What would you do? Medication.

How old are you and how many years post menopause? I am exploring this too. I am almost 76. Early menopause at 39.

What drug did you transition to after prolia?

Your comment means a lot. I am 77 and also not medicating. I am trying a year of a more natural snd dedicated approach with walking a minimum of 30 minutes a day, osteoporosis exercises, use of weights, supplements, bone collagen, and bone building diet. The doctor recommended Evenity since my lower spine showed -3.3 but said he completely understood my decision. I will have another bine density scan in a year and see what happens. We have to each do what feels right for us.

@laurafuentes I'm sorry to hear that tymlos didn't work out for you, hope you have a great success on forteo.

I'm wondering how high your p1np and ctx went after 2 months of tymlos, do you mind share? Having tested only couples of times, my p1np was at 400 after 13 mo of forteo (no ctx). At 17 mo, p1np was at 200 and ctx at 900, which worries me somewhat. My high p1np also didn't correlate high gains in bmd, only average-ish on L spine, no hip or femoral neck gain. I'm eager to see what second year result will reveal.

In addition, what relay drug did you take after evenity, and before tymlos?

Thanks a lot!

@laurafuentes I'm sorry to hear that tymlos didn't work out for you, hope you have a great success on forteo.

I'm wondering how high your p1np and ctx went after 2 months of tymlos, do you mind share? Having tested only couples of times, my p1np was at 400 after 13 mo of forteo (no ctx). At 17 mo, p1np was at 200 and ctx at 900, which worries me somewhat. My high p1np also didn't correlate high gains in bmd, only average-ish on L spine, no hip or femoral neck gain. I'm eager to see what second year result will reveal.

In addition, what relay drug did you take after evenity, and before tymlos?

Thanks a lot!

@mayblin Here are answers to your questions about my blood test results after taking Tymlos for 2 months:

P1NP
Dec. 1, 2023 30 March 5, 2024 112

CTX
Dec 1, 2023 205 March 5, 2024 774

I used Tymlos full-strength, daily, from Dec 22 to Feb 10, then reduced dose to 50% or 37.5%, till Feb 21. (Total, 2 months.)

I don't know what these numbers mean, honestly. My doctor's message about these results said only that Tymlos had the "expected effect."

Not sure what's meant by "relay drug." I didn't take anything for the 3 weeks between stopping Tymlos and starting Forteo. (So far, doing alternate days is feeling fine.)

Wishing everyone the best!

@babs10 the discussion about weight and dosing was about Evenity. And I think the optimal dose for that is the full dose, though I have had some trouble tolerating it.

When I came on this forum and described using the adjustable dosing for Tymlos, my goal was still the full 8 clicks on the pen (80mcg). I used the adjustable dosing to ramp up. The goal is still to get as high as you can. You will still have some side effects, potentially, for an hour or two- it is about tolerability. Most don't seem to even need to do this. I am sensitive. If you tolerate Forteo, which most do, great (except for the cost, but there is now a generic). If you don't tolerate it, I would think your insurance would then cover Tymlos. Let us know!

Keith McCormick did Forteo then one dose of Reclast I believe. And then more holistic/"whole body" approaches. I think he had something like 22 fractures. He was/is a triathalon athlete. I believe some of the fractures were in his feet. I asked him about this and also heard it in an interview.

@glojo and others there is nothing "natural" about 680mg of strontium, the therapeutic dose. It is hugely more than what we ingest normally. It will make the density on DEXA look better than it is, because strontium replaces calcium in bone and is denser. Finally, the European version of the FDA banned it for a short time in the ranelate form due to cardiovascular risks. We don't know if that is true for the US supplements. In Europe it was reinstated as an option for those not at risk of cardiovascular events and who cannot take anything else but have serious osteoporosis.

I started it a long time ago, when I couldn't tolerate any meds. I would not take it now, but that is me.

Thank you so much for weighing in. Since my insurance only covers Forteo (after rejecting Prolia), I might be stuck. Maybe doctor's can appeal if there is a bad reaction? I weigh 125 pounds and recently read a post somewhere that rightly said people at 125 lbs shouldn't have the same dose as someone who weighs 170 lbs so being able to adjust the dose does make good sense with the Tymlos.

I haven't read Keith McCormick's books yet, but have watched some of his videos. I find him especially credible because he is not straight anti-medication. He understands that some people need and will benefit from it. Do you happen to know if he ever took any medication? I'm not clear on that.

I don't meet he income guidelines for Forteo so my fee is going to be $1920 a month. Let that sink in...absurd. There is a cap of $8000 and nothing due after that, but our system needs an overhaul, that's for sure.

Thank you so much for weighing in. Much appreciated.

Yes, first drug. My concerns:

1. No mention of any kind of long term plan after Forteo
2. Side effects whatever they could be since we are all different
3. Could Forteo possibly negatively impact what I believe are strong bones despite my low BMD score?

Thanks.

My situation is almost identical to yours, and I’m about to start a bio-similar drug to Forteo. I am 65, fit, athletic and a downhill skier with a -3.1 lumbar spine and a -2.7 femoral neck. My endocrinologist recommended Prolia until she found out I had no intention of stopping to ski double black diamonds in the mountains. Since I haven’t fractured anything, I don’t qualify for Forteo in Canada (that was her anabolic of choice for me as she said we aren’t sure if Evenity causes cardiovascular problems yet and I have a family history plus an irregular heartbeat).

Osnuvo is a bio-similar teriparatide, and I’m told it is virtually the same as Forteo, but a fraction of the cost. I’m still out west skiing and heading home this week. I plan to look at the profile of the drug compared to Forteo more closely, as well as talk to their patient service that my endocrinologist signed me up for. If I’m satisfied I’ll start the first week in April. My endocrinologist said the dose is fine for me (125 lbs), as they also give it to children.