New precision approach could revolutionize osteoporosis care

Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.

Inclusion Criteria: 1. Diagnosed Osteoporosis by DXA (BMD t-score ≤ -2.5 with or without fragility fractures) 2. Treatment naive with respect to with anabolic or antiresorptive bone drugs. 3. Premenopausal, menopausal, and post-menopausal females. 4. 45 years old and older. 5. Presence or absence of diabetes 6. Normal levels of Vitamin D 7. Absence of all exclusion criteria on clinical workup Patients diagnosed as osteoporotic due to the presence of fragility fractures, but without osteoporotic t-scores, will not be included because they would require fractures as a study endpoint which would entail a multi-center approach. Moreover, abnormal bone quality has been shown to be present in these patients, which requires bone histology for assessment. Exclusion Criteria: 1. Pregnant or trying to become pregnant or are breastfeeding. 2. Participation in a study of an investigational drug during the past 30 days. 3. Treatment with anabolic or antiresorptive bone drugs. 4. Use of systemic anticoagulation (blood thinner) 5. Planned or anticipated oral surgery within the next 12 months. 6. Allergy to the antibiotics demeclocycline or tetracycline. 7. Planning to move out of the area within 18 months of the study. 8. Inability to stand or sit upright for at least 30 minutes. 9. Chronic alcoholism and/or drug addiction. 10. Prior radiation therapy (external beam or implant radiation) involving the skeleton (only if randomized to the bone forming drug (anabolic Forteo®)). 11. Systemic illnesses or organ diseases that may affect bone (except type 1 or type 2 Diabetes Mellitus). 12. Clinical condition that may limit study participation (e.g., heart diseases (unstable angina), lung diseases (severe COPD), other infections). 13. Abnormalities of the esophagus (tube connecting the mouth to the stomach) which delay esophageal emptying such as stricture (narrowing) or achalasia (a condition that prevents normal swallowing). 14. Have other bone diseases that are not linked to age or menopause. 15. Have a history of malignancy (cancer), not including non-melanoma skin cancer. 16. Vitamin D (Calcidiol) level below the normal range (below 20ng/mL). 17. AFTER RANDOMIZATION: If randomized to Group 1 Teriparatide and radius BMD t-score is less than -3.5 and does not sign consent to continue in the study.