Forteo was approved in 2002 as a one-time injection for osteoporosis that was the first new bone density medication to come along in awhile.
When I first heard about this drug I had my concerns. Mainly because of the increased risk of cancer from forcing bone to do what it was not meant to do. Of even bigger concern is that any “bone density medication approach” to low bone density is just not the right approach. These medications do absolutely nothing to fix the problem that ate away at your bone in the first place.
Bone is not a static tissue, merely hanging around to provide support to keep you upright and attach muscles to. The past decade has been filled with research on just how much bone is integrated in with the rest of your body. As crazy as this may sound, your bones are intricately connected to your GI tract, your risk of diabetes and your fertility. And probably much more that we aren’t aware of just yet.
In other words, if you have been diagnosed with osteopenia or osteoporosis, there is something very much wrong with the way your body is functioning as a whole. It could mean that you’re stressed and your gut is inflamed. It could mean that your prescription for SSRIs or acid-blocking drugs has destroyed your bones. It could mean you’ve got runaway inflammation and this is sucking the calcium out of your bones. It could mean you’re deficient in vitamin D. It could mean you eat too many animal products. And on and on.
Hopefully you get the idea that bone density is a systemic problem and in now way do any of the bone density medications fix the underlying problem. Even if bone density medications increase your bone density for a short period of time, unless you fix the underlying situation that put the low bone density there in the first place there are going to be problems in the future.
And, if the bone density medication that your doctor chose just happens to be the injection for osteoporosis, aka Forteo (teriparatide), the problem may be much larger than you know.
You see, Forteo doesn’t fix the problem (I know, I know–I’ve said this at least 4 times already). So what happens AFTER you’ve had your injection for osteoporosis? Turns out that, if you are NOT put on ANOTHER drug for bone density after your injection, you lose bone even faster.
This has already been well established for postmenopausal women. This particular study evaluates whether the use of injections for osteoporosis in premenopausal women lead to the same dilemma. Here’s what they found in a study of 21 premenopausal women with osteoporosis who were given Forteo:
- The women all had increases in bone density after the injections (lumbar spine 10.8%, hip 6.2%, femoral neck 7.6%).
- 15 of these premenopausal women who had gained 11.1% at the lumbar spine and 6.1% at the hip were not given any additional bone density medications.
- Two years later bone density declined by 4.8% at the lumbar spine, but less at the hip (-1.1%) and femoral neck (-1.5%).
- The 10 women who lost more than 3% at the lumbar spine (an average of -7.3% lost within 2 years) where the ones who had larger increases in lumbar spine bone density during the teriparatide treatment. These women also tended to have more bone turnover markers (not a good thing).
So, while the injection for osteoporosis did indeed lead to an increase in bone density, merely TWO YEARS later, their bones were headed south. It would not be much of a stretch to imaging that these women were going to be worse off then before they started Forteo just a few short years down the line.
The key is understanding that bone density should be checked decades before it hits the crisis stage. Our office has done bone density testing for years now and promote patients in their 20s, 30s and 40s to have their bone density checked. We’ve identified more than a few patients whose bone density was 5 or even 10% lower than what it should be for his or her age.
At this point, the changes need to be less dramatic and can sometimes be as simple as increasing intake of vitamin D. Sometimes it requires a full lifestyle overhaul. Either way, your best bet is to find out where YOU stand, so you can do something about it before it becomes a crisis and medications are used that may leave you worse off then when you started.