Evenity + HRT synergy?

Thanks for the link! This observational study offers some real-world experience with the combination of Evenity and HRT, which may be useful for those considering Evenity treatment who are currently on HRT.

There are a couple of RCTs done for the combination of teriparatide + HRT, links in this post:
https://connect.mayoclinic.org/comment/1602274/
Neither study directly compared teriparatide + HRT to teriparatide alone; and both used teriparatide doses higher than the standard Forteo dose of 20mcg/day.

@mayblin Thanks so much for this!

I too am curious if anyone’s doctor is prescribing HRT alongside Tymlos or Forteo. I was under the assumption it would help, but there seem to be no studies or data to support this idea. Only that it could help maintain bone afterward. But if you have to follow up with Fosamax or similar anyway, do we really know HRT will add to this?

@lp30 It seems - from my brief glance at a couple of studies - that both HRT and bisphosphonates cause cell death of osteoclasts, which would explain why both are classified as anti-resorptive. (Disclaimer: I have zero background in biochem! Just a lay person trying to learn.) If both therapies have the same action, it would seem that either could be employed. An important question must be which gives better results.

@lp30 I’m 75 and I just asked my GYN about HRT with my bone condition and she said the HRT at my age might kill me. Didn’t say why!

@karyn23 - it appears that the Royal OP Society https://theros.org.uk/information-and-support/treatments-and-medicines/a-to-z-list-of-medicines/hormone-replacement-therapy-hrt/ promotes HRT as effective as bisphosphonates. Seems that (thinking outside the conventional medical box) if one was taking Evenity and HRT and had significant improvement, then she could continue with HRT as the follow-up to maintain the gains...just a thought...

@singingbones Your thought makes sense to me. Thank you for the Royal OP Society info!

@jmc50 Gah! Surely there's room for a conversation on why she feels that way AND what the specific risks are and their odds of occurring. Some doctors welcome the conversation - why wouldn't they want a well-informed patient? - and some doctors can't be bothered. Frustrating, particularly when there are no hard and fast answers. My understanding is that at a certain age, with certain comorbidities, HRT may not be good for heart and brain health. It seems there are not enough studies to get clear answers one way or the other.

@lp30 I am a 70-year-old woman with an early subtotal hysterectomy (one ovary removed and the other was left a small part of it) at age 34. A month ago, I went through rigorous consultation with my cardiologist, and he cleared me for HRT/ transdermal estradiol \/patch starting with the smallest dose, 0.025 mg, and going up to 0.05 mg if my heart and blood pressure are OK. I started Teriparatide/Forteo 2 days ago. Currently, I am experiencing "heavy chest" after each injection, and my blood pressure is a little bit high. I think this is a Forteo side effect and hope to adjust to it.

@jmc50
time for another opinion?