Loss of BMD in hips after taking Forteo or teriparatide?
I’m scheduled to start a biosimilar to Forteo in a couple of weeks and I just read a post today from a woman who lost bone density in her hips after being on Forteo. I got interrupted and couldn’t find the post again, so I’m asking the question here as now I’m afraid to start. My T-score in my spine is -3.1 and my hips are -2.8. I’m borderline whether I need an anabolic and the only reason I’m doing it is because I downhill ski, as well as cross-country and backcountry skiing. I can’t afford to lose in my hips. My endocrinologist warned I may lose in my forearm, but she didn’t say anything about losing in my hips. Now I’m wondering if I should not start it and just go on a Actonel, Reclast or Prolia …. Or do nothing! This is all scaring me silly.
Interested in more discussions like this? Go to the Osteoporosis & Bone Health Support Group.
All I know personally is that Forteo was way too potent for me and I could tolerate Tymlos, though as you know I worked up to it 🙂
Today I read that femur neck only progresses 2.8% in the first 6 months and 7.5% if Evenity is done for the full 12 months. Surely this is from anti-resorptive action but the gain is much stronger than with Reclast (though values are extremely varied for Reclast among studies). So the idea of a boost over 3-4 months may mainly apply to the spine. Nevertheless studies are being done on Evenity for 6 months and Reclast for 6 months vs Evenity for 12 (followed by 12 months Reclast).
I saw 1) 6 months Evenity, 12 months Reclast, 6 months Evenity. 2) 6 months of each 3) 6 months Evenity, 12 months Reclast, 4) 12 months of each and 5) 6 months Evenity, 18 months on Reclast
Interesting .... I'll be keeping my eye on this topic as I'm sure I can benefit from Evenity in the future. I will personally feel more comfortable when it has been on the market for five years or more:)
@awfultruth thank you so much for your link! A great comprehensive review and explanation of increased porosity, cortical thickness, and outer diameters of cortical bone resulted from Teriparatide treatment. The increase porosity that concern some of us doesn’t appear to be correlated with bone strength reduction. Rather, it is accompanied by apposition of new bone at peristeal site etc. As @gently pointed out, coupled bone remodeling is crucial for healthier and stronger bones. The porosity increase may just provide more grounds for the coupled process. Bone strength is multi factorial based. Anatomical and mechanical properties play important role, other than bmd. This paper explained how the outer diameters’ increase actually plays a role in resistance to fracture.
Thank you @awfultruth and @gently! I leant a lot from your perspective and help.
Is HRT suitable for a 78 year old?
CC
Windy
Please tell me the procedure for gradually taking Tymlos.
CC
@06111945cc The Tymos pen as 8 clicks for a full dose. You can feel the clicks. You can start at a full dose and if you have any issues, go back to 2 or 4, whatever you can tolerate. Once your body adjusts, move up. You want to aim for 6 or 7 clicks at least out of 8. Talk to your doctor about this of course. If you refrigerate it, the Tymlos pen can last longer so the reduced dose doesn't mean you have to throw it out at 30 days. I checked this with the company.
Thank you.
CC
Not so sure about the children. It isn't recommeded for children whose bones are still growing. It is given to kids with hypocalcemia. But the dosage is titrated by weight. And given more frequently by infusion.
Maybe you are right? I didn’t challenge her when she answered my question that way. Look her up. She has done lots of research on osteoporosis and hyperparathyroid. Her name is Dr. Aliyah Khan in Oakville, Ontario, Canada. Having said that, she is the endocrinologist who gave me the prescription and said “come see me in two years, your family doctor can look after you in the meantime”. Her listed scholarly achievements are impressive, which is why I chose her. But unfortunately she is spread too thin to answer all my questions or closely follow me. I’m waiting for her to answer an email with a list of questions!
https://experts.mcmaster.ca/display/aliya