Starting FORTEO tomorrow and so nervous.

Apologies for the delay in responding. I wanted to provide a comprehensive response. Currently, I am under the care of the head of OB/GYN at Georgetown University Hospital for my overall health. Following their recommendation of Forteo, they also mentioned that I could continue with Hormone Replacement Therapy (HRT), which aids in preserving bone density. However, it's worth noting that while HRT helps maintain bone, it may not promote bone growth as rapidly as necessary for my current needs. Additionally, due to variations in the machines used for my recent scans, it's debatable whether I am experiencing bone loss or gain.

My regular gynecologist was initially hesitant to prescribe it back in 2018, citing my age of 68 as a factor. Despite presenting her with studies on transdermal Hormone Replacement Therapy (HRT) conducted on women a decade past menopause, she remained cautious but eventually acquiesced, prescribing the lowest feasible dosage. While HRT undoubtedly assists with various aspects such as hair, skin, and overall energy, and building and preserving bone, she declined to increase the dosage. I believe that had she done so, the extent of my bone loss might have been mitigated. Unfortunately, conducting a comprehensive review of all transdermal HRT studies is beyond my means at the moment. Nonetheless, here are a few noteworthy studies:

ACP Journal: https://www.acpjournals.org/doi/abs/10.7326/0003-4819-117-1-1

American College of Obstetricians and Gynecologists (2020):

https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2013/04/postmenopausal-estrogen-therapy-route-of-administration-and-risk-of-venous-thromboembolism which concludes:

The Estrogen and Thromboembolism Risk study, a multicenter case–control study of thromboembolism among postmenopausal women aged 45–70 years, demonstrated an odds ratio for venous thromboembolism in users of oral and transdermal estrogen to be 4.2 (95% CI, 1.5–11.6) and 0.9 (95% CI,0.4–2.1), respectively, when compared with nonusers 10. Transdermal estrogen had no increased risk compared with nonusers. Similar results were reported elsewhere 30 31 32 33 34 35 and of particular importance, in women who were stratified for weight 36 and the presence of prothrombotic mutations

BodyLogic/NAMS/University of Southern California references:
https://www.bodylogicmd.com/blog/should-you-use-hormone-replacement-therapy-after-65-why-attitudes-are-changing/#:~:text=For%20many%20women%2C%20the%20benefits,or%20duration%20of%20hormone%20therapy

“Hormone therapy does not need to be routinely discontinued in women aged older than 60 or 65 years and can be considered for continuation beyond age 65 years for persistent [vasomotor], [quality of life] issues, or prevention of osteoporosis after appropriate evaluation and counseling of benefits and risks.”

Convincing a doctor based solely on a handful of transdermal HRT studies is challenging, especially when the medical community doesn't seem to prioritize conducting its own thorough review. Consequently, the response from most doctors tends to be negative or some variation thereof. However, the doctor at Georgetown did acknowledge that remaining on the lowest dose was likely acceptable. Additionally, they suggested that after my two-year course of Forteo, it might reduce the necessity for a subsequent drug to prevent further bone loss. It's worth mentioning that I am adamantly opposed to taking bisphosphonates under any circumstances.

As previously mentioned, I began low-dose transdermal HRT around the age of 68 and I’m now 74. And yes, the primary reason for initiating this therapy was to mitigate bone loss. Until you brought it up, I hadn't been aware of CTX. Your observation regarding the necessity for a higher dose for bone preservation is valid. The physician at Georgetown advised against increasing the dosage for the time being while I'm on Forteo. However, she expressed a potential willingness to reconsider this decision in two years. Hopefully, by then, there will be increased efforts within the medical community to conduct comprehensive literature reviews and additional studies on the utilization of HRT for postmenopausal women.

Sorry this was so long!

I have just recently started hormone therapy using Estradiol and Estriol and Progrsterone.. I will add Testosterone. My doctors have told me only a tiny dose of hormones is needed. If I decide to start Tymlos, Forteo’s cousin, I will stay on the hormones during and afterwards, likely for life.

I started this thread asking for positive experiences with Forteo (as I was very nervous about starting it) a couple of weeks ago prior to starting Forteo, so I wanted to circle back with my experiences. After having 12 shots now, I'm pleased to report I've had virtually NO side effects. I had very very mild nausea and short-term diarrhea the first couple of days that was quickly and easily managed with one Pepto bismol tablet and a ginger gummy! I've had no bone or muscle pains whatsoever. No headaches. No dizzy spells. No increase in belly fat that some have reported. When I started transdermal HRT in 2018, I had an increase in belly fat; however, after using the Forteo shot, it actually seems to have gone down a little. Knock on wood.

Since I live alone with my dog, I don't like to take any kind of new med at night in case of side effects. I'd rather take it in the morning so that if I have any effects, it's broad daylight, everything is open, and I'm not driving around at 10pm trying to find an Urgent Care facility and worrying about my dog. So, I decided to go to my doctor's office for the first shot so they could show me the right way to do it. I videotaped it. Yes, I did. I didn't want to forget anything later when home and alone and nervous again. In the end, the shot is really so very simple, I didn't really need the video but it was a security blanket. Since my first shot in the doc's office was at 2:30 pm, I was able to see how I reacted to it. Over the next couple of days, when I saw I was ok, I gradually shifted my shot to the evening around 8pm. It relaxes me and I find I'm sleeping through the night again and feeling rested in the mornings.

I know everyone is different; we have different medical histories, are on different meds, etc., but with all the scary stuff out there, I wanted to share my positive experience. I was SO afraid of starting any osteo med but now I'm so grateful to have it. I'm also grateful to all of you who took a moment to tell me your positive experiences which gave me the courage to go forward. Thank you! Now I'm hoping it will quickly build bone so I don't have to worry about that any more!

Two years of forteo. Shots easy. No discernible side effects

vkmov, first, no apologies! I'm grateful for your time and effort in providing detailed response and thoughts. I really like to read personal experiences or encounters, and compare them to those described in literature. I've just recently started exploring HRT as an option so I have lots of catchup to do. Coincidently I just got an appointment with my gyn due to a cancelation. Am very eager to hear what she has to say, mainly the risk factors in my case. I also have cardiologist apptmt lined up so I could make some sort of preliminary conclusion before I meet my endo.

Thank you so much for the links, I'll read them all and prepare myself to ask educated questions.

Best of luck to you with forteo therapy!

I was put on Forteo for two years for a crushed spine after kypoplasty. I had to Reclast prescribed at Mayo because I had osteoporosis. I worked very well for me. If you live alone get someone to help you.

There is an online form. The income requirements are listed on the form. For a single person, income must be less than $44,000. That would include income from pensions, social security, and royalities. I don’t remember if spouse support income is included. Be sure you Google Lily Cares Foundation, not just Lily. There are 2 different support sites. The 1st one I looked at would not consider me because I had part D insurance. The Foundation is totally different. Once you fill out the form, your doctor is contacted and has to provide information. Good luck.

I am not challenging your comment about the income level but I wanted to share that Lily Cares Foundation covered 2 years of Forteo for me with no copay. The time frame was Sept of 2021 through 2023. I applied through the medical clinic where my Endo is. My income is quite a bit higher than the $44,000 you mentioned.

I didn't believe Lilly Cares would help out. The clinic kept calling me to get me to fill out the paperwork. I finally did. It turns out that drugs are listed by Tier, and Forteo is (or was) a high enough tier that one could make more than 4 times $44,000 and still get assistance. All my Forteo was covered 100%.

Perhaps Forteo's Tier number has gone down, but I would contact your clinic and get the paperwork from them and return the application to your clinic.

The Tier numbers I saw were not necessarily the Medicare Tier numbers. These tier numbers were with a chart about prescription payment assistance.

I thought I would share the chart so everyone can see where they fit. I also am attaching the Group 1 list that includes Forteo.