Forteo (teriparatide) followed by HRT: My Experience

Thanks so much for sharing your results!

maybin: Great post. I mentioned a nearly identical protocol for the treatment of osteoporosis but it was embedded in another post. I took forteo for 2 years, with great results as well, and followed with the .025 estrogen patch. (I had a hysterectomy so didn't need the progesterone.) The estrogen patch resulted in me keeping the gains I had made on forteo.

@mayblin Wow! I really needed to see this! Great numbers and improvement. I'm 5 mos to the end of my second year on Tymlos and just started on BHRT. At 65 my beginning Dexa was -3.6 in the spine and -3.1 after one year on Tymlos. I just added the BHRT 3 weeks ago. So hopeful that Tymlos shows more positive gains next Feb when I have my second Dexa and that the BHRT will also add to and keep those gains going. I was older than you when all of this started and also 18 years post menopause....so that may play a factor in how effective the BHRT is. I think starting when you did, only 11 years post (close to the 10 year/age 60 magic numbers), that may be helping you!! Cheers to you!

@mkoch, I am in a similar situation to you, but I am still on a half a dose of Tymlos with my estrogen patch. I also have had a hysterectomy, but I still have my ovaries and cervix. My functional physicians want me to take progesterone and my pharmacist also suggested it. Has any medical person wanted you to take progesterone even though you have had a hysterectomy? I have had issues with the progesterone capsule and cream. I feel fine on just the estrogen. Thanks for posting. It is very encouraging that the estrogen helped you keep your gains.

@mkoch, I must have missed your post earlier! Thanks so much for sharing - your experience sounds very similar, almost identical 🙂

If you’re comfortable sharing, I’d be curious to know what tools you’re using to monitor your progress. Do you track bone turnover markers in addition to DXA? I’m also very interested in your longer-term plan, especially whether you and your doctor have considered cycling back to an anabolic in the future if the need arises. Thank you!

@psmnonna, You’ve already seen good gains from your first year on Tymlos, and sometimes the second year on a PTH analog brings even more noticeable improvements - hopefully that happens for you too!

Adding HRT to Tymlos is a big step, and I’ll be curious to see your February DXA. As you’ve pointed out, timing of HRT may play a role, but responses can vary widely in reality. Please keep us updated - many of us can learn from your experience and better appreciate the role of estrogen.

@psmnonna I'd like to do that as well. What kind of MD started you on BHRT?
Thank you!

@drsuefowler: No, a doctor never had suggested I take progesterone telling me I didn't need to because of the hysterectomy. No uterus-no need. Adding progesterone is to protect the uterine lining from hyperplasia due to estrogen alone so that's a moot point if you don't have a uterus to protect. And I probably saw at least three gynecologists over the years due to retirements in the ob/gyn office and none ever suggested progesterone. I was also told, but this was years back, that data from the Women's Health Initiative Study suggested that estrogen alone (ERT) didn't significantly increase one's risk for breast cancer but combining estrogen with progesterone (HRT) did. Maybe your functional physician is trying to unnecessarily balance your hormones but I say go with your gut, especially if, like you say, you've had issues with the progesterone capsule and cream. Besides, if you still have your ovaries, you're probably still producing some progesterone.

@mayblin: I've only had DEXA scans every 2 years since I was in my forties. (73 now) My endocrinologist has NEVER mentioned bone turnover markers; I've learned about this only recently from this forum. My intent is to bring it up to her on my next visit. When I was on forteo, in my 50s, it had a black box warning and thus I was told that one was only allowed to be on it for 2 years b/c the long term effects weren't known. So when I finished my 2 years, and was taken off of forteo, my doctor wanted me to go on Prolia. But it had only been on the market for 2 years and I declined. Like I said, I kept my gains on estrogen, a very low dose patch of .025. After 15 or so years on the low dose estrogen patch I got breast cancer, stage 1. At this point I'd like to say both my sisters also got breast cancer ( though none of us tested positive for the BRCA gene) and one of my sisters was never on estrogen replacement therapy. And, the gynecologist who prescribed the estrogen patch told me studies showed that estrogen therapy alone (without progesterone) didn't significantly raise one's risk for breast cancer. But, alas, the oncologist wanted me to stop taking it. That's when I finally relented to go on Prolia. I was fine for 5 years on it, but got sick and ended up in the hospital with sepsis from a bladder infection shortly after being injected with a Prolia copy-cat drug, Jubbonti, that's only been on the market for 3 months as my health care organization switched b/c they could get the copy-cat biosimilar at a cheaper price. By the way, if one is so inclined, there is a great study on the National Institute of Health's library that clearly states 1 in 33 recipients on Prolia (and by extension one can include Jubbonti as it has the same active ingredient) get a uti after receiving the drug and 5% develop pneumonia. Of course, all drugs come with side effects and it's a risk to benefit decision. In my case, after 5 years on Prolia with no side effects, I refuse to have the copy-cat version, Jubbonti, injected into my body again. Now that I have learned on this forum that one is not limited to forteo for only 2 years, I am going to consult with my oncologist about taking this anabolic again. Since it is a bone building drug, I want my doctor's opinion if there's an outside chance it could in any way wake up any possible dormant cancer cells. My preference would be to go back on forteo. If I am advised not to, my next step is to have my endocrinologist try and get an exception for me to stay on Prolia rather than the new Jubbonti drug. If I don't get the exception, I will try and find an independent endocrinologist who isn't part of a corporate health care system and is therefore not bound by their prescribing constraints.

@drsuefowler

Yes. I take progesterone, estradiol testosterone pellet ang vaginal estradiol cream. Hysterectomy 9 years ago. Started bhrt at 76 now 77. I just started a new thread under womens health re: benefits of testosterone.
I just s