Patient: Description of condition (onset, main symptoms, hospital visited, etc.): I have had sore joints in my back and limbs for 15 years, and an ultrasound examination of my ankle joint 3 years ago concluded that I had severe bone loss. On July 26 this year, the bone density test (L3) showed that the T value was -3.1 and the Z value was -1.8, which is severe osteoporosis. 2.Some doctors recommend not to use Tensinex because it is very toxic and can cause kidney damage in 1/10 people. I have to take Fosamax instead. I don’t know if this is correct. 3. Another doctor said that oral administration of bisphosphonates can lead to esophagitis and even cancer. I wonder if this is true? 4. If ACP, Ca and p are within normal range after 3 months of taking a-D3, should I continue to use a-D3? Thank you! Doctor Chen Ming: Zoledronic acid intravenous can simplify the treatment, there is no esophagitis side effects, but should pay attention to the kidney side effects, usually not more than 2 years. Oral Fosamax has less side effects, but requires weekly fasting treatment, which is more troublesome. It can be used appropriately, mainly on a case-by-case basis. However, none of the above drugs can replace the basic diagnosis and treatment. The diagnosis of osteoporosis is not only the measurement of bone density, but should be based on gender age and symptoms of low back pain as well as history of fracture. X-rays of painful areas must be taken first, excluding other pain-causing diseases such as bone tumors, before osteoporosis can be diagnosed. Basic treatment includes appropriate and regular weight-bearing activities to prevent fractures from strenuous exercise, more sun exposure, dietary calcium supplementation, and active vitamin D supplementation.