Mixed results 1 year after Forteo: What are your thoughts?

Yes, the lab reported normal results by age. But what is "normal" may not be ideal. My LDL was listed as "abnormal" but I would bet it is normal. Not the ideal value but probably falls into what is the reality. Otherwise, the medical professionals would not be trying to get everyone on statins.

I keep seeing references to everyone needing to monitor bone markers but I have seen no one mention what the numbers mean.

Hi @normahorn allow me to bud in here. I have just started learning about bone markers. It seems many clinical settings are not using them as a standardized protocol. After watching 2 separate interviews with 2 clinicians (endocrinologists) who practice at MGH, I was surprised to learn that even a setting like MGH doesn't follow them! Maybe too much variation exists especially with regards to CTX? Nonetheless personally I felt it would be very nice to have them at diagnosis, for a future reference, regardless of their accuracy or interpretation.

As far as cholesterol and the hot topic of statin, personally I'm in the camp of using a sensible choice of statin. I'm an example of careless lifestyle choices which handed me with a mild cad ( shame on me!!! 3 generations of both sides of family have no cvd or diabetes, almost no meds living into their 80s and 90s). My numbers were not too far from guidelines low 200s total, 60-70s hdl, 130-150 ldl. The discovery of my cad was accidental from a CT to investigate my cough. I thanked the MD for potentially saving my life, or extending my life. Cardiologists don't call hdl 'good' cholesterol anymore. If my understanding is correct, the new guidelines for ldl is below 100, and ldl is the one that you want to pay attention to. If one has 2nd risk factor, the target for ldl is under 70, which is easy to achieve in my case with a low dose of statin, but hard with just diet and life style. In my case i could only reduce my ldl to around 100 with a strict diet and some exercise. With that said, the door for future evenity may be closed for me, leaving me with one less choice among the limited treatment tools.

Thank you for the information regarding BTM.

However, you missed my point regarding terminology used. To me "normal" does not refer to guidelines or recommendations but to what is typical of the average person. The average adult woman is 5'4" in height and weighs 170.6 lbs. So the normal for women is to be almost classified as obese with a BMI of 29.3. With lipids, the upper limit for LDL of 100, I would guess, is not what would be found in the average woman.

Thank you for pointing hat out, I know what you meant now! Closer to the average height, I weigh about 115 lbs, a low bmi for sure. Getting personalized medical care for 'smaller' sized patients is vital, i agree.

All of our lab numbers or biomarkers will fall within a spectrum, more or less. If the number(s) become extreme, it'd definitely raise an eyebrow. But sometimes, the little things sneak upon us over the years. My ldl in the past fluctuated depending on what i ate, many times they were normal. Well it sure did its damage. If there is a guideline to adjust normal range according to weight or age, would that be nice! I'm so glad I got this managed right before diagnosis of op. It'd be a lot tougher to figure out management of multiple disease states all at once.

The main reason I wanted to put my voice in this topic of cholesterol, is in regards of evenity's side effects upon cardiovascular system. I haven't read into the mechanism behind this yet, but for those of us whose lipids are borderline like mine, we should be on guards.

The fracture clinic I went to did not mention lipid levels at all but suggested Evenity for me. I recently pointed out to the NP that the network system she belongs to has flagged me as being malnourised. (4'11 weighing 100 lb) Pushing full dose Evenity might be cause for a malprctice claim if I blindly followed her plan.

I wish there would be more consideration given when terms such as normal or recommended levels are used interchangeably. They are not the same.

My Endocrinologist told me that Fosamax locks in the bone increase. Without it you will loose the Forteo bone density increase.

@lkel could you share the reason why your physician chose fosamax over other bisphosphonates after forteo therapy as a 'lockin' agent? Thank you!

He only said that if I didn't follow up with Fosamax I would lose the gains I got from Forteo.
I found this about a research study: Recently, some researches showed that sequential administration of parathyroid hormone followed by bisphosphonate was effective in increasing the BMD of osteoporotic patients, in which the followed therapy of bisphosphonate could effectively maintain and elevate the BMD after teriparatide discontinuation [17].

Thank you very much for your reply lkel. Is your doctor monitoring your current fosamax treatment with any bone turnover markers, or just with Dexa annually? If you don’t mind, please share Dexa results following fosamax therapy.

Just so you are aware, Fosamax is not the only bisphosphonate on the market. It was recommended to me by Dr McCormick , because I’ve had some history of GERD. That he would recommend Actonel, not Fosamax . Look into that . Maybe a possibility .