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Forteo after Tymlos?

Osteoporosis & Bone Health | Last Active: Feb 10 1:59pm | Replies (17)
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@bayhorse

Could you please tell me the purpose of getting a bone marker test? Is it used to determine whether a particular drug is doing any good so if need be you can switch to another drug mid-stream (so to speak)? I have been on Tymlos nearly two years; good gains the first, but I just had a dexa and results were disappointing for this 2nd year, no progress in the hip, minimal gains in the spine. So I'm wondering whether it would be beneficial once I start a new drug to have bone marker tests at some point rather than just following a doc's prescribed course of the drug.

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Replies to "Could you please tell me the purpose of getting a bone marker test? Is it used..."
katwhisperer | @katwhisperer | Feb 8 2:41pm

I'm in the same boat...disappointing results and never any mention of bone markers by rheum or endo - just saw mentions of it on this forum. Neither advises more time on tymlos or starting forteo- they only suggest a bisphosphenate or Prolia (no way on the latter!)

Frankly no one I consult really gives helpful guidance - they just list all the available treatment options and say it's up to me. I can get THAT from Dr. Google.

Leaning towards a 1x week bisphosphate for a couple of years.

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gently | @gently | Feb 8 7:05pm

bayhorse, bone markers are generally used after the first couple of months of a new osteoporosis medication to determine if a medication is working in your body. While there is usually a large sometimes 100% rise in P1NP after two months of an anabolic, the change at one month with bisphosphonates is usually a 30 to 50% drop in CTX.
A lack of change might initiate an effort to determine a secondary cause of osteoporosis or the need for a different medication.
CTX with Prolia decreases rapidly usually to below baseline in the first month of use. Decrease in P1NP is slower, but also significant.
Many endocrinologist don't use bone markers.
There is speculation that there might be an ideal relationship between CTX and P1NP. I speculate myself, but the closest I've read is that there needs to be a balance.

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