Forteo daily self injections VS Evenity monthly shots?

I don't see the advantage of getting a drug like Evenity in the blood stream faster. Maybe slower would actually be better.

@nycmusic
tillymack, yes, and to your advantage. figure 1 is interesting.
https://onlinelibrary.wiley.com/doi/full/10.1359/JBMR.051020

@gently: Hi! We share some of the same health history, i.e. NET sm bowel with liver Mets and now osteoporosis.
Peer Protocol: Remove Evenity box from refer and open to get to room temp about 45min prior. I have been told to avoid headaches from Evenity shots to drink a cup of caffeine coffee 15-30min before shots plus I chew up 3-6 green olives about 10min prior - the sodium opens the veins and arteries providing best blood circulation. I have drunk lots of water (64oz/day) for 2 days prior to be well hydrated.
I put ice pack on the injection area 10 min prior (skin gets so cold it is kinda numb). Finally I clean injection area with alcohol, let dry, and pinch-up a roll of fatty tissue - then I insert needle and slowly inject the 1st syringe -slowly remove needle. Repeat for 2nd syringe. Total injected is 210mg.
The needle is not small like the “pen type injectors”, it is about 1 1/4” long and the syringe has to be pushed in.
After injections I clean area with alcohol and lie back down and relax. If I feel uncomfortable I put the ice back on the injection area.
I have tried different times of the day and think before bedtime is the best for me. Next morning the area may be a little irritated pink and tender. This tenderness and irritation may last a couple days. As I was learning and profecting my protocol there were times when I could feel a knot under the skin from the shot and some general skin swelling; however, I chalk this up to my lack of expertise in giving shots (gave shot too fast, position of needle, location with less fatty tissue, etc). Learning a new technique is a learning curve. I feel that Any discomfort I felt was from my ignorance and not the fault of the Evenity. Since beginning this treatment I do have small, random little pains (feet, hands, ribs, hips), but was told by my dr to expect minor events. I tell myself “Evenity is doing its magic”! I have never had nausea, but I eat very lightly that day and not right before the injections. A little bone pang is worth it to have given my “porosis a chance to be a penia” again. I’m thinking positive.
I chose to self-inject because I wanted the freedom to pick the time of day and be able to lie down after the injection to relax & be comfortable (I didn’t want to be uncomfortable driving home). We all hate having unknowns taking new treatments! Has my saga helped you compare the different treatments?
Best health in 2026! Bette dbamos1945

@gently Thank you for the link! I agree the study supports that HRT and teriparatide can be used together, and the combination was well tolerated during trial period.

A small nuance though: this study used teriparatide 40mcg daily rather than the currently approved 20mcg daily dose, and the higher 40mcg has been shown to have significantly stronger bone building effect than 20mcg. Also, the study compared
teriparatide + HRT vs HRT alone and showed superior results, though it did not compare
teriparatide + HRT vs teriparatide alone

i think it would be very interesting to know whether HRT + current usual 20mcg teriparatide provides extra benefit beyond teriparatide 20mcg (Forteo) by itself; that question cannot really be answered from this study.

@dbamos1945 if you don't mind, could you share which insurance coverage you use for the 3mo billing (medicare part-d, original medicare with or without supplement, or medicare advantage)? I'm also curious how the self-injection is set up administratively, since most patients receive these injections in a clinic or an infusion center. Thank you

@mayblin: First of all my dr told me I could self-administer, particularly since I am diabetic insulin dependent. I ordered the first rx on phone with mail-order pharmacy and the agent encouraged me to have the drug delivered to the dr office (perhaps she was telling me this would be in my financial favor?). She did not ask if I was self-administering. They asked for the Dr office address and phone.
I have Original and an ex-employer supplemental insurance including formulary drugs.

Thank you so much for the information @dbamos1945, that’s very helpful. I appreciate you sharing how it’s been set up for you.

@tillymack I don't see why not. I know of a clinical trial that involved giving Evenity and Forteo treatments at the same time. Not sure what the outcome was. I'm interested in doing Forteo and possibly HRT or a SERM. I'll see what my doctor thinks of this and share once I know more.