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Osteoporosis Treatment
nodeerhere posted:
I've taken reclast for osteoporosis and have not had a dose since Nov, 2012. I moved and had to change doctors and the new doctor said don't take the dose in 2013. My former doctor, when asked, did not agree. I intend to change doctors this year. Meanwhile, my new internist stated that the biophosphenates, including Reclast do not build bone. They stop bone loss. She said Prolia does build bone. I've read some of the discussions on this forum where it is stated that Reclast does build bone. Also there are side effects to Prolia that sound horrible. I truly have no idea how I should be treated. Doctors disagree on just about everything. How does someone know what is best for themselves?
bonebabe responded:
Our Osteoporosis Center medical director believes that Prolia should not be given cavalierly. That it should only be used when all other meds have been tried without success.

Reclast and the other bisphosphonates do not build bone per se. They slow down the body's resorption of bone, giving the body a natural way to catch up with its bone building.

When we're young the balance between bone building and bone resorption is equal. As we age, the process gets screwed up and the bone building is slower than the bone resorption. That causes thinning of the bones. If the meds slow down the resorption process, the body can make more new bone cells to waylay the loss of bone mass.

If your Reclast was working for you and you haven't fractured since taking it, I'd continue with it.
nodeerhere replied to bonebabe's response:
I appreciate your response. The doctor I saw stated that post menopausal women do not build bone. Hence her suggestion of prolia. I did not take the reclast this year but will see a new rheumatologist soon. And if he suggests prolia I don't think I will follow his advice. It is very hard being in a new place and going to new medical people.
bonebabe replied to nodeerhere's response:
What are your T-scores? Have you fractured a bone since age 40? Are you on or have ever been on for greater that 6 weeks, corticosteroids?

It is hard finding new doctors and sometimes the first one or two just aren't a good fit. Keep looking until you're comfortable. The NOF (National Osteoporosis Foundation) has a good website - - that has a section on how to talk to yur doctor about osteoporosis. It also has a lot of other information you might find helpful.

As for bone building after menopause...well...yes and no. As long as you're alive, your body makes new cells, including new bone cells. But, as I stated above, the body naturally will absorb those older cells faster than it can make new ones. That's why you lose bone as you age. Menopause and the loss of estrogen upset the balance of things.

Prolia will slow down the absorption and speed up the bone building. You have to be careful with it as you don't want to build up more bone than your body can handle. If the Reclast didn't work for you in letting your body rebuild it's bone at its own pace, then Prolia might be a good choice for you. The NOF website also goes into great detail about each of the osteo meds. It's worth checking out.

BTW, our medical director is also a rheumatologist and is on the board of the International Society of Clinical Densitometrists. I trust her judgment.
nodeerhere replied to bonebabe's response:
Lumbar spine Tscore -1.4
Left hip -2.7
No broken bones. No corticosteroids. Last Reclast Nov 2012. The doc I left wanted me on Reclast. But I moved to South FL. Rheumatologist did not impress me with knowledge and office was very poorly run. Internists have not impressed me. Even the radiology was not as good as NJ where they gave me a full report and took scans of both hips.
bonebabe replied to nodeerhere's response:
You don't meet the criteria for Prolia.

I agree with your former internist. Stay on the Reclast.

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For more information, visit the National Osteoporosis Foundation website