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Forteo (teriparatide) followed by HRT: My Experience
I wanted to start a thread sharing my experience with Forteo → HRT, since this treatment sequence is less discussed but may be very helpful for other women navigating osteoporosis.
I was diagnosed with osteoporosis at age 59. My lowest T-score was –3.4 at the lumbar spine, with hip and femoral neck in the osteopenia/borderline osteoporosis range. My endocrinologist ruled out secondary causes. Without a family history, postmenopausal estrogen deficiency seemed the most likely contributor, though low BMI, protein intake, and activity level/type may have played a role.
Shortly after diagnosis, I improved my diet and added weight-bearing exercise. I started Forteo (teriparatide) within a few months and continued for 22 months. P1NP was 137 µg/L at the end of Forteo.
At age 61 (11 years postmenopausal), I transitioned to HRT: transdermal estradiol 0.025 mg/day patches plus oral micronized progesterone 100 mg/day. It’s now been 15 months on HRT. CTX stayed 110–130 pg/mL after 6mo starting HRT.
Since the start of Forteo to 15 months on HRT, my results have improved as follows:
• Lumbar spine T-score: –3.4 to –1.9
• Total hip T-score: –2.2 to –1.7
• Femoral neck T-score: –2.5 to –1.8
• TBS: 1.264 to 1.34
All DXA scans were performed on the same machine by the same technician. Detailed DXA results, including percent changes from previous scans and baseline, T-scores, and TBS values, are presented in the attached spreadsheet if anyone is interested.
Between my last two DXA scans, I also used three leftover Forteo pens with off-label dosing.
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Note: I use the term “HRT” because it’s widely recognized. In medical literature, “MHT” (menopausal hormone therapy) is the standard term. In my case, I used regulated, body-identical estradiol and micronized progesterone, sometimes referred to as bHRT.
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Thanks for reading! I would love to hear your thoughts, experiences, and insights. Also please feel free to ask any questions.
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@mayapath2health
I started bhrt at 76. I'll never stop.
@mayapath2health, I will be 75 this month, so I am much older than you are. The reason I didn't take Evenity was because of having to take Prolia or Reclast afterward. Since Evenity is very strong, I would be concerned that Estrogen might not be strong enough to hold in gains? Of course, I don't know. Reclast appears to have more side effects for some people than Prolia does. However, an osteoporosis specialist told me that I could take Reclast once and be done for life? Since you are only 62, you might consider HRT as a long term plan.
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1 Reaction@gravity3 Would love to know more!! What led you to start, what kind/dose, and what benefits? I was told since I had menopause in mid-40s that at 62 it was too late to start as menopause had been over 15 (nearly 20) years ago).
@mayapath2health
I had sudden onset menopause at 38. At 76 I made my decision to start bhrt because I wanted quality over quantity for my remaining years of life. I did not start for bone support but understand that it can help. I wanted many of the other benefits primarily restored libido. I have a estradiol/testosterone pellet inserted every 12 weeks, I have vaginal estradiol as well as progesterone. I'll look up the doses and post. As far as risk.....life is a risk.
i was diagnosed with osteoporosis at 55.....was prescribed biophosphonate tablets and vitD supplements....didnt work work...few months ago...i decided to change from osrtho to endocrinologist.....he performed a series to serum PTH test with a gap of 15 days to a month....it came out to be high and fluctuating.....the the doctor prescribe ultasound neck , which showed a nodule on parathyroid gland...to rule out cancer i was advised to take sestamibi scan of thyroid and parathyroid gland,...whcih came out negative.....m calcium levels were always normal....so the final diagnosis was normocalcemic hyperparathyroidism....which caused the osteoporosis......i am on alderonic acid(osteofos) and will be going ultrasound guided radiofrequency ablation to vaporise the abnormal gland.....that would most likely treat and hopefully cure the osteoporosis/boneloss..........if i would have taken HRT as advised by my orthopedc doctor...i would have lost more bone.
@mayapath2health
Other benefits:
Improved muscle mass retention.
No more senile purpura
Almost no urine leaking
Better sleep and mood.
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1 ReactionThat becausethe rule of thimb said higher risk 10 years postmenopausal. But even the drugs have a risk...i personalchoose the estrogenpatch for my risk... fingers crossed. @mayapath2health
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