PTH and osteoporosis: With the widespread introduction of bisphosphonates into clinical practice, adverse effects, such as osteonecrosis of the jaw, increased risk of esophageal cancer, and severe suppression of bone turnover, have been recognized.8–10 Long-term use of bisphosphonates impaired the bone-forming capacity and even blunted the anabolic effect of parathyroid hormone (PTH) treatment.11 PTH is the only FDA-approved anabolic osteoporosis medication.