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@lynn59

Hi gently. I’m on Forteo and take 1200 mg of calcium daily through a combination of food and supplements, plus 2000 IU of vitamin D and k2. Do you think I should have my calcium levels tested now that I am 6 months into using teraparatide? Or other blood levels? My endocrinologist didn’t request any post drug testing. I took the initiative and had my family doctor ask for a CTX and P1NP which all looked good (the drug is working), but I haven’t repeated a 24 hour calcium urine test or anything else since taking the drug.

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Replies to "Hi gently. I’m on Forteo and take 1200 mg of calcium daily through a combination of..."

@lynn59 hi. I've read that it is common protocol in the US to test for hypercalcemia prior to and at one month because hypercalcemia should be resolved before taking Forteo and can cause hypercalcemia. The thinking is that if the medication doesn't cause hypercalcemia within the first month it is unlikely to over the 18 months of treatment. This testing is not usual in the EU nor in NZ. Mild transcient hypercalcemia is expected with both Forteo and Tymlos.
Does your family doctor order a yearly metabolic panel (CMP). Sometimes an endocrinologist reviews those tests to determine if you need additional testing.
2000 IU of vitamin D is recommended for D deficiency. It may be perfect because Forteo makes good use of D and can deplete the resource, then again it may be a little high. Excess D on it's own can cause hypercalcemia, so I would want D testing. On Forteo 50 ng/mL (125 nmol/L) or close to is best ( I'm told).
The metabolic testing will give indications of the need for further testing through serum calcium and egfr. The endocrinologist I see tests for PTH which your family doctor might add on for you.
I applaud your initiative and your doctor's cooperation.
I'd like to compare my bone markers at six months with yours.
My prescribing endocrinologist doesn't oder the 24 hour urine unless there are metabolic hints about loss of kidney function.
I'd say add d and pth to the metabolic panel. I'm having CTX and P1NP every three months, as I'm close to 2 years on Forteo and want a 3rd year.