit 60 year olds the most.

[@PrevMedHealth]

It's a very good point. Yes, you understand the problem well; it's not “medical denial” to see the real challenges here.

[@Huskyman33]

Seem to miss a key point that although these drugs increase bone density, it’s not the flexible type bone that is desired but rather brittle bone. Why not promote things that actually build healthy bone such as D, K2, protein (collagen) rich foods?

[@Bee-Kind-Baker]

It’s important to note that bisphosphonates can reduce bone loss a little, but will not reverse it

[@PrevMedHealth]

Yes. Thanks

[@zeshef]

Missed opportunity to mention denosumab as compared to traditional bisphosphonates. And also, the use of these compounds in the bone cancer/metastasis setting when lytic lesions are also impacting the integrity of skeletal structures (particularly load baring).

[@condoguy710]

I’m 60, my t score of the femoral neck was -2.4 in 2019, it’s now -2.0. Doctor said I have osteopenia, I have celiac disease that wasn’t detected til I was 47 and my vitamin D level was 11 back then. The report says my risk of hip fracture in 10 years is 7% 🤷‍♂️

[@PrevMedHealth]

Thanks for sharing. Good luck on next steps.

[@FreedomFox1]

Low levels of testosterone and estrogen decrease bone density substantially. Even as a young man in my 30’s, low testosterone gave me osteopenia (almost osteoporosis). My doctor told me that natural hormone therapy (which I’m now on) would be the most effective treatment. I wonder why this isn’t offered to women? I realize there was a concern about cancer with artificial steroids. But these days you can get natural hormones from compounding pharmacies. That’s worth considering for post-menopausal women (100% of whom have both low estrogen and low testosterone).

[@PrevMedHealth]

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[@ahmedthamir9531]

so ...what are you saying about bisphosphonate ?what is the optimal duration of treatment ?

[@PrevMedHealth]

It isn’t clear yet. But 4 years is looking good at this point.

[@ameralgayar4931]

Thank you very much for the very helpfull information

[@PrevMedHealth]

Thanks. I hope you are well.

[@sandan2358]

I have osteoporosis, after 5 years of treatment there was no improvement on my bone density. Now my health ins no longer covers Prolia. My Dr recommends I take 6 calcium tablets a day and Vit D3. That doesn’t seem right to me. Where do I go for help?

[@PrevMedHealth]

There is actually a lot of evidence that shows you don’t get further benefit beyond 4 or 5 years.

[@yadealone]

Forteo may help. I was on it for two years and my bone density got better estrogen for one year now at 65. I’m doing another bone density scan after some time. I was severe osteoporosis maybe 5 yrs ago. Forteo was great. I am going to be seeing a doctor tomorrow about the osteoporosis I have and I really don’t want to take any of the other medication‘s like Fosamax and some of the others have a lot of side effects. I want to go back on the Forteo and stay on it, there was a two year limit before but I believe now that has been lifted. I’m just don’t know if they’ll offer it.

[@JGH1708]

At 52 I've got osteoporosis. As a male who has lifted weights for 30 years, doesnt smoke or drink and eats well I dont want to take bisphosphates. After using them for a few years then what happens?

[@gate-gate6863]

Once you start any osteoporosis medication you can never stop

[@lynnwilliams5432]

June 26 broke my femur behind the Greater Trochanter stem 6/27 did a anterior hip replacement. Almost 9weeks out on cane now. Was in good shape going in. Osteoporosis taking Atendonate. 81 years female . Diet recommendations? I am Carnivore but I mean supplements?

[@musikalitet]

I don´t understand a Word of what you tell….. could you tell it more understandabel…?

[@PrevMedHealth]

Sorry. We have done a lot of work in that space over the past couple of years.