Hi Raven, thanks for joining us.  I would check with your Dr. and ask this question to see if she/he knows of any studies that where done on this combination of treatment.

Here are two quotes I found on this that you can read and see if your Dr. agrees.  In the Cleveland Clinic pdf from Deal et al, it mentions the following.  Here's the link on page 598.

"Alendronate (Fosamax) has an addictive effect on bone mass when given after a course of Teriparatide or rhPTH 1-84, but no fracture data have been published."

"Based on the AAA trial, most experts would use Forteo as initial therapy for 2 years (the FDA-approved interval) in high-risk patients, followed by an antiresorptive agent to maintain and further the increase in bone mass achieved with Forteo (Cleveland Clinic on Forteo, Deal et al, 2003)."  See page 598.

Of course the above is about Fosamax, but this article was written before Reclast was on the market and Reclast is also a antiresorptive.  Here's another one I found from PubMed that's interesting that I would take with you on your next appointment to see what the Dr. says.

Source PubMed (National Inst. of Health)  http://www.ncbi.nlm.nih.gov/sites/entrez  Article/study title: "Maintenance of increased bone mass after recombinant human parathyroid hormone (1-84) with sequential zoledronate treatment in ovariectomized rats."  This study was a sequential treatment with Forteo and Reclast.  Read the summary and see what you and your Dr. think.  It was a treatment where Forteo was used for a certain number of weeks and then Reclast followed in kind.  The conclusion says: "The zoledronate (Reclast) after rhPTH(1-84) as a sequential regimen was quite consistently effective. "Copyright 2004 American Society for Bone and Mineral Research."  Keep in mind this was hPTH (full dna chain of human parathyroid hormone) and not rhPTH (Forteo), but it does sound promising.

If you have any trouble with displaying the article at PubMed, I went to the site and typed in the query "antiresorptive following an anabolic."  The authors are: Rhee Y, Won YY, Baek MH, Lim SK from (J Bone Miner Res. 2004 Jun;19(6):931-7. Epub 2004 Jan 19.Click here to read).  There are a couple of other studies listed on this page on the same topic so I would see if your Dr. agrees.  The general concencus on follow-up treatment after Forteo is any of the antiresorptives (Fosamax, Actonel, Boniva, and Reclast).  I remember that your Dr. didn't feel Actonel was a suitable follow up treatment after Forteo, but I can't find any study that says this, so your Dr. must know something we don't.

Good luck and if you have another question don't hesitate to post again, and take the printed copies of these studies with you to get your Dr.'s opinion on it.  As always, check with your Dr. to see if he or she agress since the Dr. is the only one who is familiar with your medical history and t-scores.

I would be very interested in what you find out and I'm sure our members will also, since those of us who took Forteo have to find an effective follow-up treatment to maintain the theory of Loss, Restore and Maintain (LRM) benefits seen from osteoporosis treatments.

Keep in touch so we can find out if these studies help any, because I sure hope they do.  One thing to keep in mind is this new biannual tx is for osteopenia and may not be recommended if your t-scores are in the osteoporosis range, but I'm not absolutely sure what the qualifications are and how strict the recommedations are.  If you still have at least on score that is in the osteoporosis range you may stand a better chance for qualification.