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Loss of BMD in hips after taking Forteo or teriparatide?
Osteoporosis & Bone Health | Last Active: Apr 9 3:49pm | Replies (95)Comment receiving replies
sallyj2,
I'll write what I really think with liberty because it's April Fool's Day.
Forteo might be safer than Tymlos because the dose is so much lower (4x). Forteo at 20mcg is (I would say "Likely", but am forbidden that word on this forum, so) perhaps, too high a dose for many of us (lightweights).
Osteoclasts clean the bone before osteoblasts lay down new bone. These cells are said to work most efficiently when coupled. The nature of Tymlos' attachment to the bone allows for an earlier uncoupling of the clasic/blastic team.
While neither of these drugs poses great risk, there is the risk of complication because of co-diseases. And there is a risk of allergic reaction.
Tymlos contains preservative, which is why it doesn't need refrigeration, that increases the possiblility of allergic reaction. Since you can quickly stop taking either of these drugs, they are safter than drugs that persist in your body for months. But there are many brave souls who work at tolerating these side effects.
Finally, it is in my mind, that a slower development of new bone provides an opportunity for the bone to become seated--settle more deeply into the bone matrix where osteoblasts mature into osteocytes. Osteocytes are said to be the cells that remodel our bones making them more flexible specifically in response to our activities.
Bisphosphonates are safe for most. And they have prevented many more fractures than they have caused. I'd sure take them if there weren't the anabolics. I'd prefer to keep bone gains recycling than hold those gains. I think there is a perfect balance of osteoclast/osteoblast acheivable through more intermittant dosing of Forteo. After Forteo I plan on more forteo.
Don't be fooled by my thinking. I may recognize the shortfall on my next dxa, or the one after, or by one of those painful fractures.
Replies to "sallyj2, I'll write what I really think with liberty because it's April Fool's Day. Forteo might..."
@gently @sallyj2 @lynn59 I'd like to throw in my two cents here.
Forteo and tymlos are sister drugs as we know. On the quest of figuring out my initial puzzling 13mo forteo results, I've read many theories and explanations regarding the increased cortical porosity by forteo and the consequences of it. Do you know forteo increases cortical bone thickness? Actually tymlos does it too, with less intensity due to its altered receptor binding configuration. In most clinical studies, tymlos showed a slight advantages in the reduction of fracture risk, as well as in btm% increase. When you think about this further, the question arises: why would the porosity increase by forteo (in 1/4 of relative dosage in comparison to tymlos) ended up a closeup in terms of fracture risk reduction, and bmd increase? If increased cortical porosity is strongly associated with a weaker bone (in adults), then the results presented in numerous clinical studies wouldn't show that forteo has a statistical significance in fracture risk reduction. So we need to put the concern of porosity increase in a right perspective here. As far as my hip and femur neck results at 13 mo of forteo, dexa showed no change. I wonder if this is because I had a base t score at osteopenia range hence less room for improvemnt. The result could also be looked at another way: the no change is great because without forteo, I'd have further 1-3% yearly loss instead. So forteo kept my hip and femur bone stable. Im quite happy with forteo so far as far as side effects go: only initial low blood pressure for 1.5 mo, nothing else! You can read there are many other people got great improvements in hips and or femur neck with forteo. Usually it is the negative news that catch our mind the most, unforturnately.
Choosing a drug is so personal and sort of like gamble here too. One drug that worked great for one individual doesn't mean it will work the same for the next. Our personal believes, health status and preferences all play a role. Unexpected side effects will throw us off too and force us to make a change. Then there is insurance coverage... the best drug is the one works for us. But before you try one, you really don't know that perfect drug for you, forteo or tymlos.
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@gently. My endocrinologist said the Forteo dose is not too high for me (I’m 5’2” and weigh 120 lbs). She said they give it to children. I’m about to start, so it will be interesting to see how my body reacts.