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Loss of BMD in hips after taking Forteo or teriparatide?
Osteoporosis & Bone Health | Last Active: Sep 24 1:31am | Replies (95)Comment receiving replies
Hi @gently. Thank you for your explanation. I didn’t sleep last night worrying about it. I will do a little more research and probably go ahead as your comments make sense and my current endocrinologist mentioned forearm loss but not hip loss (maybe for that reason?).
I’ve thought about my options for 8 months before deciding to go on Forteo. The premise to build bone then lock it in is logical. But now I’m going back to what my long term endocrinologist said (he is just retired) …. I may never need an anabolic, I just need to stop my recent rapid loss (-2.4%) per year in the past two years. I’m 65 years old and before then my T-scores were fairly stable around -2.5 to -2.8 for the past 15 years. I believe the recent drop was due to lack of exercise (Covid), and drinking too much wine (caregiver for dying parent during Covid) and cutting out a large portion of my daily calcium with intermittent fasting (no breakfast yoghurt/berries/milk/nuts) to lose the weight I gained from lack of exercise and the wine!!! I’m back to my normal exercise routine (4X per week of weight training for at least an hour, plus sport activities and lots of dog walks), and I’m only drinking a few glasses of wine a week. Plus I’m super careful about getting my calcium through diet and when I don’t I make sure I supplement. I just hope I’m not doing an anabolic unnecessarily in case I get a random side effect like tinnitus, or hair loss/belly fat or something worse like decreased strength in my forearm or hip.
This disorder is a tough one. With no symptoms or fractures from it, it is hard to agree to a medication that can screw up what’s not yet screwed up. Especially since so many people say DEXA’s aren’t accurate. I’m basing going on this drug, because of my DEXA score, so when you put those two together it is kinda scary. I had a REMs/Echolight and my density score in my spine was better than with the DEXA (-2.6 vs -3.1). Hip was the same. But their bone quality score has mine in the green and I’m a petite woman, so maybe I’m not at a high risk? So many difficult questions with no concrete answers. I still feel I should probably give Forteo a try, as my goal is to increase my bone density/strength so I can continue to do my sports (ski) for as long as possible with more bone safety.
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@lynn59 Deciding what to do after seeing bone loss in a DXA report is sure complicated. One suggestion I have is that you don't have to do anything immediately. Doctors may sometimes make it seem that way but you can certainly take some time to research, think about and get comfortable with whatever action you choose to take. A month or two or three to carefully consider your choice is not going to cost you much bone and it may be well worth it in your long term success.
Your effort to figure out why you are now losing bone and you were not before is definitely something to put effort into. If you are into weight training I strongly suggest looking into Belinda Beck and the studies she's done which had success in improving bone density and hip strength.
On another point, you seemed to have looked at osteoporosis meds and come away with the idea that anabolics are risky and anti-resorptives are not. I don't see it as that simple. For myself I try to balance out what the trials and studies showed as side effects and what people on forums are reporting. All the meds have serious problems you just have to sort out the possible benefits and possible negative consequences as best you can. For myself in my situation with bone loss that I could not stop with natural means, I choose Evenity as the first
med. It is newer and that is a negative but the positives seemed to outweigh the negatives and give it the highest score in my mind.
OTH, Forteo has been in use for many many years and has a pretty good track record. I don't see it as being more dangerous than anti-resorptives at all.
Also DXA s being inaccurate is a loose and almost useless way of looking at things. If people have a worrisome DXA score they sometimes talk about DXAs being inaccurate as a way of reducing their anxiety. Yes there are accuracy issues but DXAs are the best tool/device we have commonly available at present to determine our likelihood to fracture. Some other devices have much higher radiation exposure. DXAs are very low radiation. REMS/Echolight may turn out to be great but it is not yet well proven enough in my opinion. So is it possible your latest DXA is inaccurate, yes. You can get another one done or you can pay someone like Lani Simpson to review your DXA scans to confirm their accuracy. I did that. Unfortunately she said the bone loss my DXA's showed was accurate. At least I knew rapid bone loss was indeed happening and could make decisions based on that.
My suggestion is to do what you are doing which is learning about bone loss and evaluating the possible courses of action and don't let the world pressure you into quick decisions.