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№ 042

Teriparatide

A bone-building drug. A parathyroid-hormone fragment (PTH 1-34), FDA-approved as Forteo for severe osteoporosis. Anabolic for bone, the opposite of bisphosphonates.

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Teriparatide: A bone-building drug. A parathyroid-hormone fragment (PTH 1-34), FDA-approved as Forteo for severe osteoporosis. Anabolic for bone, the opposite of bisphosphonates. Teriparatide is the active piece of parathyroid hormone (PTH 1-34).

FDA ⓘ
Approved
WADA
Not banned
Typical dose
20 mcg sub-q daily
Half-life ⓘ
~1 hour
Route ⓘ
Subcutaneous
Schedule
Once daily
In plain English

Teriparatide is the active piece of parathyroid hormone (PTH 1-34). FDA-approved as Forteo for severe osteoporosis. Unlike most osteoporosis drugs, it actually builds new bone instead of just slowing bone loss. Daily injection, capped at 24 months total lifetime use per FDA label.

Status & legalityWhat do these mean? →
Natty? ⓘ
Grey area

FDA-approved drug used for severe osteoporosis. Federations don't typically address it.

FDA ⓘ
Approved

Approved as Forteo (2002) for severe osteoporosis in postmenopausal women, men with primary or hypogonadal osteoporosis, and glucocorticoid-induced osteoporosis.

Compounding ⓘ
Approved drug

Available as an FDA-approved drug, not a compounded peptide.

WADA ⓘ
Not listed
Prescribed ⓘ

Yes, endocrinology and rheumatology providers prescribe it for osteoporosis. ~24 months is the standard course; the FDA removed the hard 2-year lifetime cap in Nov 2020, so longer use is label-permitted if high fracture risk persists.

Who it's for

  • →Severe osteoporosis under endocrine care
  • →Stress-fracture recovery (off-label)
  • →Older adults with high fracture risk

What to expect

  1. Week 1

    Subtle. Some calcium-flux symptoms early.

  2. Week 4

    Bone markers improving on labs.

  3. Week 8

    Cumulative bone density gains over months, not weeks.

Looking at Teriparatide? Your next 3 steps

  1. 1Work out your exact dose

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  2. 2See what to stack & monitor

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How it works (mechanism)

Recombinant first 34 amino acids of parathyroid hormone (PTH 1-34). Intermittent daily dosing favors osteoblast activity over osteoclast activity, building new bone, opposite of bisphosphonates which slow bone breakdown.

Dosing protocol

Members only

Stacks well with

Members only

Side effects

01Nausea
02Mild calcium fluctuations
03Headache
04Leg cramps
05Theoretical osteosarcoma risk (rat data; the FDA removed the boxed warning in 2020, now a standard Warning)

When NOT to use

  • ⚠Paget's disease
  • ⚠Prior radiation to bone
  • ⚠Hypercalcemia
  • ⚠Active malignancy
  • ⚠Pregnancy / nursing

Bloodwork to monitor

  • • Serum calcium baseline + at 1 month + every 6 months
  • • 25-OH vitamin D

Common mistakes

  • • Continuing past ~2 years without an ongoing high-fracture-risk reason (the hard lifetime cap was removed in 2020)
  • • Skipping calcium / vitamin D adequacy first
  • • Underestimating the prescription-and-monitoring requirement

Drug & supplement interactions

  • ⚠Digitalis (digoxin): teriparatide-induced calcium fluctuations may sensitize to digitalis effects
  • ⚠Thiazide diuretics: may cause hypercalcemia
  • ⚠Standard ~2-year course (the hard 24-month lifetime cap was removed in 2020), combine with calcium and vitamin D adequacy
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AI Coach, live sample
Members only
is 250mcg of bpc enough for a knee injury?
For a knee, 250 mcg sub-q daily is the standard working dose and a solid place to start. The trick with BPC is consistency, give it weeks, not days. Inject close to the joint, run it 4-6 weeks, and don't drop below 200 mcg, it tends to stop cracking the threshold reliably down there. If it hasn't moved at all by week 3, that's when adding TB-500 earns its place.
how much bac water for a 10mg reta vial?
3 mL is the standard play for a 10 mg reta vial. That's 3,333 mcg/mL, clean unit math across the titration: 2 mg = 60 units, 4 mg = 120 units, 6 mg = 180 units on a 100-unit insulin syringe. Run 2 mL instead if you want fewer, more concentrated shots (5,000 mcg/mL, so 2 mg = 40 units). Since most people titrate up over ~12 weeks, 3 mL keeps the numbers cleanest.
what should i track on bloodwork for tirzepatide?
Lipid panel, ALT/AST (liver enzymes), and an A1C, baseline before you start then every 3 months. If you've got metabolic-syndrome history, add fasting glucose and insulin so you can actually watch insulin sensitivity improve. You don't need a big hormone panel for a GLP-1.

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Frequently asked

What is Teriparatide?+
Teriparatide is the active piece of parathyroid hormone (PTH 1-34). FDA-approved as Forteo for severe osteoporosis. Unlike most osteoporosis drugs, it actually builds new bone instead of just slowing bone loss. Daily injection, capped at 24 months total lifetime use per FDA label.
Is Teriparatide FDA approved?+
Approved as Forteo (2002) for severe osteoporosis in postmenopausal women, men with primary or hypogonadal osteoporosis, and glucocorticoid-induced osteoporosis.
Is Teriparatide legal?+
Teriparatide is FDA-approved and legal to obtain by prescription in the US. Yes, endocrinology and rheumatology providers prescribe it for osteoporosis. ~24 months is the standard course; the FDA removed the hard 2-year lifetime cap in Nov 2020, so longer use is label-permitted if high fracture risk persists.
Is Teriparatide banned by WADA?+
Teriparatide is not currently on the WADA prohibited list.
Are you still natty after taking Teriparatide?+
Grey area. FDA-approved drug used for severe osteoporosis. Federations don't typically address it.
Do doctors prescribe Teriparatide?+
Yes, endocrinology and rheumatology providers prescribe it for osteoporosis. ~24 months is the standard course; the FDA removed the hard 2-year lifetime cap in Nov 2020, so longer use is label-permitted if high fracture risk persists.
What's the typical dose of Teriparatide?+
20 mcg sub-q daily, per FDA label.
What are the side effects of Teriparatide?+
Common side effects include: Nausea; Mild calcium fluctuations; Headache; Leg cramps. Less common effects and full safety details are on the entry page.
How long until Teriparatide starts working?+
Subtle. Some calcium-flux symptoms early.
What can you stack with Teriparatide?+
Common pairings: Standalone is the standard medical use. Full stacking protocol and timing on the entry page.
Where do people get Teriparatide?+
Teriparatide is dispensed through licensed pharmacies with a prescription. Some compounding pharmacies and telehealth services prescribe it. Pepdex is not a vendor or pharmacy. See /coa for how to verify Certificate of Analysis on any supplier.

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