The Effects of Supraphysiologic Doses of Vitamin D3 in Conjunction With Teriparatide on Bone Mineral Density in Two Postmenopausal Females With Severe Osteoporosis

Abstract

Teriparatide was approved by the FDA in 2002 for the treatment of osteoporosis in postmenopausal women who are at high risk for fractures. Previous studies involving the use of teriparatide in conjunction with vitamin D and calcium supplementation have suggested that sufficient vitamin D levels may not be a requirement to achieve an effective response to teriparatide. We present a case of two postmenopausal females with severe osteoporosis who were treated with teriparatide along with calcium and supraphysiologic doses of vitamin D, as illustrated by an increase from their baseline serum 25-hydroxyvitamin D concentrations. Both patients experienced an increase in bone mineral density that was significantly higher than what has been seen in prior studies of teriparatide administration in conjunction with physiologic doses of vitamin D. These findings suggest that administering supraphysiologic doses of vitamin D may in fact potentiate the effects of teriparatide in postmenopausal females with osteoporosis, resulting in larger increases in bone mineral density than would otherwise be expected.