Help with fractures!

[Megee]

I am seeking advice to help with my fractures. Have had the 2 year treatment with Forteo, still having issues. What do I do next?

[Oscarbuddy]

Sorry to hear you are still having issues! That's discouraging considering Forteo is marketed as a good bone builder. Are you getting fractures in the same area? Has your doctor recommended an anti-resorptive like Fosamax or Reclast? (there are many others). I would only recommend to see a specialist like an endocrinologist or rheumatologist. I don't know your situation, but also maybe consult a physical therapist or personal trainer to see what types of exercise you can do to strengthen your bones. They can also tell you how to strengthen your muscles to prevent falls and improve your balance. Also, a specialist may look into other lab tests (blood work, urine, etc) that may help diagnosing the cause of the low bone density and fractures. I am working with an endocrinologist and she has found that I have subclinical hyperthyroidism, (more tests to come) which may contribute to my osteoporosis. Good luck with your next steps and thank you for sharing.

[Met00]

Have you been tested for underlying causes? If not, it's really important to get the tests done - coeliac disease, blood levels of Vit D, calcium, parathyroid and thyroid - as left untreated, any issues with these will continue to raise your fracture risk and medication may be ineffective.

[Mark_ABH in reply to Met00]

I second this advice. @Megee I hope you had a metabolic workup with an endocrinologist or rheumatologist before starting Forteo. If not, it's time to get all those tests. Have you had any follow-up with your health care provider since you started Forteo?

[morris321]

I would talk to my MD about the newest drug, Romosozumab (Evenity®), a humanized monoclonal antibody, promotes bone formation and inhibits bone resorption. Good-luck!

[Hidden]

I was diagnosed with osteoporosis in my mid-50s after suffering multiple pelvic fragility fractures from doing home PT resistance band exercises as part of a program for a back injury. Had no falls and had done these exercises countless times the prior two years. No significant risk factors other than being postmenopausal (and not on HRT) and taking a PPI for GERD. It has been a rough 2-1/2 years. Had a very thorough lab workup (blood & urine). I opted for Tymlos as I felt I needed to build some new bone. I learned about TBS from the Tymlos educator. My prior 2 DEXA scans were w/o TBS (a baseline after menopause and another one 3 years later - both showed I was osteopenic.) Luckily, I found a clinic near me that does TBS with DEXA. (In US you can check a site called Medimaps to locate a TBS provider in your state.) Lo and behold, my TBS scores were in the -4s to -5s, while my DEXA scores were only -1s to -2.5. Since TBS is an indirect measure of bone quality/microarchitecture (vs. bone quantity/density), my greatest issue appears to be very poor bone quality. I also have learned that many people who suffer fragility fractures have DEXA scores in the osteopenic vs. osteoporotic range. Of course once you suffer a fragility fracture, you are by definition osteoporotic. I completed my 2 years of Tymlos recently and basically had no improvement on DEXA w/TBS - and one of my pelvic fractures still is a nonunion and somewhat displaced. I had no significant side effects from the Tymlos but was very disappointed that I did not achieve better bone density or quality. I just started Evenity last month. So far no side effects - I did have a cardio workup prior to beginning the medication. Praying the Evenity works really well - I need to build some good strong bones. My only options after 12 months of Evenity are antiresorptives, which I dread. We seriously need more and better options for osteoporosis treatments, including more medications with anabolic activity. My thoughts are with all who are traveling this unwanted journey - I wish you all well.