@mkoch Thank you very much for sharing your story, it’s so valuable to hear a long-term perspective. Forteo followed by estrogen clearly worked very well for you in maintaining Forteo gains for many years. I’m sorry you had to face breast cancer and stop estrogen - it really highlights how important it is to weigh risk versus reward and to keep monitoring over time.

From what I’ve read, after long-term Prolia treatment, switching straight to Forteo hasn’t worked well in clinical trials, with BMD often decreasing. Definitely worth discussing carefully with your doctor. Please keep us posted. Your experience gives the rest of us a lot to learn from.