@gently @sallyj2 @lynn59 I'd like to throw in my two cents here.

Forteo and tymlos are sister drugs as we know. On the quest of figuring out my initial puzzling 13mo forteo results, I've read many theories and explanations regarding the increased cortical porosity by forteo and the consequences of it. Do you know forteo increases cortical bone thickness? Actually tymlos does it too, with less intensity due to its altered receptor binding configuration. In most clinical studies, tymlos showed a slight advantages in the reduction of fracture risk, as well as in btm% increase. When you think about this further, the question arises: why would the porosity increase by forteo (in 1/4 of relative dosage in comparison to tymlos) ended up a closeup in terms of fracture risk reduction, and bmd increase? If increased cortical porosity is strongly associated with a weaker bone (in adults), then the results presented in numerous clinical studies wouldn't show that forteo has a statistical significance in fracture risk reduction. So we need to put the concern of porosity increase in a right perspective here. As far as my hip and femur neck results at 13 mo of forteo, dexa showed no change. I wonder if this is because I had a base t score at osteopenia range hence less room for improvemnt. The result could also be looked at another way: the no change is great because without forteo, I'd have further 1-3% yearly loss instead. So forteo kept my hip and femur bone stable. Im quite happy with forteo so far as far as side effects go: only initial low blood pressure for 1.5 mo, nothing else! You can read there are many other people got great improvements in hips and or femur neck with forteo. Usually it is the negative news that catch our mind the most, unforturnately.

Choosing a drug is so personal and sort of like gamble here too. One drug that worked great for one individual doesn't mean it will work the same for the next. Our personal believes, health status and preferences all play a role. Unexpected side effects will throw us off too and force us to make a change. Then there is insurance coverage... the best drug is the one works for us. But before you try one, you really don't know that perfect drug for you, forteo or tymlos.