Teriparatide vs Abaloparatide : Which PTH Analog is Better?

[pslgod69]

Introduction​

Hi guys, this is my first guide in this forum, kinda excited. This guide is about PTH Analogs, especially Teriparatide and Abaloparatide

Increasing Bonemass​

Increases in bonemass happens when Osteoblast activity exceeds Osteoclast activity, which means there are more "bone-forming" cells than "bone-resorbing" cells.

Osteoblasts are triggered by chemical reactions or hormones when a bone grows or changes. They create and release (secrete) a mix of proteins called bone matrix. Bone matrix is made of proteins like collagen mixed with calcium, phosphate and other minerals.

Parathyroid Hormone (PTH)​

Parathyroid hormone (PTH) is a hormone that your parathyroid glands make and release to control the level of calcium in your blood.

The effect of PTH on osteoblasts depends heavily on how long and how often PTH is present:

1. Continuous PTH exposure​

- Osteoblasts release signals that activate osteoclasts.
- Osteoclasts resorb bone to release calcium into the blood.
- Effect: Bone breakdown --> loss of bone density.

2. Intermittent PTH exposure (as in teriparatide or abaloparatide)​

- Short bursts of PTH stimulate osteoblast proliferation and activity.
- Increase in osteoblast lifespan (less apoptosis = more bone formation time).
- Stimulates production of bone matrix proteins like collagen type I.
- Effect: Bone formation exceeds bone resorption --> bone mass increases.

Conclusion: When under continuous exposure to PTH (eg, hyperparathyroidism), bone undergoes resorption more than formation, while intermittent exposure to low dose PTH (like daily teriparatide use) induces bone formation more than resorption.

PTH and PTHrP Analogs​

Spoiler

These analogs are usually used medically to treat osteoporosis, but we can use is for increasing general bonemass

PTH and PTHrP analogs tell Osteoblasts to multiply, work harder, and live longer, while also make stem cells become new osteoblasts. That’s why they can add bone mass so quickly they switch to an anabolic state that bones normally only hit during growth or fracture healing.

A few of these analogs are Teriparatide (PTH) and Abaloparatide (PTHrP). Though they both stimulate the Osteoblast, they have a few key differences.

Here's the differences:

Feature​	Teriparatide (PTH)​	Abaloparatide (PTHrP)​
Source	Human parathyroid hormone 1–34	Human parathyroid hormone–related protein 1–34
Receptor target	PTH1 receptor	PTH1 receptor (different binding orientation, shorter signaling time)
Bone anabolic effects	Strong	Slightly stronger in early months
Hypercalcemia (bone cancer) risk	More common (~10–11%)	Less common (~3–4%)
Injection	Daily subcutaneous	Daily subcutaneous
Max use	2 years	2 years
Cost	$1,500–$4,000/month (US)	$1,200–$2,500/month (US)
Availability	Widely available worldwide	Less available, mostly US/EU
Research and data	More clinical history and data	Newer, possibly faster BMD gains, but fewer long-term studies

Now, it should've been obvious which one is better

Spoiler: Answer and Supporting research

Answer: Abaloparatide

supporting research:

Spoiler: Answer and Supporting research

"Traditional therapy for osteoporosis includes bisphosphonates and teriparatide. Studies have compared the efficacy of conventional treatment to abaloparatide. In a double-blind, controlled, randomized phase II clinical trial, the safety and efficacy of abaloparatide were assessed compared to teriparatide and placebo. Among these treatment groups, abaloparatide demonstrated superiority in enhancing overall BMD. A comparative study comparing 2 sequential therapies (2 years of initial teriparatide followed by alendronate therapy and 2 years of abaloparatide followed by alendronate therapy) demonstrated that abaloparatide followed by alendronate has a greater treatment efficacy."

https://www.ncbi.nlm.nih.gov/sites/books/NBK587447/

Spoiler: Common questions

Q: If it is obvious that abaloparatide is better on both effects and cost, why do some people still use teriparatide?
A: Teriparatide has been around much longer than abaloparatide, so doctors simply know a lot more about it. It’s been approved since 2002, giving researchers over twenty years worth of studies, follow-ups, and real world experience to see how it works and how safe it is. We’ve seen its benefits on bone density, fracture risk, and bone quality across all kinds of patients. Women after menopause, men with osteoporosis, and even people whose bones were weakened by long-term steroid use. Abaloparatide, on the other hand, only has been approved in 2017, so while it works in a similar way, it just doesn’t have the same long track record. That’s why many doctors feel more confident reaching for teriparatide when they want a proven, reliable option.

Downsides of Using Analogs​

If there's good, there's bad. Here's some major downsides of using PTH or PTHrP analogs:
- High cost : These drugs are expensive, costing thousands of dollars per month without insurance.
- Limited use window : Because of a potential risk of bone tumors seen in animal studies, treatment usually limited to 2 years total in a lifetime.
- Possible side effects : Common ones include nausea, dizziness, leg cramps, and increased calcium levels in blood or urine. Rarely, they can cause kidney stones.
- Bone loss after stopping : The gains in bone density can drop off if another bone protecting treatment (like bisphosphonates) isn’t used afterward.

Spoiler: Teriparatide

"Warnings

Osteosarcoma: The FDA has removed the box warnings regarding osteosarcoma. However, the FDA still recommends avoiding teriparatide in patients with predisposing conditions, which can increase the risk of osteosarcoma. Conditions include Paget disease of bone, history of primary or secondary skeletal malignancy, history of ionizing radiation involving the skeleton, pediatric and young patients with open epiphysis, and hereditary disorders increasing the risk of osteosarcoma. According to the American Association of Clinical Endocrinology (AACE) guidelines, teriparatide should be avoided in patients with increased alkaline phosphatase of skeletal origin.

Calciphylaxis and cutaneous calcification: A potential risk of calciphylaxis and cutaneous calcification is apparent. Use caution in patients with risk factors for calciphylaxis, such as chronic kidney disease, autoimmune disorders, and concurrent warfarin or systemic corticosteroid use.

Hypercalcemia: Teriparatide can cause hypercalcemia and may worsen hypercalcemia in patients with pre-existing hypercalcemia. Avoid the use of teriparatide in patients with primary hyperparathyroidism.

Risk of Urolithiasis: Use in patients with hypercalciuria and urolithiasis should be considered after a risk-benefit evaluation, as teriparatide causes hypercalciuria, which promotes urinary stones. Monitor urinary calcium excretion."

.

Spoiler: Abaloparatide

"Box Warnings
Abaloparatide is contraindicated in individuals with a history of systemic hypersensitivity to either abaloparatide or its excipients. Cases of eczema and urticaria have been reported.

Warning and Precautions
Abaloparatide previously carried a boxed warning for an increased risk of osteosarcoma, but the FDA has removed this warning when retaining information about osteosarcoma as a caution. In a 2-year animal study, abaloparatide administration showed increased events of osteosarcoma and osteoblastoma. A comprehensive pathology study of rats undergoing prolonged parathyroid hormone analog treatment exhibited increased rates of osteosarcoma, osteosarcoma-related mortality, and metastatic potential. This is not advisable in patients who have open epiphyses or those who have a genetic predisposition to osteosarcoma.

Abaloparatide use is also not recommended in patients with Paget disease, idiopathic increased alkaline phosphatase levels, open epiphyseal plates, or bone malignancies. Abaloparatide should not be given to patients who have previously undergone implant radiation therapy or external beam radiotherapy that involved their skeleton. There is an increased risk of hypercalciuria, urolithiasis, and postural hypotension."

.

Closing​

Thank you for reading, hope you all enjoy. Forgive me if there's any inaccuracy, bad english, bad formatting, wrong use of words, and anything else.

Spoiler: Sources

https://www.ncbi.nlm.nih.gov/books/NBK559248/
https://www.ncbi.nlm.nih.gov/sites/books/NBK587447/
https://pmc.ncbi.nlm.nih.gov/articles/PMC3874264/#S3
https://www.drugs.com/drug-class/parathyroid-hormone-and-analogs.html
https://www.nature.com/articles/s41467-025-59665-7
https://biologyinsights.com/osteoblasts-and-osteoclasts-their-role-in-bone-remodeling/
https://my.clevelandclinic.org/health/body/24871-osteoblasts-and-osteoclasts
https://my.clevelandclinic.org/health/articles/22355-parathyroid-hormone
https://www.ncbi.nlm.nih.gov/books/NBK499940/
https://www.clinicalcorrelations.org/2016/03/03/pth-versus-pthrp-small-differences-big-implications/
chatgpt

---

spam rep this low effor thread

 

[KeepCopingLads]

now all we need is a before and after to prove it can increase bonemass

 

[pslgod69]

i wouldv'e tagged some individuals but idk how to

bump

 

[pslgod69]

Hypercalcemia (bone cancer)

Hypercalcemia is a condition in which the calcium level in the blood becomes too high. not bone cancer. sorry

 

[NotaChadyet]

this looks so "perplexity.ai"

 

[pslgod69]

this looks so "perplexity.ai"

Nuh uh i did my own research

 

[ybuyhgui]

Introduction​

Hi guys, this is my first guide in this forum, kinda excited. This guide is about PTH Analogs, especially Teriparatide and Abaloparatide

Increasing Bonemass​

Increases in bonemass happens when Osteoblast activity exceeds Osteoclast activity, which means there are more "bone-forming" cells than "bone-resorbing" cells.

Osteoblasts are triggered by chemical reactions or hormones when a bone grows or changes. They create and release (secrete) a mix of proteins called bone matrix. Bone matrix is made of proteins like collagen mixed with calcium, phosphate and other minerals.

Parathyroid Hormone (PTH)​

Parathyroid hormone (PTH) is a hormone that your parathyroid glands make and release to control the level of calcium in your blood.

The effect of PTH on osteoblasts depends heavily on how long and how often PTH is present:

1. Continuous PTH exposure​

- Osteoblasts release signals that activate osteoclasts.
- Osteoclasts resorb bone to release calcium into the blood.
- Effect: Bone breakdown --> loss of bone density.

2. Intermittent PTH exposure (as in teriparatide or abaloparatide)​

- Short bursts of PTH stimulate osteoblast proliferation and activity.
- Increase in osteoblast lifespan (less apoptosis = more bone formation time).
- Stimulates production of bone matrix proteins like collagen type I.
- Effect: Bone formation exceeds bone resorption --> bone mass increases.

Conclusion: When under continuous exposure to PTH (eg, hyperparathyroidism), bone undergoes resorption more than formation, while intermittent exposure to low dose PTH (like daily teriparatide use) induces bone formation more than resorption.

PTH and PTHrP Analogs​

Spoiler

These analogs are usually used medically to treat osteoporosis, but we can use is for increasing general bonemass

PTH and PTHrP analogs tell Osteoblasts to multiply, work harder, and live longer, while also make stem cells become new osteoblasts. That’s why they can add bone mass so quickly they switch to an anabolic state that bones normally only hit during growth or fracture healing.

A few of these analogs are Teriparatide (PTH) and Abaloparatide (PTHrP). Though they both stimulate the Osteoblast, they have a few key differences.

Here's the differences:

Feature​	Teriparatide (PTH)​	Abaloparatide (PTHrP)​
Source	Human parathyroid hormone 1–34	Human parathyroid hormone–related protein 1–34
Receptor target	PTH1 receptor	PTH1 receptor (different binding orientation, shorter signaling time)
Bone anabolic effects	Strong	Slightly stronger in early months
Hypercalcemia (bone cancer) risk	More common (~10–11%)	Less common (~3–4%)
Injection	Daily subcutaneous	Daily subcutaneous
Max use	2 years	2 years
Cost	$1,500–$4,000/month (US)	$1,200–$2,500/month (US)
Availability	Widely available worldwide	Less available, mostly US/EU
Research and data	More clinical history and data	Newer, possibly faster BMD gains, but fewer long-term studies

Now, it should've been obvious which one is better

Spoiler: Answer and Supporting research

Answer: Abaloparatide

supporting research:

Spoiler: Answer and Supporting research

https://www.ncbi.nlm.nih.gov/sites/books/NBK587447/

Spoiler: Common questions

Q: If it is obvious that abaloparatide is better on both effects and cost, why do some people still use teriparatide?
A: Teriparatide has been around much longer than abaloparatide, so doctors simply know a lot more about it. It’s been approved since 2002, giving researchers over twenty years worth of studies, follow-ups, and real world experience to see how it works and how safe it is. We’ve seen its benefits on bone density, fracture risk, and bone quality across all kinds of patients. Women after menopause, men with osteoporosis, and even people whose bones were weakened by long-term steroid use. Abaloparatide, on the other hand, only has been approved in 2017, so while it works in a similar way, it just doesn’t have the same long track record. That’s why many doctors feel more confident reaching for teriparatide when they want a proven, reliable option.

Downsides of Using Analogs​

If there's good, there's bad. Here's some major downsides of using PTH or PTHrP analogs:
- High cost : These drugs are expensive, costing thousands of dollars per month without insurance.
- Limited use window : Because of a potential risk of bone tumors seen in animal studies, treatment usually limited to 2 years total in a lifetime.
- Possible side effects : Common ones include nausea, dizziness, leg cramps, and increased calcium levels in blood or urine. Rarely, they can cause kidney stones.
- Bone loss after stopping : The gains in bone density can drop off if another bone protecting treatment (like bisphosphonates) isn’t used afterward.

Spoiler: Teriparatide

.

Spoiler: Abaloparatide

.

Closing​

Thank you for reading, hope you all enjoy. Forgive me if there's any inaccuracy, bad english, bad formatting, wrong use of words, and anything else.

Spoiler: Sources

https://www.ncbi.nlm.nih.gov/books/NBK559248/
https://www.ncbi.nlm.nih.gov/sites/books/NBK587447/
https://pmc.ncbi.nlm.nih.gov/articles/PMC3874264/#S3
https://www.drugs.com/drug-class/parathyroid-hormone-and-analogs.html
https://www.nature.com/articles/s41467-025-59665-7
https://biologyinsights.com/osteoblasts-and-osteoclasts-their-role-in-bone-remodeling/
https://my.clevelandclinic.org/health/body/24871-osteoblasts-and-osteoclasts
https://my.clevelandclinic.org/health/articles/22355-parathyroid-hormone
https://www.ncbi.nlm.nih.gov/books/NBK499940/
https://www.clinicalcorrelations.org/2016/03/03/pth-versus-pthrp-small-differences-big-implications/
chatgpt

---

spam rep this low effor thread

very interesting thread although a bit harder to source as opposed to teri

might switch up my plans a little after some research and sourcing

 

[ybuyhgui]

the bitch whipper must provide his wisdom

@Bitchwhipper2

 

[Bitchwhipper2]

the bitch whipper must provide his wisdom

@Bitchwhipper2

Abolo deathmogs.

Just hard to source

 

[pslgod69]

Bump

 

[nik.077]

chatgpt the table gives it away bro

 

[pslgod69]

chatgpt the table gives it away bro

I did use chatgpt for some parts of the table. Look at the sources, I wrote chatgpt there

 

[KeepCopingLads]

Introduction​

Hi guys, this is my first guide in this forum, kinda excited. This guide is about PTH Analogs, especially Teriparatide and Abaloparatide

Increasing Bonemass​

Increases in bonemass happens when Osteoblast activity exceeds Osteoclast activity, which means there are more "bone-forming" cells than "bone-resorbing" cells.

Osteoblasts are triggered by chemical reactions or hormones when a bone grows or changes. They create and release (secrete) a mix of proteins called bone matrix. Bone matrix is made of proteins like collagen mixed with calcium, phosphate and other minerals.

Parathyroid Hormone (PTH)​

Parathyroid hormone (PTH) is a hormone that your parathyroid glands make and release to control the level of calcium in your blood.

The effect of PTH on osteoblasts depends heavily on how long and how often PTH is present:

1. Continuous PTH exposure​

- Osteoblasts release signals that activate osteoclasts.
- Osteoclasts resorb bone to release calcium into the blood.
- Effect: Bone breakdown --> loss of bone density.

2. Intermittent PTH exposure (as in teriparatide or abaloparatide)​

- Short bursts of PTH stimulate osteoblast proliferation and activity.
- Increase in osteoblast lifespan (less apoptosis = more bone formation time).
- Stimulates production of bone matrix proteins like collagen type I.
- Effect: Bone formation exceeds bone resorption --> bone mass increases.

Conclusion: When under continuous exposure to PTH (eg, hyperparathyroidism), bone undergoes resorption more than formation, while intermittent exposure to low dose PTH (like daily teriparatide use) induces bone formation more than resorption.

PTH and PTHrP Analogs​

Spoiler

These analogs are usually used medically to treat osteoporosis, but we can use is for increasing general bonemass

PTH and PTHrP analogs tell Osteoblasts to multiply, work harder, and live longer, while also make stem cells become new osteoblasts. That’s why they can add bone mass so quickly they switch to an anabolic state that bones normally only hit during growth or fracture healing.

A few of these analogs are Teriparatide (PTH) and Abaloparatide (PTHrP). Though they both stimulate the Osteoblast, they have a few key differences.

Here's the differences:

Feature​	Teriparatide (PTH)​	Abaloparatide (PTHrP)​
Source	Human parathyroid hormone 1–34	Human parathyroid hormone–related protein 1–34
Receptor target	PTH1 receptor	PTH1 receptor (different binding orientation, shorter signaling time)
Bone anabolic effects	Strong	Slightly stronger in early months
Hypercalcemia (bone cancer) risk	More common (~10–11%)	Less common (~3–4%)
Injection	Daily subcutaneous	Daily subcutaneous
Max use	2 years	2 years
Cost	$1,500–$4,000/month (US)	$1,200–$2,500/month (US)
Availability	Widely available worldwide	Less available, mostly US/EU
Research and data	More clinical history and data	Newer, possibly faster BMD gains, but fewer long-term studies

Now, it should've been obvious which one is better

Spoiler: Answer and Supporting research

Answer: Abaloparatide

supporting research:

Spoiler: Answer and Supporting research

https://www.ncbi.nlm.nih.gov/sites/books/NBK587447/

Spoiler: Common questions

Q: If it is obvious that abaloparatide is better on both effects and cost, why do some people still use teriparatide?
A: Teriparatide has been around much longer than abaloparatide, so doctors simply know a lot more about it. It’s been approved since 2002, giving researchers over twenty years worth of studies, follow-ups, and real world experience to see how it works and how safe it is. We’ve seen its benefits on bone density, fracture risk, and bone quality across all kinds of patients. Women after menopause, men with osteoporosis, and even people whose bones were weakened by long-term steroid use. Abaloparatide, on the other hand, only has been approved in 2017, so while it works in a similar way, it just doesn’t have the same long track record. That’s why many doctors feel more confident reaching for teriparatide when they want a proven, reliable option.

Downsides of Using Analogs​

If there's good, there's bad. Here's some major downsides of using PTH or PTHrP analogs:
- High cost : These drugs are expensive, costing thousands of dollars per month without insurance.
- Limited use window : Because of a potential risk of bone tumors seen in animal studies, treatment usually limited to 2 years total in a lifetime.
- Possible side effects : Common ones include nausea, dizziness, leg cramps, and increased calcium levels in blood or urine. Rarely, they can cause kidney stones.
- Bone loss after stopping : The gains in bone density can drop off if another bone protecting treatment (like bisphosphonates) isn’t used afterward.

Spoiler: Teriparatide

.

Spoiler: Abaloparatide

.

Closing​

Thank you for reading, hope you all enjoy. Forgive me if there's any inaccuracy, bad english, bad formatting, wrong use of words, and anything else.

Spoiler: Sources

https://www.ncbi.nlm.nih.gov/books/NBK559248/
https://www.ncbi.nlm.nih.gov/sites/books/NBK587447/
https://pmc.ncbi.nlm.nih.gov/articles/PMC3874264/#S3
https://www.drugs.com/drug-class/parathyroid-hormone-and-analogs.html
https://www.nature.com/articles/s41467-025-59665-7
https://biologyinsights.com/osteoblasts-and-osteoclasts-their-role-in-bone-remodeling/
https://my.clevelandclinic.org/health/body/24871-osteoblasts-and-osteoclasts
https://my.clevelandclinic.org/health/articles/22355-parathyroid-hormone
https://www.ncbi.nlm.nih.gov/books/NBK499940/
https://www.clinicalcorrelations.org/2016/03/03/pth-versus-pthrp-small-differences-big-implications/
chatgpt

---

spam rep this low effor thread

is this bone growth all over the body
or are we able to use it precisely where we want, for example zygos and mandible and clavicles

 

[pslgod69]

is this bone growth all over the body
or are we able to use it precisely where we want, for example zygos and mandible and clavicles

All over the body, but they emphasised research on changes on spine and hips, as it's originally treatment for osteoporosis

 

[KeepCopingLads]

hips

as in wider hips?

 

[pslgod69]

as in wider hips?

No, as in they only cared about measuring bone changes on spine and hips. Effects are still all over the body

 

[KeepCopingLads]

No, as in they only cared about measuring bone changes on spine and hips. Effects are still all over the body

any specific age
(also rep)

 

[pslgod69]

any specific age
(also rep)

Researches don't provide specific age

 

[jeoyw9192]

Researches don't provide specific age

Wouldn't make you ogre would it

 

[napyelashes]

Hypercalcemia is a condition in which the calcium level in the blood becomes too high. not bone cancer. sorry

Yeah holy shit i was abt to say theres no way im in injecting shit that comes with even a 1% of cancer

No, as in they only cared about measuring bone changes on spine and hips. Effects are still all over the body

Im assuming because of the increased density in the spine did the subject become taller or was that not stated? and could you link the supporting studies because i can't view them in ur msg

 

[DR. NICKGA]

What is the purpose? Yes you bone will be denser but its not gonna be taller

 

[pslgod69]

Wouldn't make you ogre would it

No

 

[pslgod69]

Im assuming because of the increased density in the spine did the subject become taller or was that not stated?

As I've said before, this drug was for treating osteoporosis, so most researches is about its impact on osteoporosis patients. What I meant they can become taller is because these analogs can delay growth plate closure, thus making more room for growth

 

[pslgod69]

Yes you bone will be denser but its not gonna be taller

Yes bonemass will increase, and growth plate closure would be delayed