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What does "lock in the gains" really mean?
Those of us who have taken an anabolic are required to follow up with a bisphosphonate (or something) to "lock in the gains." I still don't really understand what this means. Why would the new bone created be any more susceptible to breakdown than older bone? Or to put it another way: Once I finish the bisphosphonate treatment, won't it be the same problem -- that bone, too, could break down. I know I am missing something here, but not sure what.
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The new bone formed from anabolic meds is still suseptible to bone loss due to your underlying reason for bone loss to start with. Which could be loss of estrogen. So even with new bone formed your rate of bone loss can still be high. Which is why they recommended taking bisphosphonate to lock in gains. As this slows the bone resorption (breakdown) process.
Slowing down the process should keep your bones stronger longer.
That is my understanding.
Since no cure for osteoporosis, they should continue to monitor after all treatments complete and may recommend additional meds in the future.
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6 ReactionsMy understanding with taking Forteo is that both the osteoblasts and osteoclasts are increased while on the med. When I stop, the osteoblast boost will stop but it takes a lot longer for the osteoclast boost to stop. This would lead the bone to break down faster for awhile. But with taking something like Fosamax which slows down the osteoclast activity, you would slow any bone loss till the effect of the Forteo is done. I guess this might take a year but I don't think they are entirely sure on the length of time needed.
Again, this is just my understanding of what I've read though 🙂
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6 Reactions@luckypup Thank you so much for sharing your understanding. That is what I had understood, too -- that the osteoclast activity takes awhile to slow down, so you need to take something (eg a bisphosphonate) to stop the breakdown. But somewhere along the line I read -- or saw a diagram -- showing that that elevated breakdown normalizes within a few months. So that is why it seemed odd to me that I would have to take the hated (!) Fosamax for two whole years!! I'll have to find that study or diagram. If I do, I can share it.
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1 Reaction@oknowwhatpixie Ah! That makes sense. Actually, my problem started because I had a parathyroid tumor that none of my doctors recognized for 10 years!!! But because of my age, 74, I probably have loss of estrogen. Still, I would think that would mean I have to take some kind of medication forever, not just after stopping Tymlos. Because if I don't have enough estrogen to shore up my bones after Tymlos, I won't have it later either. 🙁
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2 Reactions@sebutler Yes, I had the same thoughts. Two years (even one) seems like an awfully long time for this to be necessary. I'll have to ponder it when the time comes for me to stop Forteo.
One thing that has bothered me 'less' with Forteo and even Fosamax is the shorter half life...or how long the drug is working in your system. If you choose Reclast, it's a once a year infusion. Man, that's a looong time to be dealing with any side effects or adverse reactions. As Forteo is daily and Fosamax is once a week, it seems like less of a long term commitment. Again, just my understanding but I would consider Fosamax on a shorter term basis.
@oknowwhatpixie I've had that same thought. I read somewhere that bone loss could plateau....though I'm sure that's without other causes like needed steroid use, other illness etc. I've wondered about HRT but my physician is out with a surgery and so can't talk to him about it just now.
I have lots of questions for him when he returns! 🙂
PS I'm 74 too 🙂