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    Old 05-21-2009, 01:33 PM   #1
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    After Forteo

    In 2006 I was diagnosed with osteoporosis. For the next two years I took Forteo; my spine BMD improved from T -3.1 to T -2.3, and my hip BMD improved from T -2.4 to T -2.1. Several studies have shown that, in the year after stopping Forteo, BMD will continue to improve if bisphosphonates are taken, but will decline if bisphosphonates are not taken. So doctors routinely prescribe bisphosphonates after ending Forteo therapy; that is what my endocrinologist wanted to do, but I declined and did not take bisphosphonates during the past year. Instead, I tried using alternative methods, including daily use of a Juvent vibrating platform, increased unipedal standing, diet modification, increased vitamin D, additional exercise, etc.

    I just had my 2009 DEXA. My hip BMD was unchanged at T -2.1, but my spine BMD had declined to T -2.7, back into osteoporosis. Half of the improvement I had made in my spine BMD while on Forteo, is gone. So I am yielding to the advice of my endocrinologist. He currently thinks I/V Boniva is better than Reclast, because in his experience I/V Boniva has substantially fewer side effects. I have had my first I/V Boniva treatment, and will continue with 3-month I/V Boniva for the time being.

    So my experimental, non-bisphosphonate effort to maintain spine BMD in the year after ending Forteo has failed.

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    Old 05-21-2009, 05:59 PM   #2
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    Re: After Forteo

    I had close to the same experience as you. I made improvement on Forteo and then declined to have IV infusions of bisphosphonates. It only took 6 months for my BMD to go way down even lower than when I started the Forteo. I guess some of this depends on when menopause hits.

    How do you feel after your first IV Boniva treatment? Are you having any side effects?

    I'm waiting on an appeal from insurance about starting another 2 year course of Forteo. I got some encouraging information this week from my doctor. When I know more I'll share it.

    Old 05-22-2009, 01:55 PM   #3
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    Re: After Forteo

    Pika B
    I am so sorry about your situation. I have been off Forteo for almost two years, and I followed it up with oral Fosamax. After the first year my dexa scan showed that I had lost almost all in my spine that I had gained and my doc upped the dosage from the 35 mg weekly to 70mg weekly. He retested my bone marker tests after 5 months-BSAP and NTX and for the first time my NTX was really good-17. Even with that he suspects a malabsorption problem so I am getting a consult with a gastroenterologist. He wants me to take either the Boniva IV or Reclast. That's encouraging that you are tolerating it okay. Keep us posted. If I truly am not absorbing Fosamax or other vitamins and minerals, I would like to know before I dive in to anything else. If there is no proof that I am not absorbing the oral medication, I am hesitant to jump into the IV. If my bone marker tests are normal, I don't know why my dexa numbers are not better. It is so frustrating, as I am sure you understand. I have enjoyed your posts on the NOF site-you and Desert Bloom always find the best research studies. I wish I was more tech saavy.
    Take care,

    Old 05-22-2009, 04:18 PM   #4
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    Re: After Forteo

    Thanks. Supposedly, the side effects from I/V Boniva usually occur in the first day or two, and so far I've noticed nothing at all. (I did drink lots of water before going in for the I/V.)

    In considering bisphosphonates, I definitely wanted an I/V. I had acid reflux for a number of years, and I didn't want to take a chance on it coming back or having any of the other digestive problems reported after oral bisphosphonates. Also, the clinical studies indicate that I/V's improve bone density better than the pills (when comparing I/V Boniva to pill Boniva, or comparing Reclast to Fosamax). To my mind, Fosamax is the least desirable bisphosphonate, because of the 10-year half-life. (If you need to have dental surgery, it's not likely you can postpone it for decades until the Fosamax leaves the bones. The half-life for I/V Boniva is about 2 days.)

    Last edited by PikaB; 05-22-2009 at 04:29 PM.

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