Teriparatide, sold as Forteo, is the first 34 amino acids of parathyroid hormone, and it does something unusual among osteoporosis treatments: it builds new bone rather than just slowing the loss of existing bone.
Most osteoporosis drugs are antiresorptive. They interfere with the cells that break bone down, which preserves what you have. Teriparatide is anabolic. It stimulates the cells that build bone, so bone density actually increases.
The reason it works comes down to timing, and it is a genuinely strange piece of biology. Continuously high parathyroid hormone breaks bone down. But the same hormone given as a short daily pulse does the opposite and builds bone up. A once daily injection creates that pulse.
It has been an approved medicine for over two decades with an extensive trial and safety record, which puts it in a completely different category from most peptides discussed online.
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Teriparatide has the sort of evidence base that almost nothing else in the peptide world can match, because it went through the full drug approval process and has been in use for more than twenty years.
The headline result is fracture reduction, which is what actually matters to patients rather than a change in a scan number. In the pivotal trial it cut vertebral fractures by about 65 percent and nonvertebral fractures by about 35 percent over roughly 20 months. Systematic reviews comparing it with other osteoporosis treatments have continued to support its position for higher risk patients.
There is also a smaller and more speculative line of research on cartilage. Animal work in injury-induced osteoarthritis found that teriparatide increased proteoglycan content and slowed cartilage breakdown, with a regenerative effect when treatment was delayed until weeks after the injury. That is interesting and it is why this peptide appears in joint discussions, but it is animal data and it is not an approved use.
The realistic summary is that teriparatide is a well proven bone drug with an intriguing but unestablished cartilage side story.
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