Ask the Nurse

I have severe osteoporosis and my doctor wants me to have a Prolia (denosumaub) injection. I have a very bad spinal vertebral compression fracture in my spine. l have an 8 compression fracture in my back. My DXA scan shows very bad results of my left hip T-score -6.1. My parathyroid hormones level is high, so my doctor doesn't want me to have Tymlos (abaloparatide) or Forteo (teriparatide) now. My question is can I shift to Forteo after taking one shot of Prolia?

Specific therapeutic questions should be addressed to your bone specialist. In general yes, women can start with Prolia (denosumaub) after 6 months change to daily anabolic injections: either Forteo (teriparatide), which has to be refrigerated or Tymlos (abalaparatide), which does NOT have to be refrigerated (assuming the person with osteoporosis has had no bone radiation or Paget’s disease).

If your PTH (parathyroid hormone) is high you should be evaluated for primary hyperparathyroidism as well as secondary hyperparathyroidism (from low vitamin D state). We also recommend a 24 hour urine collection for calcium excretion, a check for celiac disease and secondary work up. Please see our free Osteoporosis Treatment Guide for more information. And you might want to tune into our upcoming Osteoporosis Facebook Live event on November 28 at 11am EST with Dr. Pelin Batur and Dr. Chad Deal.

All My Best,
Speaking of Women’s Health Nurse

November 26, 2018 at 9:30pm