RISKS OF FORTEO VS. HRT

• By DrJamesWebb
• Posted yesterday at 2:07 pm
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I would be happy with 46 and rising. But I agree, you want at least 50-80 for someone with osteoporosis.

Not aware of anything about ferritin with osteoporosis.

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• By SusanRae
• Posted November 23, 2009 at 9:21 pm
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Dr. Webb~

A few months ago I found out my D was at 28. Three months after I had increased to 5,000 iu daily we got it up to 46. My naturopath wants me to get it up to 80+ for the winter. How long should it take to get up there? I'll have it checked again in a month or so.

Does serum ferritin have anything to do with bone health? I only found one internet reference that said if low, it could cause fragile bones. I just found out mine's a little low at 19 ("normal" scale is 10-291). I've begun taking ferrous gluconate 200% RDA. My naturopath wants to get it up to 75-100. I've been awfully tired the last few years which may have prevented me from being as active as I should--which could contribute to my osteoporosis. No one thought to check it before because my hematocrit has been high for several years.

Cheers ~ Susan

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• By decgirl
• Posted November 22, 2009 at 5:36 pm
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I've been taking Forteo for my Osteoporosis for 11 months. I just had a Dexa scan and the results showed that I now have Osteopenia. I have been trying to eat more fresh vegetables and less meat and sugar to put my body into an alkalizing mode. My Ph is still in the acid range, but I'm hopeful this will change as I learn to eat better. My goal is to stop taking any drug for my Osteopenia and treat it by changing my eating habits and get my ph level within a normal range.

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• By JilleWhite
• Posted January 21, 2009 at 1:38 pm
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I'm assuming so. My dr. has me on both.

Jill

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• By dazzlecook
• Posted January 15, 2009 at 5:38 pm
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I was diagnosed with osteoporosis at 46-no fractures. I took Fosamax/Hrt for 2 years then dropped HRT due to fears of breast cancer. My bone density improved dramatically with HRT, but after it was dropped, my bones got MUCH worse. But I couldn't find a doc to prescribe HRT anymore. Fosamax turned my hair purple which I could tolerate except I began to get constant eye infections, so I stopped it and just used exercise and calcium for treatment. Then the scan proved my bones were much worse again. I went on Forteo. I have been having knee pains, early arthritis, and ligament pain in knees with weakness. My hip is -3.92 now. I plan to stay active with dance, yoga, etc. Do you think Forteo is causing knee problem? I am not concerned about the cancer risk. Can I take HRT along with Forteo. One doctor told me yes, and another no. I do have a script for HRT low dose, but I am afraid to take it. Also, my bone scan after 6 months on Forteo showed continued bone loss in hips and improvement in spine.

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• By aida
• Posted October 27, 2008 at 7:18 pm
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Hi Gloucester,

No particular reason for no show on Xray ..I think it actually fractured when I got on the Xray table - I felt a painful crunch in spine (pain was below R shoulder blade until then. Matter of fact I think I have had many fractures (ribs) in past 10 years (from coughing, lifting car hatchback awkwardly, rib cage slipping when leaning over arm of chair to retrieve something from floor etc) . pain bad especially if cough or laugh, sometimes felt a lump at site..and recovery time months - but NOTHING showed on Xray. And compared to ribs the pain of T7 fracture was much worse. ..Then after vertebroplasty I was in so much pain I had a CT scan as a pedicule may have fractured during procedure - no fracture showed there however CT did show a tiny fracture in neck - not on MRI or Xray.Had minor problems with neck for some time in 2006-7 which finally settled.. not bad enough to seek med. advice.. this may be the fracture that showed - they apparently dont treat neck fractures and they usually self heal.
In one way it was lucky I DID have fractured spine as would not have qualified for Forteo (too young) and MRI is not usually possible at short notice in Australia unless high chance a fracture is present. As I said , this Professor is a wonderful guy!!

Something else I forgot to mention about Forteo.. there has been discussion here as to the recommended maximum of days ( doses) in a Pen. Elli Lilly tell you to toss it after the 28th dose.. there are usually a few more days left.. the priming step is factored in to this too.. I asked Lilly here about it and they said it is a precaution as the rubber (nipple?) which the sharp pierces cannot be guaranteed air tight after 28 days and the remainder of the medication may not be effective. Ive had number of "sharps" which were "blunt" so that month I only just got 28 from pen!!
I use it for 30 days if possible. Hope this helps. I am getting my Dr to apply to Lilly here for help with costs - my medical fund isnt interested. Probably wont get positive response from Iilly but worth a try.
Keep on researching.. never EVER give up.
Aida

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• By Gloucester
• Posted October 26, 2008 at 3:48 pm
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Aida:

Thanks so much for responding. The longer the better I say. Interesting that you say your fracture did not show up on a X-ray. Another misrepresentation from my doctor; she said an X-ray would show all fractures. Was there anything unusual about the fracture which made it impossible to see on an X-ray.
The fact that your mother was strong is a very good news. My mom was not and was in fact bed ridden with the pain of osteoporosis for about 15 years. This is something I want to avoid. Gloucester

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• By aida
• Posted October 26, 2008 at 4:09 am
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Hi Gloucester and others.....I would like to add to discussion - it may help. Dr James has sound advice.... I have been interacting with this site for many months now and learned HEAPS.
I live in Sydney Australia...and have been on Forteo since April this year. I had bone density scan about 3 years ago as a precaution because my elderly mother at 86 yrs broke her arm and had her first bd scan - result osteoporosis (at 86 half the population could have osteop!!) My scan showed osteoporosis (at age 57) So my GP put me on Fosamax - I used it for about 15 months - stopping when the jaw and teeth scare emerged...then was waiting another 12 months to have another scan to see if it helped. (My mother died at 89 in 2007 but had no history of back problems and was a very fit lady). In March this year (aged 59) I fractured my T7 spine - not doing anything strenuous - and had another bone density scan - same scores as before - (-4.5 and -4.9). I was sent to a wonderful endocrinologist/ for osteoporosis who said my scores were VERY bad and my osteo is SEVERE - like a ninety year old!!. At this stage we didnt know I had a fracture as X ray didnt show any. However he diagnosed Scheuermanns Disease (from Xray)- a de-generative spinal tissue disease of teen years - no known cause or cure, and Ive had no painful symptoms. That explained such low scores as at age 30 I probably didnt get to peak bone density - - then menopause finished me off.. After a MRI showed the fracture I had a vertobroplasty(cement injected into veretebrae) not fusion.. to fix the fracture (also did T8 as was weak from Sch. D). I was bed ridden for almost 2 months after surgery which is supposed to reduce pain immediately by 50%. Consolation - cant fracture T7 and 8 again! We discussed treatment for Osteoporosis. Forteo was only resort. My density has to improve 20%. HRT gets body to make bone for first few months by very small % and then stops. Other drugs would also only give about 5% benefit. The Fosamax does not make bone - it protects what we have. So as scores were same before fosamax and after it MAY have stablised my density. The good news is that apparently if a person is prescribed Forteo it is not very efficient IMMEDIATELY after a course of Fosamax as it cant break thru the coating to start to make new bone. So hopefully because I had 15 months without fosamax I will get full benefit of the Forteo from day 1. In Australia we can only have it for 18 months in a lifetime and it costs $850 per months for a pen (no medical benefit relief at all). Even when submitting need/too young etc claim to medical boards. I had no side effects with fosamax. The forteo has been causing mild nausea (3 hrs after the shot) and I now use just before bed - asleep when it kicks in. (took me 6 months to figure this one out - kept blaming other things.)
Forteo certainly has NOT given ME any pain relief. I still have severe muscle spasms across back doing little things - peeling veges, rinsing a cup, putting something in microwave, and sometimes carrying two laden dinner plates. This has only just started to improve (warm weather? I hope). I still cant sit and play the piano nor the guitar (even sitting on an upright chair). My fracture is directly related to arm movement. Had lots of hydro therapy - recent course in much warmer pool and just standing there - no movements, letting the warmth work. I also have been on muscle relaxants for many months - weaning off them now but dont think they did anything anyway.
Sorry this is so longwinded but Forteo was the only choice for me - dont care about the bone cancer - rats only live about 2 years so if I get another 20 human years of quality life - not doubled up in next few years on a frame - Im happy. Dr said 12 months after fracture I will be back to how I was - a lively (young) 60 yr old doing all the things I did before (10 pin bowling !! etc mmmmmmmmm...)
Hope this helps you sift thru all the stuff. My advice is research as much as you can - like you are doing - then you make a decision for YOU.
Good luck Aida

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• By MaryAnn1
• Posted October 25, 2008 at 3:23 pm
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Dr. Joseph Lane is his name. Google him. He does not take insurance and last I heard it is $500 per visit.

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• By Sally48
• Posted October 25, 2008 at 12:19 pm
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Gloucester
I am now taking Menostar after much thought. Three years ago I was using Fosamax plus a HRT several different types first a pill made by a formulally pharmacy. This is more in tune to your bodies hormones. Then an estriodial progesterone cream used on the belly area. I don't remember the dosage. The problem after 4 years of use was I had an abnormal mammogram, irregular heart beats, and dizziness when getting out of bed. I have had none of this on Menostar so far. I will never take full dose hormones again, because of the side effects. It should be used the least possible time, and monitored carefully. I was also on Fosamax too.
Amgen has a new drug in the works for osteo also. Not a drug such as Fosamax. Will get back on the weight vest and the support group. I put 5lbs in a back pack and walked to the gym this week, worked out well and got me to the needed 127lbs. Take care Sally

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• By Gloucester
• Posted October 25, 2008 at 2:28 am
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Sally48:

Why did you go off Menostar that is also one of the HRTs I am thinking of taking? It sounds like you took it at the same time you took Fossamax which is what my first doctor suggested many moons ago. Only at that time they only at Prempro. What dosage were you taking and were you also taking a progesteron and if so what one and how much. How long did you take it and again why did you stop. Please post the info about the weighted vests when you get it Thanks
Gloucester

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• By idie
• Posted October 24, 2008 at 9:55 pm
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I thought I'll chime in and report on my own experience with HRT. When over 3 years ago I found out that I had severe osteoporosis, I was shocked and felt like this was a death sentence, especially when this primary care doctor immediately wanted to put me on Forteo. He did not suggest that I see an endocrinologist to get to the bottom of this, he just handed me a brochure about Forteo showing this dreaded black box warning. My gynocologist disagreed with the idea of prescribing Forteo and instead, suggested that I immediately go on HRT. For three years now, I have been on the lowest dose of the patch "Vivelle" and take prometrium (progesterone) every two months. I was terrified to go back to get a Dexa after three years of sticking my head in the sand, but finally got up the courage to go just this September. The results of that scan showed that my T-scores in my hip improved by just a point or so, the score for my spine remained the same, hip -2.6 and spine -3.4. My biggest fear was that I would have a big drop in my scores, so I was pleased that it basically stayed the same. 


I thought it was also shocking for me to find out that the reason I dropped so low
in my T-scores 3 years ago, was that my previous gyno had taken me off HRT. An endocrinologist (who also tried to immediately put me on Forteo), told me
that when you come off HRT that this often happens. I am sure this doesn't apply to everyone, but perhaps to someone who already was osteopenic. I should,
no doubt, have stayed on HRT.
By the way, I had terrible
side effects from Fosomax and Actonel and had to get off this medication after two weeks of taking it.

When I came upon this wonderful website, I learned about the JUVENT platform,
which I ordered right away. I have been using it since May - so it has been 5 mos. Next September, I will find out whether it made any difference. I also walk 5 miles a day, 5 to 6 times a week, take Calcium and plenty of Vita D. That is it. Just thought if I share with everybody what I am doing, members of this site might benefit from it.


To find the right thing for each of us is difficult and stressful. As it has been stated
many times on this board - what is good for one person is not necessarily good
for another.
That is why this website is so helpful. The exchange of experiences, info on side effects,
resources, etc. is invaluable. Idie

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• By windblown
• Posted October 22, 2008 at 3:46 pm
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Hi Gloucester: Check the link below from the NOF's directory of Dr.s that treat osteoporosis. Generally you can find an osteo clinic at the major Univ Med Centers. I see a Mineral Metabolism Dr in San Bernardino at a Univ Med Center. I know there is one in Santa Monica, and possibly at UCLA or USC. You would have to call to see if they have an osteo or metabolic bone disorder clinic. When you look at the list below, notice that it also includes Densitometrists and Physical Therapists, so if you want an MD, look for those listed.

http://www.nof.org/ppndirectory/ppn_directory_results.asp

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• By Sally48
• Posted October 22, 2008 at 3:43 pm
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Hi Reversiblecat
Your question on the weighted vest, if I get one, which I am still researching, I would wear it when I work out and walk. I am going to a support group at my bone doctors next month Nov. 4 to listen to a talk on proper exercising and will bring up the vest to make sure it would help. I do try to reach 127 with coat shoes bag etc. I was also recently in August diagnosed with gluten sensitivity as well as peanut and soy. When I switched over to rice, corn etc. that is when I lost the weight. I have never been able to gain until I was on hormones, and then only five pounds. I have been off hormones for about three years but still kept the weight. I am feeling better with the weight off, and haven't gained any on Menostar. You being only 100 lbs. I think 27lbs would be to much for you to carry around and may cause fractures. I did gain bone on Fosamax and HRT in the spine and hip. After going off HRT I have lost in the hip but still gained in the spine. I will get back to you after going to the support group Nov 4th. Take care Sally48

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• By Sally48
• Posted October 22, 2008 at 3:22 pm
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Gloucester Thanks for the info on Harvard, I have been researching weighted vests, still haven't decided. I was on NOF>org and saw that low impact exercises is the way to go. Also walking in water about waist deep is great as you have resistance in the water. The web site also had Find a Doctor list so perhaps you could find one in your area. Take care Sally48

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• By SharonG
• Posted October 21, 2008 at 9:08 pm
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Gloucester,
I'm not a doctor, of course, but I think that breaking a rib coughing is not that uncommon. Perhaps a second DEXA test is in order if you think the first is inaccurate. I too am 60 and have scores -3 or so and I believe that the medications are worse than the illness. I am trying to be vigilent about vit. D, did the 24 hour urine test, did a crossover collagen test (controversial), exercise and try to drink Dr. Oz's green drink daily. It is normal to lose bone as you get older; it would be odd if you didn't. My mother had osteoporosis and did nothing about it. She broke her arm when she was 76, other than that nothing. Good luck with whatever you decide to do.
Sharon

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• By Gloucester
• Posted October 21, 2008 at 8:29 pm
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Don't envy me. I know those DEXA scores do not tell the whole story. Here's the rest. A few years ago I fractured a rib coughing. I was coughing my lungs out but still how many people do that. I think that shows that my bones are weaker than the numbers show.
I am seriously considering some form of HRT. In a book, YOU Staying Young by Michael Roizen and Mehmet OZ (it's very good) recommends a pharmaceutical grade synthetic bioidentical estrogen Angeliq a 17 beta estrodial at a small dose of .3 milligrams. It combines an estrodial with Prometrium and he is also adding dose of 162.5 mgs of aspirin. The problem is he is recommending it only for women who are just entering menopause not for a 60 year old like me. I certainly would not hesitate to take this if I were 10 years younger. But according to the authors the risks outweigh the benefits if you start it 10 + years after menopause. But for people with osteopenia maybe the risks do not outweigh the benefits.
Gloucester

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• By SharonG
• Posted October 21, 2008 at 4:15 pm
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Hi,
I'm kind of surprised that you were prescribed Fosomax with osteopenia. I would be very pleased if I had your scores. Calcium, D3, and exercise would be all that I would take for the bones if I had your scores. That drug is too potent to take as a prevention. My opinion.
Sharon

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• By Nancy08
• Posted October 21, 2008 at 7:06 am
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I was also on Fasamax and did not help. Then I took forteo for 6 months and it helped with the pain but bone density got worse. Now all I take is Calcium(Hydroxyapatite), Vitamin D3 1.000 units daily, Strontium and Magnesium. Also in the news (not main stream news, of course), is Vit K2 which they say is a bone builder, but I do not take it. Keep in mind that Forteo has side effect of producing bone cancer in mice. All the best to you!!

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• By Gloucester
• Posted October 20, 2008 at 10:14 pm
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Biking Barbara:

What is Dr. Lane's first name and why did you think he knew what he was talking about. Does he take health insurance or what was the cost of this visit? Did he run any tests on you?

Gloucester

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