After reviewing the prescription insert, medication guide and approval history submitted to the FDA, we were unable to find any evidence suggesting a link between denosumab (Prolia) and the risk of glaucoma or increased intraocular pressure. Of course, always talk to your healthcare provider and pharmacist about your medical history, concerns and other prescriptions and over-the-counter medicines you take before starting a new treatment.View Thread
Here's some information NOF has published for healthcare professionals about bisphosphonate use in bariatric surgery patients. For the complete article visit http://www.nof.org/node/453 . If you've had bariatric surgery, you may want to share this information with your doctor.
"When osteoporosis is suspected in a bariatric surgery patient, secondary disease should be suspected first, and if present, should become the focus of treatment interventions. The etiology of the clinical presentation and biochemical indices such as vitamin D deficiency, hypocalcemia, elevated alkaline phosphatase, and secondary hyperparathyroidism should be clearly defined and appropriate treatment interventions initiated. Abnormal DXA may in fact be indicative of both primary and secondary disease however, aggressive treatment of the underlying cause of the secondary disease can result in significant improvements in BMD[34>. The addition of a bisphosphonate to the treatment regimen should only be considered after clinical and biochemical resolution of secondary metabolic bone disease (MBD).
Bisphosphonates inhibit bone resorption, slow calcium efflux from the skeleton and cause a compensatory rise in PTH. Administered in the presence of vitamin D deficiency such as that seen in our patient, normal serum calcium cannot be maintained despite dramatic increases in serum PTH, and life-threatening hypocalcemia can result[35-37>. Therefore, caution is advised when considering the use of oral bisphosphonates in this population due to the high prevalence of vitamin D deficiency and subclinical osteomalacia.
Oral bisphosphonate use in bariatric surgery patients should also be approached cautiously due to the lack of safety and efficacy data. Specifically, tolerance has not been established in the surgical gut, and risk of ulceration at surgical anastamosis has not been defined. Efficacy of oral bisphosphonates has also come into question following bariatric bypass procedures due to the high likelihood that the drug may not be adequately absorbed. It is for these reasons that if treatment for primary osteoporosis is indicated in a bariatric surgery patient, there should be no clinical or biochemical evidence of secondary bone disease, the patient should be taking daily calcium and vitamin D supplements, and intravenous bisphosphonates should be considered."View Thread
Dear Bill - You are not alone! According to the National Osteoporosis Foundation (NOF), up to one in four men will break a bone due to osteoporosis. We recently developed a 14-page electronic "brochure" called The Man's Guide to Osteoporosis . We hope this information is helpful to you. Please let us know if there's anything else we can do to help.View Thread
Dear Periwinkle — To answer your second question about why everyone is moved to another drug when they complete their two years of Forteo, this is because Forteo stops working almost immediately when you finish taking the medication. Many other osteoporosis medications stay in the body for a long time and can continue to work for a while, even when you stop taking them. This is not the case with Forteo. Many people experience substantial gains in bone density while on Forteo. If they don't switch to another drug, they can lose these gains fairly quickly. Unfortunately, these losses increase a person's risk of breaking a bone.
Exercise has many benefits for people with and at risk of osteoporosis. While we don't know how much bone density a person can gain from exercising, exercise may help prevent bone loss, reduce the risk of fractures and lessen the likelihood of falling. For your bone health, it is important to maintain a well-rounded exercise program that includes weight-bearing exercises and muscle-strengthening (resistance) exercises. Balance, posture and functional exercises are also important. For general information about these exercises, please visit Exercise for Healthy Bones
Finally, working with a physical therapist (PT) who is knowledgeable about osteoporosis can help you develop an exercise program that is individualized to your needs. You may want to ask your healthcare provider if you can have a referral to see a PT.View Thread
You may also want to read some of Dr. Adi Cohen's comments related to osteoporosis in premenopausal women. You can do so by visiting Dr. Adi Cohen's profile and looking under "Latest Activity."
It's important that you have a knowledgeable healthcare provider who can do any necessary testing and provide appropriate guidance for you. An endocrinologist, rheumatologist or gynecologist who works with osteoporosis patients may be able to help you.