significant previous use of bone health modifying treatments

known congenital or acquired bone disease other than osteoporosis

significant renal disease, liver disease, cardiopulmonary disease, or psychiatric disease

abnormal calcium or parathyroid hormone level

serum vitamin D \<20 ng/mL or \>60ng/mL

serum alkaline phosphatase above upper normal limit with no explanation

anemia (hematocrit \<32%)

history of malignancy (except non-melanoma skin carcinoma), radiation therapy, or gouty arthritis

history of urolithiasis within the last one year

excessive alcohol use or substance abuse

use of oral or parenteral glucocorticoids for more than 14 days within the past 6 months

extensive dental work involving extraction or dental implant within the past or upcoming 2 months

known sensitivity to mammalian cell-derived drug products

known contraindications to denosumab, teriparatide, or any of their excipients

known contraindications to tetracycline, demeclocycline, or other antibiotics in this drug class

continuous use of tetracycline for \>1-month duration within the last 10 years

Bone Modeling Effects of Combined Anabolic/Antiresorptive Administration