Elevated ALP after 3 months of Forteo

paulita, elevated ALP can indicate bone growth and is common on Forteo and Tymlos. you might ask that the next test measure isoenzyme ALP if your physicians are concerned. Be sure they understand about your use of Forteo. It is a good sign. But then, you are on the best medication for osteoporosis.

ALP …. alkaline phosphatase? Mine was elevated a little bit. Strange my doctor didn’t even realize it could be from Tymlos. and that it could be a good thing

There is a bone specific ALP--BALP, but the generalized test doesn't distinguish. It seems a little scary when our doctors don't know something that we've discovered accidentally. We can trust our doctors to do the best they can for us, but the reality is that they have too many diseases with myriad pharmaceuticals to investigate. Even if your provider is an endocrinologist there are so many diseases and way too many patients.
Inspite of the common physician disregard for patient research, it really is something that the present state of medicine requires of us. Elevated ALP can be the result of other disease. So you can be assured of their diligence. Cheers to your doc, they prescribed the best med in spite of all the fanfare over the newer medications. And cheers to you for being a little wiser than most. That's a really good thing.

My ALP (serum, total) almost doubled after I started Forteo and my endo said it was normal being on Forteo. Near the end of Forteo treatment, ALP did come down to my regular normal.

I read a bit about ALP - it could come from liver, bones and other tissues. When the bone formation is ramping up while one is on an anabolic, bone specific ALP increases and this reflects the mineralization phase of bone formation. Bone specific ALP is part of total ALP hence your serum total ALP goes up on Forteo. Some endo does lab work for bone specific ALP.

Thanks for your replies folks. I am SO happy to be on Forteo and it looks like it's doing its job - Yay! I did have to fight for it. I guess my doc was concerned about elevated ALP because I have MGUS but I'm sure it is a sign of bone turnover/building. My MCHC was high too so we'll test that in two weeks also. Again that might be nothing e.g. dehydration. I am being well taken care of anyway.

Just noticed that my LDL and Triglycerides have gone up quite a bit also. Is there a link to taking teriparatide do you think?

Thank you for this discussion. I’m always learning something new about these meds. I didn’t realize the ALP may increase and it would be a good thing. @gently and @mayblin would this apply to tymlos as well? I’m assuming since they are so similar.

Yes.
Mayblin's last answer was so much better than mine; I'm waiting to read her's first.

There were no lipid profile changes during Forteo treatment in my experience. I worked on my LDLc and triglycerides - my labs were stabalized before the diagnosis of osteoporosis and they didnt change much during use of Forteo even with increased protein intake. To me, eliminating processed food (carbs) did wonders to my trigliceride readings and cutting down saturated fats from animal sources helped a lot in reducing LDLc.

@bluebonnet242 yes I think it applies to tymlos also although total serum ALP is not sensitive enough as a marker for bone formation. The bone-specific ALP changes a lot less in magnitude during antiresorptive or anabolic therapy when compared to P1NP. This might be one of the reasons that the International Osteoporosis Foundation recommends P1NP and CTX as bone formation and resorption reference marker respectively, in clinical studies.