Bone Not “Good Enough” = Anabolic Forteo
Bone that has Fractured = Bone NOT Good Enough = Bone which requires the Anabolic, Forteo. Any fracture, especially vertebral compression fracture, can mean that the bone is NOT Good Enough. A Falling Bone Mineral Density (BMD) can mean that the bone is NOT Good Enough.
Orthopedic Surgeons see patients because their bone has fractured. Often this is a Fragility Fracture – a fracture due to a fall from standing height. I treat osteoporosis because of the patients I saw as an orthopedic surgeon. My orthopedic training makes Fracture Prevention my #1 goal.
Forteo (Teriparatide) is the only Anabolic on the US market at this time. Forteo’s primary action is to stimulate the osteoblasts to make new bone matrix. This occurs during the 2 years that a person takes Forteo. Full calcium accumulation in the new bone matrix can take up to 3 additional years.
Once the bone has been built up and is Good Enough, it is essential to preserve it with an Antiresorptive. The improvement can last for decades, IF antiresorptive medication is continued as needed.
Of course, patients must take adequate Calcium (Citrate) and Vitamin D3. I recommend 1200-1500 mg Calcium in divided doses of not more than 5-600 mg each. My recommended Vitamin D3 dose is whatever is enough to keep the 25-hydroxy Vitamin D level above 40 ng/ml. 2000 IU daily is a good starting point.
If your bone is not good enough, make it good enough with the Anabolic, Forteo. Then preserve it with one of many Antiresorptives.
Jay Ginther, MD