Just went through my physical cycle. Blood work damn near perfect. Good cholesterol could be a bit higher; bad a bit lower. But everything in range. Closing in on 70 - 6'2", 183, 110/70 BP, resting heart rate of 60, in the gym 4-5 days a week for 45 years. No drugs (prescribed or otherwise), no smoke, essentially no drink (glass of wine twice a year maybe), healthy diet - clean living. My wife strongly encourages me while at the physical to inquire about a baseline bone density test. The females in my family are overwhelmed with osteoporosis and osteopenia -- genes. Dr. is reluctant but agrees to request it and see if Medicare will cover. They agree - test scheduled a week later. Get the results -- spine, forearm are just fine. But I'm one tenth of a point into the osteoporosis score in my hip/femur. A -2.6 when -2.5 is the beginning of the range. Interesting.
Without any contact with me, I get a note from the pharmacy telling me my Fosamax (alendronate) is ready. If you're not familiar - pull up the list of possible side effects. The side-effect list is longer than the femurs we're trying to preserve and many of them persist even after you stop taking the drug. Some very severe. He also suggests I go on a 2000 IU daily dose of vitamin D and start an exercise program.
I point out to him -- In my PROFILE -- I take a multivitamin that includes 2000 IU's of vitamin D. Does he want me to take ANOTHER 2000? In my PROFILE - I do calisthenics and weights (resistance training) targeting legs 3 days a week and cardio-boxing/walking 3-4 days a week which also targets the legs/bones. Does he want me to do more than the 40-70 minutes a day I've been doing since I was 20? I eat foods routinely in healthy amounts that are vitamin D rich - dairy products, salmon, tuna, eggs. More of that? I explain that because of the possible negative side effects, I only want to take Fosamax if it's absolutely necessary - so I want to explore dietary and exercise/PT options first, with possible more frequent bone scans to see if we're holding our own, getting worse, getting better. Particularly since almost ALL the data about the disease is based on post-menopausal women. Virtually no data out there taken from men with osteoporosis. So, wouldn't it make sense to go slow on meds?
His reply sounds like an old Emily Latilla skit in Sat Night Live. "Oh, that's very different. Never mind." Your vitamin D regimen sounds fine. Your exercise regimen sounds great. Forget the Fosamax. Since you're barely in the range, we'll just scan again in 2 years.
Initially, he didn't want to schedule it. Reluctantly he did. Without consulting me, he a sent prescription to pharmacy. And when I focused his attention on info that was already in my profile, he did a 180. If I'd blindly followed his advice I'd be overdoing Vitamin D and starting a drug with lots of possible negative side effects that I probably don't need to be on at all yet. Is it me? My buddy thinks most docs are just hourly employees working for whoever is paying the bill - Medicare, Insurance company. I think he's right.