Anyone use HRT as their immediate follow-up to Tymlos or Forteo?

Posted by annie208 @annie208, Feb 11 4:32am

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?

Interested in more discussions like this? Go to the Osteoporosis & Bone Health Support Group.

lbrown742 | @lbrown742 | May 27 11:46am

In reply to @mayblin "@lbrown742, @hdeff Do you monitor bone turnover markers (BTM) during treatment?" + (show)

@mayblin yes, I had them done about 7 weeks in. My P1NP increased by 297%.

lbrown742 | @lbrown742 | May 27 11:49am

I started hrt about 6 weeks before Tymlos. I'm hoping to use it at the end of Tymlos to hold onto my gains.

hdeff | @hdeff | May 27 1:12pm

In reply to @mayblin "@lbrown742, @hdeff Do you monitor bone turnover markers (BTM) during treatment?" + (show)

@mayblin no, my endocrinologist doesn't seem to do that :+(

mayblin | @mayblin | May 27 3:41pm

In reply to @lbrown742 "@mayblin yes, I had them done about 7 weeks in. My P1NP increased by 297%." + (show)

@lbrown742, that's a great response! I hope you'll be able to use HRT afterward to help maintain the gains from Tymlos as well. Thanks for sharing.

singingbones | @singingbones | May 28 9:10am

I am on the home stretch of my anabolic - Evenity in my case. I have been on a low dose of vaginal estrogen for several yrs, but the amount of estrogen barely registers in blood labs. A new dr added a higher dose of estrogen to be used systemically/topically a month ago. For me, that will be an overlap of only 3 mo before the Evenity course is finished.

As with you, my desire is to use HRT as my follow-up to maintain gains from the drug. I have also increased my protein and Ornero-type exercises.

lp30 | @lp30 | 7 hours ago

In reply to @psmnonna "@annie208 Yes to all. I finished my 2 years of Tymlos at the end of Feb..." + (show)

@psmnonna I am just starting the patch along with Tymlos and can't figure out where the heck to put it since they say it has to be 2 inches away from any current or future injection sites and I rotate the Tymlos all around my abdomen (esp. use lower area ). I 'm trying to avoid butt because I use a heating pad on my lower back and was told never put high heat near the patch. Where did you put yours? Thank you so much and hope you are doing well!

lp30 | @lp30 | 7 hours ago

i am 8 months into Tymlos, also 63, and just beginning the same HRT you described. How has this worked for you? And where do you put the patch so as not to interfere with injection sites? Thank you and hope you are doing well!

lp30 | @lp30 | 7 hours ago

In reply to @lbrown742 "I am 67 and never took hrt. My endocrinologist agreed to start me on hrt. About..." + (show)

@lbrown742 I hope to skip Reclast when I am done with Tymlos too. Can you tell me where you put your patch so it did not interfere with your injection sites? Thank you!