Forteo side affects

My Endo prescribed Alendronate to lock in the gains.

Why do you have to lock in gains if Forteo builds new bones? When you stop does it go away like Prolia?

Apparently when we go off any anabolic, bone building medication (Forteo, Tymlos, Evenity) it is advisable to go on a bisphosphomate or Reclast to “lock-in” the gains. I think this is because our osteoclasts will continue to take away bone at the same accelerated rate for awhile, but our osteoblasts will stop building bone at the accelerated rate immediately. The bisphosphomates stop our bones from remodelling, so if we go on them for one year, the imbalance will be stopped, thereby “locking in” the gains. This is my layman’s way of understanding it, so if anyone has a more technical explanation, please share!!

Prolia works in a different way. It inhibits osteoclasts from removing bone (which helps with density), but doesn’t not stimulate osteoblasts to build more bone. When you go off Prolia, the osteoclasts come out of hidding and start working with a vengeance. This is why some people have fractured vertebrae if they don’t come off of Prolia properly. Again, this is my layman’s explanation:)

lynn, I've ascertained that the sequence of windyshores' treatment is right, but she took Evenity for four months not three.

Thanks @gently. I will miss @windyshores comments on this site. She was one of the best contributors, as are you and a few others that I gained a lot of understanding from. I watched the YouTube video of the guy who also posted it on this website (my apologizes for not remembering his name), and one of his slides suggested the sequence of Forteo/Tymlos to Evenity to Reclast. Then I remembered that @windyshores did just that! I thought the front end of Evenity was to build bone, and the end inhibited osteoclasts, but it sounds from your message that it works in the reverse? That actually makes sense, as I always wondered why you had to go on a bisphosphomate if Evenity worked like one at the end!

lynn59, you have it right-- the first three months of Evenity primarily builds bone. Evenity-bone is not the remodeled bone of the pth therapies--Forteo or Tymlos. It's a heavier unarticulated bone and it's periosteal bone. It is inside the sheath covering the bone, but on the outside of existing bone. Evenity doesn't remove old bone, it adds bone. It is a wonderful concept of building a scaffold to protect bones from collapsing. Windyshores speculated that after Evenity, because it builds so much bone quickly, Tymlos or Forteo wouldn't have anything to do.
We sparred. She'd laugh to see how often I quote her. I hope she is lurking and laughing.

Oh wow. Now I’m learning something new. Is that why all the endocrinologists seem to gravitate towards Evenity? Because of the type of bone it builds?

I did not have side effects. When you say grave concerns what do you refer to? Are you a person who commonly experiences side effects from medications?

lynn59, partly. We tend to measure the value of the pharmaceuticals in terms of bone density. Even the new TBS software measures density, but attempts to measure it in trabecular bone. Density isn't the only property of bone strength, it is the easiest to recognize with imaging.
And like Prolia, Evenity is fast.
Partly, though, it is Amgen's intense advertising campaign, directed our way, but mainly targeting and capturing our physicians, despite the black box warning for cardiac issues. "Plan Prolia as her next step after Evenity." There is speaker income and study funding for some. The endocrinologist I see proudly told me that he has been offered a speakership.
Both of these medication add layers of unarticulated bone to the outside of bone, where bone has never been before. It's called modeled bone because it prevents the removal of fissured, brittle bone.
Many women my age have very brittle bone from years of bisphosphonate use, and if a person is on the verge of fracture, these drugs could be the best choice.
The medications that build the strongest most integrated bone called remodeled bone are Forteo and Tymlos. Remodeling removes damaged bone, replaces that bone with articulated bone and restores lost trabecular bone.

Given those comments, I’m glad I choice a Forteo biosimiliar drug! Maybe Evenity will be right for me down the road? I’m only 66 years old so I’d rather not go on Prolia until my 80s. Maybe I’ll just do Reclast in April to lock-in my gains, then take a drug holiday! The only reason I was thinking of following with Evenity was to get me out of osteoporosis. I’m hoping my gains me from -3.5 in my spine to -2.8🤞. I’ve been very good with my diet and heavy weightlifting during my 18 months on teraparatite.