@sbt54, i think it’s worth looking into your Dexa results, before and after tymlos.

I had a similar problem like yours, but i was on forteo. At one year of treatment, my spine had an expected bmd increase, but hip and femoral neck had almost close to 8% decrease. Later my endo looked into it and we also had the results reread. It turns out there were technical errors which underestimated pretreatment hip/femoral neck bmd, the follow-up scan wasn’t done ‘perfectly’ either. Essentially my hip and femur bmd stayed the same, not a decrease.

Hip and femur neck scans are prone to errors, so you might want to keep that in mind.