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Recovery & healing

Teriparatide

FDA-approved PTH analog that stimulates bone formation. Used clinically for osteoporosis and investigationally for stress fractures and fracture healing.

FDA-approved for osteoporosis Recovery & healing Anti-aging Fitness & muscle

Reviewed 2026-09-12
Full name
Parathyroid Hormone 1-34 (PTH 1-34)
Also known as
Forteo
Regulatory status
FDA-approved for osteoporosis in post-menopausal women and men

Origin

Recombinant human PTH 1-34, the N-terminal active fragment of parathyroid hormone. FDA-approved in 2002 as an anabolic bone agent, unlike antiresorptive bisphosphonates, with 20+ years of post-market surveillance.

Mechanism

Binds PTH1 receptors on osteoblasts, activating Wnt/beta-catenin signaling and increasing osteoid production. Intermittent (daily) dosing favors bone anabolism over resorption, building cortical and trabecular bone mass.

Research summary

Evidence

Large RCTs demonstrated a 65% reduction in vertebral fracture risk and a 53% reduction in non-vertebral fracture risk. Post-market surveillance of over 75,000 patients found zero attributable osteosarcoma cases despite a rat-toxicology signal at very high doses; the FDA removed the black-box osteosarcoma warning in 2023. Off-label use for stress fractures/delayed union is growing but less evidenced. PTH resistance caps therapy at 2 years maximum.

Evidence tier: FDA-approved for osteoporosis — see the methodology note for how this is assessed.

Citations

Reported benefits

  • significant increase in bone mineral density
  • 65% reduction in vertebral fracture risk
  • 53% reduction in non-vertebral fracture risk
  • off-label: potential acceleration of stress-fracture healing

Dosing protocols reported in the literature & community

These are protocols reported by compounding pharmacies, published trials, or self-experimentation communities — not a prescription. Start low, especially for anything new.

Reported dosing protocols
RouteReported protocol
Subcutaneous self-injectionFDA-approved: 20 mcg once daily via pen injector; maximum duration 2 years.

Side effects

  • dizziness (transient, first 4 hours post-dose)
  • injection-site reactions
  • mild hypercalcemia
  • nausea
  • leg cramps

Safety notes

Safety: Black-box osteosarcoma warning removed in 2023 following a large surveillance study. Contraindicated in active/history of bone metastases, skeletal malignancies, prior skeletal radiation, and Paget's disease. Requires periodic calcium/phosphate monitoring.
Community & reddit notes (anecdotal — not clinical evidence)

Clinical osteoporosis use is well-established. Off-label athletic/orthopedic interest for stress-fracture healing is growing on mechanistic appeal, though RCT evidence for that use remains limited; competitive-sport use raises doping/ethical concerns.