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

@janflute if you don't have a health condition that concerns your doc about Reclast, they will probably suggest kidney testing, then hydration day before, day of and day after, and a slow infusion. You can also medicate beforehand. Many women I know have absolutely no side effects, but many who do have side effects post here. My test dose is because I have afib, kidney disease and med reactions and my doc wants the test dose for those reasons. Not sure your doc will prescribe a test dose without a reason-? My nephrologist is very concerned for my kidneys with Reclast and communicated that to my endo.

I would think that switching to Evenity might be a good possibility if the Forteo is truly not working or even making things worse. Is it possible the technician made an error?!

I will stop Forteo on July 21,2024. At that time I need to have a Reclast infusion to hold any bone gains in place. My oral surgeon would prefer me to take Fosomax instead of Reclast, because of complications with the jaw bone should I need invasive dental work in the future. Are there any studies comparing the efficacy of Reclast vs Fosomax in holding bone gains after Forteo?

@janflute i haven’t come across direct comparison of reclast vs fosamax in a clinical study. The impression i have is that reclast is more powerful. If you could tolerate fosamax and jaw bone is a concern, would fosamax be a better choice in your case, since you could stop using it for a while should oral surgery be needed?

In any case, it is said that effects on jaw bone is minimum if one uses 5 years of fosamax max or 3 annual injections of reclast max. Correct me if this is wrong.

I have a similar time table as yours. Need to decide what to do at end of forteo which is early September.

@mayblin I don't think lack of exercise explains your situation. I hope you will do Forteo for two years and have a DEXA then. It is still early to do a DEXA. The loss in your hip is a mystery. What does your doctor say?

For those who are nervous about Reclast, you could ask for a test dose of 20% to see how you react. Then have another infusion at a dose of your choice in 3 months. Again, discuss with a doc!

@awfultruth, @mayblin, @gently @windyshores or anyone! LOL
A couple things - I had nutritional chemistry and wanted to chime in on the protein. Get an adequate digestible source of complete proteins - whether you eat meats/fish OR rice/corn/beans - which together makes a complete protein source, does not matter. Why? Your body needs to break it down into amino acids because they build it back up to YOUR body's signature protein. This is the same with cholesterol. People think eating eggs is bad but then they turn to "components" of cholesterol (like oils in foods) and they give their body an EASIER way to make the signature cholesterol.
Protein, carbs or fats -- UNUSED -- will be stored as fat.
Calcium: Calcium levels should be tested BEFORE you adopt any calcium supplements! As stated above, too much calcium in the body can cause devastating effects like calcium lime deposits on your kitchen faucets!
My own blood calcium stays at 9.6 for 40 years. Dr.'s always try to put me on calcium BEFORE they do the test and then they have to take me off. I am lactose free for 6 years and post menopausal for 20 and my calcium does not budge. Your body has a decent way of metabolizing what it needs if you give it a decent diet.
When one ages, one can't metabolize certain things (especially w/o hormones!) so supplements and changes are necessary. But, I always ask for testing to guide my supplement decisions.
Question was asked about good sources of protein: eggs, salmon, tuna, fillet, chicken, pork tenderloin, and yes, even red meat (for HEME iron - I have a problem with iron). Dark green leafy vegetables, don't drink milk with iron containing products, and drink quality nondairy milks if you drink that. Some actually SUCK with 0 protein! For almost the same money you can get 8 or 20 grams of protein. (not to mention calcium and D).
I'd suggest 65 grams of protein per day, with 90 grams if you are counting incomplete sources. More can't hurt.
Now for the real reason I write:
I don't understand the P1NP test score from the literature I just read. It sounds like an INCREASE is bad indicating that the bone is remodeling (breaking down) at an advancing rate as the number goes higher.
But then it contradicts in the same articles that the increase means the bone medicines are WORKING. I'm really lost in this. I just can't interpret the material.
3 months ago, starting the Tymlos and after one reclast infusion the previous year, I was at 49. Three months later I am at 90. I freaked out but then I kept coming across info that maybe its a good thing.
I'll be doing the DEXA with the software analysis (TBD?) next month.
I went to the surgeon and he said "it looks like your spine bones are a little denser in the xrays!" (since my discs are degenerating at an advancing clip, I was happy to hear that! )
Thank you, Lori

@loriesco not to worry. Your P1NP numbers look good to me. Others will probably comment who have more experience with following the bone markers along with their meds but from my limited experience and studying this, yours are fine. The starting number of 49 is a mid-range number for how much bone building your body is doing without an anabolic med. The 90 reading is a good step up indicating your body is responding to the Tymlos by creating more bone.
OTH if your initial reading was 90 that might be a bit worrisome as an indication that your body without meds is trying to build a lot of bone and probably is also "cleaning up" a lot of bone. I do not know how taking Reclast might have effected your baseline P1NP but generally your numbers indicate bone building was normal range before and now it's kicked into high gear which is what you want.
You did not mention your CTX score which indicating bone breakdown is used along side the P1NP to get a view of the balance between building up and tearing down. If you have your CTX scores that might help clarify things further.

@loriesco not to worry. Your P1NP numbers look good to me. Others will probably comment who have more experience with following the bone markers along with their meds but from my limited experience and studying this, yours are fine. The starting number of 49 is a mid-range number for how much bone building your body is doing without an anabolic med. The 90 reading is a good step up indicating your body is responding to the Tymlos by creating more bone.
OTH if your initial reading was 90 that might be a bit worrisome as an indication that your body without meds is trying to build a lot of bone and probably is also "cleaning up" a lot of bone. I do not know how taking Reclast might have effected your baseline P1NP but generally your numbers indicate bone building was normal range before and now it's kicked into high gear which is what you want.
You did not mention your CTX score which indicating bone breakdown is used along side the P1NP to get a view of the balance between building up and tearing down. If you have your CTX scores that might help clarify things further.

thank you that is wonderful news. The CTX , along with the first P1NP of 49, was 322. Here's another mixed misunderstanding for me. Google says: "Beta-crosslaps test results are normal when less than 300 pg/ml. Above 300 pg/ml indicates increased bone resorption. In this case, the patient may have osteoporosis, Paget's disease, hyperthyroidism, and hyperparathyroidism."
So - do you understand why I am frustrated and anxious? My score is higher than 300, but that is supposed to be GOOD in the first part of the quote. Then, (like the P1NP) it goes on to say that it means negative stuff - osteoporosis and disease. Why can't people write in simple language. It should be qualified with "if you are on bone stimulating medications the response should be taken as an indicator that medicines are positively working in comparison to those who AREN'T taking them, which indicates an underlying concern.
Shouldn't I have had a second CTX at 3 months like the P1NP?!
The Reclast was done Aug. 2024. The Tymlos started mid March but I had such bad reactions I skipped the following month. The P1NP/CTX mid June and now the P1NP. Let me know if I should ask for a CTX to compare? thank you!!!