Osteoporosis and riding

This morning I met with a P.A. to go over my bone density test results. I was diagnosed with osteoporosis two years ago, but my doctor never followed up or recommended any treatment. Now, I have to start taking Fosamax. Is anyone else treating osteoporosis? Any problems with the meds? Has it impacted your riding?

My femurs are in bad shape. I had an accident two years ago and shattered my right femur. The surgeon said he didn’t think the osteoporosis was factor in the injury. It healed very nicely. Here’s the catch: Fosamax increases the risk of femur fracture and jaw bone problems. So, I’m damned if I do take it and damned if I don’t.

I didn’t expect this, but I have risk factors being fine boned and petite plus having used proton pump inhibitors for years. Such a drag getting old.


I’m not taking medication. The jaw bone necrosis potential side effect was just too much crazy for me. When I remember, I take calcium and vitamin D, although the calcium gives me muscle cramps even when it’s with magnesium. I run and do barn work and try not to do anything stupid. But I’m young for osteoporosis, so … I have to hope I stay active and don’t do something stupid for a good long time, which seems somewhat unlikely.


Thanks for your reply. I’m active and have been taking lots of Vitamin D and now am increasing my calcium and magnesium supplements. Funny thing, I have not lost any height. A friend who does not have osteoporosis has shrunk two inches.

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I was diagnosed with osteoporosis almost seven years ago. I took Fosamax for five years. I had no problems with it, and my bone densities increased so that I was in the osteopenia category last time it was checked (I’m due again later this year). I’ve been off Fosamax for almost two years now. After my diagnosis, I continued riding, and still do. The only impact the diagnosis had on my riding is that I’m more careful. Like my husband said, “You can’t just sit on the couch the rest of your life.”


True words! I plan to ride as usual, but will be more careful if my horse is especially frisky. Glad to hear you had no problems with Fosamax. I will start this week, fingers crossed it goes okay.

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Also osteoporotic. Took Fosamax for a couple of years, some improvement. Now on Prolia, which is only a twice a year injection. Better response to Prolia, now osteopenic .
My doctor knows me too well to tell me to stop riding. I try to be careful, but , well, horses…
Edited to add no bad side effects with either med.


I asked about getting Prolia, but was told insurance won’t pay for it until they see result from other meds. I can ask for it after taking Fosamax for four months.

We horsewoman are tough. We will ride and take our chances.


I was diagnosed with osteopenia seven years ago & Dr wanted me on Prolia.
But after the 1st injection & Googling side effects I opted out.
I take D3 (3-5K U daily), no calcium except from diet.
Last bone density still about the same (I’m due this month) but at my last physical (Feb '22) I’d lost almost 2" height.
I see my GP & oncologist in February & suppose both will want me to address bone issues.
Getting Old is a trial :unamused:


This describes me, as well. My OBGYN went over my test results w me and pointed out areas where I was better than average. My GP did not do that. I’ve not shown up for addition bone scans, but I may now that she shared the positives. I’m not a fan of the medications available

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Have you checked out any fraction risk calculators like FRAX?

I would look into that and maybe use that to help guide your decision about whether or not to take the meds.

Though the meds supposedly result in increased bone density (by the scans), I think the quality of the bone may be questionable (hence the risk of fractures such as the thigh and jaw bone issues).


No, I haven’t looked into FRAX. Will do that. My results showed a 25% chance of breaking a wrist or arm in the next 10 years and a 7.5% chance of hip fracture. I agree it is difficult to balance the risk of taking meds to not taking anything.

A FB friend mentioned taking a natural algae-based supplement for bone health and stated she had gained bone density. I can’t remember what it was. The PA said she would look into it if I could find the product. Anyone heard of it?

I haven’t heard of it but I have seen where prunes were recommended as good for the bones. I think I’ve seen in previous osteoporosis posts here on COTH where a few have recommended prunes.

I was sent to an endocrinologist based on the results of my scans. I’m not totally convinced I’m all that fragile…I did come off my old man twice prior to my scans and no fractures. One of them I got significant air and landed on my back and was dragged a bit before decided to stop.

When the endo dr was typing up my history he stopped typing and turned his head at me all wide eyed when I said I rode (lol wish I had a recording of that! Figured I’d better not tell him I do eventing… :joy:). I checked my FRAX score and decided based on that and the fact that last year I slipped on the ice (again, pretty good air with that one) and landed on my hip and smashed my elbow and was fine. Also fell going up the stairs (who does that???). My regular GP was fine with me not taking the meds. I am more aware of my diet now though so I guess the scans were useful to me that way. In the past I wasn’t getting enough protein so I’ve been working on that.

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My FRAX score was included in test results:

FRAX* Based on femoral neck BMD: DualFemur (Right)

10-year Probability of Fracture
Major Osteoporotic Fracture: 25.0 %
Hip Fracture: 7.8 %
Population: USA (Caucasian)
Risk Factors: History of Fracture (Adult), Secondary Osteoporosis

Holy smokes!! Your scores are way worse than mine. I have hypocalciuria— I basically urinate out my calcium. I am starting Reclast Monday. My doctors discussed all the issues and concerns and I chose this once a year option.

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I am start Fosamax tomorrow. One pill a week. If their is some improvement, I may be able to switch to Reclast.

As I mentioned in the other discussion, I was diagnosed two years ago, but my doctor did not follow up. This is my second bone scan and things got worse. That is annoying.

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I was diagnosed in my early 60’s. My doctor sent me for a DEXA just to get a baseline. I have always been very physically active and there was no reason to suspect osteoporosis. And I was osteoporotic. We were both a bit taken aback.

I think there is a big genetic factor. My Mom had it. Two broken hips, the first of which was probably from a fall and a break. The second one might have been a break and a fall. Then very painful small vertebral fractures. Seeing her repeated pain that impacted her quality of life in her last years was why I chose to treat.

I also stay active, do weight-bearing exercise, and take calcium and vitamin D.

I have no personal experience but I have lots of patients (RDH) that are on/have been on Fosamax. The vast majority of necrotic episodes with the jaw are after dental work, specifically extraction of teeth and sometimes more invasive work like root canals and possibly crowns. So say you get a tooth extracted while on Fosamax, that area is the potential site where necrosis starts because of the trauma to the bone. We generally advise patients to work with their doctors to come off Fosamax should they need dental work like that to minimize potential issues.

I do have patients who have spontaneous jaw issues but they’re less common, and mostly on my older women (late 80s/early 90s) who took Fosamax early in it’s inception when the protocols were very aggressive.

My recommendation would be to work closely with your dentist to monitor your bone levels now vs every six months going forward just to catch anything early. We’re all very familiar with it!

For your second scan, was it at the same facility and same person doing the scan? From what I’ve read, there can be a lot of variability between different dexa scan instruments and also whoever is doing them. I’ve also read that Echolight scans are supposedly more accurate but I don’t have any experience with that.

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Yes, same facility. This is not my only problem with my doctor and HMO. Follow-up after tests have been somewhat non-existent. It’s not the first time and I’ve had to interpret test results myself.

Ironically, I received a letter yesterday telling me my doctor has left the practice. For the last two years, I’ve only seen her PAs, so no big loss. I have been assigned to an osteopath. Maybe that will be an improvement.


Yesterday, I took my first dose of Fosamax. Now I have severe back pain, which is a side effect. Anyone else experience this?