Quantity of medication Forteo pin administers with "one click"

My blood calcium increased from baseline 9.7 to 10.5 for months 1-6 after starting forteo. Afterwards, it came back to pretreatment level. The most recent one in Feb this year also was high at 10.4, I think its due to the blood was taken 4 hours after injection. Hope the changes in calcium levels were as expected.

gently and windyshores: you both suggested reducing calcium intake amount could mitigate the increase in blood level. How much would you say is an appropriate amount of reduction when hyperglycemia occurs? Also, has either of you heard of adjusted calcium level and the usage of it?

Question for gently - could you explain your intake of calcium 2 hours prior to forteo injection? I dont quite understand it, since there will be a transient intra-day increase of calcium 4-6 hours post forteo injection. Thanks

My blood calcium increased from baseline 9.7 to 10.5 for months 1-6 after starting forteo. Afterwards, it came back to pretreatment level. The most recent one in Feb this year also was high at 10.4, I think its due to the blood was taken 4 hours after injection. Hope the changes in calcium levels were as expected.

gently and windyshores: you both suggested reducing calcium intake amount could mitigate the increase in blood level. How much would you say is an appropriate amount of reduction when hyperglycemia occurs? Also, has either of you heard of adjusted calcium level and the usage of it?

Question for gently - could you explain your intake of calcium 2 hours prior to forteo injection? I dont quite understand it, since there will be a transient intra-day increase of calcium 4-6 hours post forteo injection. Thanks

mayblin, my hypothetical is that pth pulls calcium from various sources and into the bloodstream. Forteo induces more absorption from the intestine, draws back calcium from the kidneys and pulls calcium from the bone. My thought is that if the calcium supply is sufficiently available, the bone stores of calcium can remain untouched.
Conversation with a bone reseacher, though with some intricacies that I retained only the conclusion to, my suspicions were loosely confirmed.
If I can find those notes,
I worried that drawing calcium from bone might be an important step in anabolism. Doesn't it seem like taking calcium from the bone would stimulate osteoblasts? I'm told not.
Windyshores' answer is reassuring.
In that vein, if a person is having side effects, I'd want to experiment lowering calcium intake (dramatically if I were the patient) to see if I could eliminate the adverse effect.
I've read about lowering calcium intake or lowering D3 to decrease absorption. The body regulates circulating calcium even to the detriment of other organs in to protect the brain. So serum levels of calcium aren't reliable for determining parathyroid disease for example.
I think you have to experiment, but we don't get tested often enough to go by numbers.
I also think we are too-calcified. My thinking (in all areas) remains suspect.

Some have already answered part of the original post. I have completed Forteo treatment in fall of 2023. I went through 25 or so pens during my treatment. The pens only have one click. On the pens I used, the plunger did make some noise when it's pulled back before injecting. Perhaps that could be considered "clicks". The amount the interior part of the plunger that you see in the medication does not move enough on one dose to be able to tell how far it moved. It is pretty well not noticeable.

Have you been checking your blood pressure? Mine dropped to low 80s/lo 50s (my normal was low100s/mid60s), which made me very fatigued all day long, even though I injected before bedtime. Lots of time I had to lie down to feel comfortable. The thing helped I think was lot of water (10-12 cups throughout the day) and adding salt when needed. After one and half months or so I felt totally normal. I guess I was lucky not having any other symptoms.

You probably know forteo is known to increase blood calcium transiently. My blood calcium was increased to 10.5 for a few months then went down afterwards. Recently I switched to AM injection and noticed blood calcium would increase within a few hours of injection. The high calcium level didn't cause any symptoms for me though.

Headache and insomnia could be side effects, but they don't appear to be remarkably increased (insomnia slightly increased) compared to non-forteo treated population according to package
insert. I think it could be serious when blood pressure gets too low. Dizziness could occur, and syncope if it occurs, could be very serious.

Every other day dosing seems a very good idea. If all your symptoms occurred only after starting of forteo, and they persists, that will be concerning.

Best wishes

Hi mayblin, I'm starting Forteo in April. I see that lots of water and salty food prior to injection seemed to help. How long before injection did you take water/salty food? Also, after 1.5 months did you still need to hydrate/eat salty food prior to the injection? Or did your body get used to Forteo and you resumed you normal eating/drinking patterns?

How much calcium were you consuming? I'm trying to get all 1200mg of calcium through food vs supplements. On a rare occasion, I take 250mg calcium at night if I don't reach my daily quota from food.