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Anyone use HRT as their immediate follow-up to Tymlos or Forteo?
I'm 63 and will finish 24 months on Tymlos six months from now. At that time, I'll have 6 final months on my commercial insurance before starting Medicare.
I'm one who is probably above-average motivated to delay using a bisphosphonate to "lock in gains" for as long as possible. I don't want to do it anytime soon because I feel like a lot of changes are afoot in this field and best practices are evolving to where more and more people are going to be "allowed" to stay on anabolics past 24 months. That excites me and I don't want to do a bisphosphonate and then dampen the future efficacy of any anabolics I might be offered.
Anyway, I've been researching new-fangled approaches to drug selection and sequencing for my impending "24-months-on-Tymlos-is-now-complete" phase. Working hard and smart on a Prior Authorization for Evenity after Tymlos intrigues me as one possibility as does the use of late-start (11 years after menopause) HRT alone for my next phase.
When we touched on possibilities for this next phase (as we often do in my appointments) my endo caught me off guard because we had just gone over extra lipid testing I had done (APOB and LIPO(a) ) and when I asked him how he was "feeling" about the eventual possibility of using over-60, late-start HRT for locking in gains he said "I have no problem with HRT for you-- your LIPO(a) is near 0 and your other numbers look good. Why do you want to wait till you're done with Tymlos? Why don't you start now and get the benefits of HRT now?"
This was a 20 minute appointment and time was up and the nurse came in and I got whisked away to get my A1C checked or some such thing. I told him I had a lot more questions and would make a longer appointment very soon--he said great/good idea, that he always forgets I'm one of his only patients who does her own research and has her own ideas (?!) and he welcomed the discussion. He said he was calling in .025 patches and 100mg micronized progesterone that day, anyway, so that I'd have them available if I decided I want to get started now.
TLDR: I believe there a couple of you on here who are using HRT as your Tymlos or Forteo or teriparatide follow-up regime... (?). If so, did any of you get started on the HRT while on the home stretch of your anabolic? Or did you wait till your course of Tymlos, Forteo, etc., was complete?
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@md79
There is a workout program called Onero based on the Liftmore studies done by Dr Belinda Beck in Australia. You can look her up and read more about her research. The program focuses on high intensity resistance training and uses back squats, overhead press, deadlifts and jumping. It is done with professionals, most often physical therapists, who have been certified in the program and needs to be done with their expertise to avoid injury. There are only a very few clinics around the US that offer Onero, and not near me. The closest clinics with therapists certified in Onero are 2.5 hrs away from where I live. So since I've done weight training most of my life I'm winging it on my own. Please don't do that! I use online workouts that use those same basic Onero moves. Apps like Nike training and Fiton are free and have hundreds of weight training workouts... Along with every other kind of workout you can think of to balance out the weight training days. On YouTube there are free workouts from various people that use weights. One free workout resource is Dr Lisa Moore who has program called Brickhouse Bones. Her workouts are all specific to osteoporosis. She is a PT and I do her workouts a lot. All of these are just suggestions of places to find those Onero movements that actually build bone, but the key is to work up to a very HEAVY weight VERY SLOWLY to avoid injury. Whatever your or anyone's level, exercise and movement are truly necessary for long term health in general, not just bone health. If you are lucky enough to live near a clinic that has Onero trained therapists it would be worth it to check into it. You can find locations by searching online for Onero or Dr Belinda Beck and the Bone Clinic. Good luck!!
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2 ReactionsI have never been on HRT but I am researching now to see if it would be a fit
With endocrinologist #1, all she offered me was Tymlos and I wouldn't do it, I am waiting for a 2nd opnion, my appointment isn't until Oct, and researching whether I can go on HRT at the age of 68 for bone density, while doing other things like weight training, exercise, algae calicium supplements
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1 Reaction@psmnonna This is very helpful information. Looks like there is one Onero-trained clinic in Seattle, WA. I'll get my 1st appointment with a question about how soon I can start training if I am on 13th week after the T11 fracture.
@md79
Wow! That is great you have a clinic accessible to you! They are very careful to start with an evaluation session first and then starting the program where it best fits you. Again, I've not experienced it but read a lot of their online information. I hope you can do the program and report back here over time. A first person experience would be helpful to all of us.
Cheers!
Nonna
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3 ReactionsI've been on both since I started Forteo, at the same dose that your doctor has prescribed.
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3 Reactions@md79 I would say be very careful. In order for participants to be in the lift more study, you had to be fracture free and only have osteopena. I had previously fractured my feet and wrist. I have severe osteoporosis and wanted to try and build bone lifting weights. 3 or 4 months in I had a stress fracture in my ankle. My doctor said you should not lift heavy with severe osteoporosis as it actually increases your risk for stress fractures. I'm currently taking Tymlos and hrt and doing light weights. Hopefully I will get good gains and then lift heavy in the future.
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3 Reactions@lbrown742 Thank you for sharing your opinion. That is my worry and fear. My appointment with a gynecologist for HRT is soon on June 1st, and a rheumatologist for osteoporosis treatment in the middle of June. Until then, I need to get clearance from a cardiologist with hypertension and some plaques in my coronary arteries. My dental implant was removed due to failure to fuse, and my dentist said it will take about 4-6 month untill full bone recovery.
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1 Reaction@md79 I was lucky that my endocrinologist agreed to put me on hrt. I was 14 years post menopause. One thing the hrt did help me with was my lipoprotein a which was slightly out of range. The estrogen has helped lower it considerably. I'm hoping to just stay on it forever and use it as my only follow up to Tymlos only using Reclast if absolutely needed. We'll see. It's so difficult to know what to do! Best wishes
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6 Reactions@lbrown742 Thank you, and best wishes to you and All in this journey! I hope the gynecologist I am going to see will agree to put me on HRT as well.
@lbrown742, @hdeff
Do you monitor bone turnover markers (BTM) during treatment?