Adding Oral Estrogen on Post menopause woman

Estrogen does more to maintain bones rather than build bone density. With those scores, you really might consider a bone builder like Forteo or Tymlos first and then go on estrogen to maintain (if you can get it prescribed by your doc. If not, perhaps through Alloy Health you can). After years of trying to build my bones naturally and suffering even greater loss, I finally accepted that I would need a drug. My drug of choice was Forteo due to the fact that it restored bone density predominantly in the spine and because it was the most "natural" of the options being that it is parathyroid hormone which the body recognizes. Once I was finished with the full course, I went on bioidentical hormones which has maintained my gains.

Estrogen does more to maintain bones rather than build bone density. With those scores, you really might consider a bone builder like Forteo or Tymlos first and then go on estrogen to maintain (if you can get it prescribed by your doc. If not, perhaps through Alloy Health you can). After years of trying to build my bones naturally and suffering even greater loss, I finally accepted that I would need a drug. My drug of choice was Forteo due to the fact that it restored bone density predominantly in the spine and because it was the most "natural" of the options being that it is parathyroid hormone which the body recognizes. Once I was finished with the full course, I went on bioidentical hormones which has maintained my gains.

I'm confused. Excess parathyroid hormone leeches calcium from bones. Does Forteo block parathyroid hormone?

Hi, I agree with @teb. Your scores require serious consideration of medication. My lumbar spine Dexa score is -3.1 and I don’t want to take a chance it will get worse as I’m still very active at 65. Like you, I am super reticent to start medications and I am waiting until my appointment next Monday with Dr. McCormick to help guide my choice. I’m on the same page as @teb with starting with Forteo (even though my endocrinologist suggested Prolia, and when pushed about a bone builder he chose Evenity). I’m having a hard time finding anyone who will give me HRT so I may have to follow with Reclast. I would really prefer to start HRT afterwards though.

yes, high parathyroid hormone levels cause bone loss. Forteo is a very small dose of PTH once a day and they found that this actually stimulates bone growth.

Intermittant PTH stimulates bone growth. Constant PTH causes bone loss. Paradoxically!
An injection of Forteo which is a portion of the parathyroid hormone floods the blood stream. Through a series of chemical responses, pth stimulates your kidneys to return departing calcium from the bloodstream back into the bloodstream; takes calcium back from the bone; activates 125D.

I speculate that taking calcium from the bone jump starts the effect that the osteoclasts exert on bone remodeling, stimulating the osteoblasts to lay down all the calcium gathered from those various sources. An effect enhanced by the availability of 125D
I'm fascinated by the process and have been trying to find a precise description of the timing of the chemical cascasde caused by daily injections of Forteo. There are rumors of more effective intermittancy patterns (that is longer periods between injections--daily or weekly).

I've been on Forteo since April. The P1NP bone markers for new bone have gone from 65 to
117. I so like this drug.
Good thinking, teb.

There are the Japanese Tower studies where they used weekly injections of 57 or 58 mcg of teriparatide and had the same results although the total weekly dosage was so much less. The aren't large studies, but the potential is exciting. Then the Crossman studies in the US using three months on and three months off with the better results. I think you are right ultimately less is more effective. I don't have any links with me, but I can send them though just googling will get you there. My plane is to may Forteo my only drug.

I went on HRT at about 62 years old. I was lucky in that I had a doctor whom I was able to convince that it was the best option for me. As someone with autoimmune issues, I did not want to go on anything that would further mess with my immune system and he ultimately agreed. If you don't want to go on Reclast afterwards and want a script for HRT, Alloy Health may be the way to go. An MD will review your case at no cost, determine whether you are a good candidate and if so, write the prescription. If you want a personal consult with one of their docs, the cost is $35. Cost for the medication is virtually the same as through any doctor prescribing it as at our age, insurance won't cover it (but it's not expensive out of pocket). It's really a great service, helping women who want HRT as most doctors are still reluctant to prescribe especially once you are well into menopause. The other alternative is finding a doctor certified as a menopause specialist and you can find a database on the North American Menopause Society website (if you are in the states). I am seeing a menopause specialist, Dr Felice Gersh, here in SoCal and she is extremely experienced and knowledgeable. When I initially went on hormones the philosophy was "lowest dose, shortest amount of time" but that mindset is shifting due to the revelations on the faulty analysis, confounders and misrepresention of the WHI study. I'll be seeing Dr Gersh again in a couple of weeks and based on our last discussion, I think it is likely she will be increasing my dose for greater effectiveness at maintaining my density (along with many other things). The only downside to going the route of personal appointments with a menopause specialist is the very high cost of a visit as many of them do not accept insurance. So, the alternative is the online service but for me, a lengthy analysis and discussion was really important so I opted for the specialist. Once I'm established with her and we figure out best dose, I may just switch to Alloy and continue on.

Intermittant PTH stimulates bone growth. Constant PTH causes bone loss. Paradoxically!
An injection of Forteo which is a portion of the parathyroid hormone floods the blood stream. Through a series of chemical responses, pth stimulates your kidneys to return departing calcium from the bloodstream back into the bloodstream; takes calcium back from the bone; activates 125D.

I speculate that taking calcium from the bone jump starts the effect that the osteoclasts exert on bone remodeling, stimulating the osteoblasts to lay down all the calcium gathered from those various sources. An effect enhanced by the availability of 125D
I'm fascinated by the process and have been trying to find a precise description of the timing of the chemical cascasde caused by daily injections of Forteo. There are rumors of more effective intermittancy patterns (that is longer periods between injections--daily or weekly).

I've been on Forteo since April. The P1NP bone markers for new bone have gone from 65 to
117. I so like this drug.
Good thinking, teb.