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Is Forteo Recommended For High T Scores?
Would you recommend forteo to someone with high T scores, who has the following conditions: 65 year old male with cerebral palsy, poor balance, must use walker detached retina and very poor vision in one eye sleep apnea, on bi-pap never had a diagnosed bone fracture (except a couple broken ribs approx. 30 years ago) just recently started calcium supplements has never been on any medications for osteoporis (Fosamax, etc.) The above patient is my brother and his dr wants him to take forteo, but I think he would be put at too much risk for falling, etc. on forteo and should try Fosamax first. Opinions? Thanks!!
Mon, 2 Dec 2019
Anonymous's Response
Anonymous's
Response
Hi,
It is great that your brother has high T-scores (bone density) and generally most men do not require osteoporosis treatment for this reason. However, we also consider the FRAX score, which is your 10-fracture risk from a fall, and if your percentage is high (sometimes greater than 10%) fracture prevention with osteoporosis medication may be helpful in case your brother falls in the future. These will unlikely increase your fall risk.
Fosamax is generally recommended for first line treatment. However, this one slows bone breakdown which is usually the problem with osteoporosis... this fortunately is not your brother’s problem. Forteo specifically is used for fracture management as it can build a bone. There are certainly side effects so this is a shared decision making process as again this is not typically done, but your brother sounds like an atypical case.
Hope I have answered your query. Let me know if I can assist you further.
Regards,
Dr. David Hoch, Internal Medicine Specialist
It is great that your brother has high T-scores (bone density) and generally most men do not require osteoporosis treatment for this reason. However, we also consider the FRAX score, which is your 10-fracture risk from a fall, and if your percentage is high (sometimes greater than 10%) fracture prevention with osteoporosis medication may be helpful in case your brother falls in the future. These will unlikely increase your fall risk.
Fosamax is generally recommended for first line treatment. However, this one slows bone breakdown which is usually the problem with osteoporosis... this fortunately is not your brother’s problem. Forteo specifically is used for fracture management as it can build a bone. There are certainly side effects so this is a shared decision making process as again this is not typically done, but your brother sounds like an atypical case.
Hope I have answered your query. Let me know if I can assist you further.
Regards,
Dr. David Hoch, Internal Medicine Specialist
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