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← Return to Fracture while on Forteo
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Osteoporosis & Bone Health | Last Active: Nov 6 9:26am | Replies (6)
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I broke my second metatarsal in my left foot while on 20mcg Tymlos. The bones in the foot are mostly cortical, while the anabolic help mostly trabecular bones. In fact, studies have shown that Forteo can lead to cortical porosity. I increased my Tymlos to 40 mcg after the fracture. It took 4 plus months for my foot to heal and I still have 2 swollen toes. Six months after my fracture, my P1NP was 310 and my CTX was 1414. Studies have also shown that bone markers may be high six months after a fracture. My endo wants me to take Evista with my Tymlos. I haven't dared do that yet.
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While both estrogen and raloxifene are mild-moderate antiresorptives and could serve as a good add-on in this situation, the known 1-2% risk of venous thrombosis for raloxifene is concerning to older population. On the contrary, transdermal patches of estradiol (bioequivalent) does not share that particular concern. Furthermore, estrogen, with its many regulatory effects on bone health, is known to help with all skeletal sites! An individualized assessment for cvd risk and breast cancer risk is needed for hrt usage for sure.
@drsuefowler your ctx of 1414 after 6mo of fracture is unusual. What's your baseline ctx?