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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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I was on Forteo for the Two years and found no adverse affects. Not sure is Forteo or Forteo plus prolia changed my dexa nos. What put me away was Jubbonti. Every side affect in the book. It will be a year in Dec and ankles still locked. Bottom of feet swollen with toes. Pain everyday and night. About a 3-4. This drug is NOT a generic. FDA passed it as though it was using Prolia data. Most of the doctors know nothing about the drug therefore cannot help me. Some have asked me to spell the name of the drug!
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1 ReactionThanks for relating your experience of and info on jubbonti. So sorry you have experienced such harsh side effects.
I'm wondering if I can take Forteo and HRT together. Is that possible? My endocrinologist would not answer this question, so I have an appointment with a provider that can prescribe HRT.
@erinz, there are two key studies on the combination of teriparatide and HRT. Links are in this post: https://connect.mayoclinic.org/comment/1602274/
@lbrown742 I'm interested in adding testosterone to Menostar and progenterone (only 14 days every 3 months). Do you know why your endo is against testosterone?
Thank you!
@tillymack
She said there is not strong research supporting its use. I was only focused on getting estrogen and really didn't question her on it.
@lbrown742 Thanks for your reply!
@chikris
Year-2 HRT DXA update
I’ve now completed my two years of HRT following a course of Forteo. While this is simply my own experience, the results may still be of interest to others on a similar path, given how limited the data remain on transitioning from an anabolic agent specifically to estrogen.
Compared with last year’s DXA scan, L1-L4 spine and total hip BMD are holding steady, with the total hip showing a slight increase. I have not included the femoral neck measurement because of an unusually large jump this time. Such changes can result from small differences in leg positioning or technique (to which the femoral neck is particularly sensitive) and may not reflect a true biological change of that magnitude. All scans were performed on the same machine by the same tech.
TBS showed a modest decrease. I remain fracture free.
I’ve been using low-dose 0.025 mg/day transdermal estradiol patches throughout. Nutrition and supplements were fairly consistent over the past year; exercise and sleep less so. CTX during the second year of HRT stayed under 120 pg/mL, indicating a consistent response to estrogen. Two blood estradiol measurements came back at 42 and 50 pg/mL (baseline at 18), showing adequate absorption with no clear correlation to the timing of patch application.
Plan is to continue as is.
Any questions or thoughts are welcome.
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