Hi @mayblin,

I really appreciate you looking out for me. Thanks for the note 🙂

You are likely right on alendronate not being effective enough to catch the rebound, but I'm going to try it and measure CTX monthly. If / when my CTX goes above my baseline, I will switch to Reclast. This is something Serge Ferrari suggested last year during a presentation he gave and there is a hypothesis as to why it might work. I talked about it in my Prolia presentation https://youtu.be/XiRN3UvOEYg?si=XbRjR9MaqN3UihrL . BTW, I watched a presentation last week from the 2024 World Congress of Osteoporosis and Professor Bente Langdahl (denosumab expert) said on average, they give three Reclast shots in the first year to blunt the rebound for long term Prolia users.

I really want to wait to use Reclast as my very last treatment at 80 years old. Reclast lasts a really long time on the bones so taking holiday's will probably not be as big of an advantage as being on alendronate. Dr. Mike McClung has proposed this strategy.