It is hard to answer generally because we all seem to tolerate different drugs differently. For me, Tymlos was a godsend, because I am sensitive to meds and could adjust the dose (and ramp up slowly). The half life of Tymlos and Forteo is one hour so they are gone very quickly. Many doctors seem to be going to Evenity first but I also felt nervous about it two years ago. I have now done 4 months of Evenity (the time when it is most potent for bone growth) and will now go to a low dose Reclast in two months (with IV hydration and slow infusion).

If your DEXA scores are just over the line of -2.5, you may be able to try holistic methods, and it is even possible that Fosamax could help if you will never need bone builders. At a certain age, Prolia is a possibility too because the main issue with that is getting off, but you can do it for 10 years. My doctors don't use it at all. I personally would never take it.

Forteo can now be taken more than two years and I assume Tymlos will follow. I am not sure the doses can be compared: it may be a case of apples and oranges since they work a little differently. We need to check that!

Tymlos greatly improved my bones. Spine improved 20% and went from severe to borderline. I have 7 spinal fractures (some from trauma, some from osteoporosis) and didn;t have a choice. I don't know if you have a choice or not.