Will meds help build bone?
Q. Would you kindly comment on Forteo, a bone-formation medication now being prescribed by some physicians to treat osteoporosis? Thank you.
A. Forteo is a synthetic form of parathyroid hormone. It increases bone density and bone strength. It is used for both men and women at high risk of fractures. Forteo is given as a daily injection under the skin of the thigh or abdomen. Your physician will show you how to use the medication-dispensing pen to ensure proper dosing.
Forteo should not be used for more than two years by those who have bone disorders other than osteoporosis; have ever had kidney stones, bone cancer or radiation treatments involving bones; those with hyperparathyroidism; people with an allergy to teriparatide; and those with high blood levels of alkaline phosphatase or calcium. It may be harmful to unborn babies, and it is not known whether it can be passed through breast milk. Avoid alcohol and tobacco while on Forteo, since these substances can decrease bone density. Certain medications, such as digoxin, should not be taken with it.
Side effects can include allergic reactions, lightheadedness/fainting, rapid/forceful heartbeat during injection, nausea, vomiting, constipation, muscle weakness, mild dizziness, leg cramps, joint pain, headache/neck pain, and pain, swelling, itching, bruising or redness at the injection site and more.
Forteo has also been found to cause an increased risk of osteosarcomas (malignant bone tumors) in male and female rats. It is not known whether this risk is valid in humans. The recommended dose is 20 micrograms daily.
I have no experience with Forteo, but based on the information I have, I likely would not prescribe it.
Q. I am a 76-year-old male with several health problems. I have had type II diabetes for 40 years. I keep good control with no known damage from it. I also have well-controlled (with medication) high blood pressure. I am now having a problem with a high potassium level. It went from 4.9 to over 6.5 in one year. I have included a copy of my blood work. Do you have any suggestions?
A. Thank you for including your lab results, because they tell the story. Your kidneys do not appear to be functioning properly. As a result, they are not excreting as much potassium as they should. Your blood urea nitrogen (BUN) is quite high at 60. It should be below 20. Finally, your creatinine level is also high (2.1). It should be under 1.0.
Hypertension and diabetes can cause kidney disease. It may also be secondary to one of the medications you are taking. I recommend that you be examined by a kidney specialist (nephrologist), who can test you further. He or she can suggest treatment options for you.
Good luck, and let me know the results.
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