I like Dr. Ben Leder's YouTube video Combinations and Sequencing of Approaches to Osteoporosis.

Bone markers showed that Tymlos was getting tired at 18 months, but I continued for the full two years. I would not continue for more than that. @gently's ideas on keeping bones receptive to more anabolic use by using a milder anti-resorptive are interesting.

As I wrote before, if initial treatment gets us to a place we are happy with, I think a full Reclast treatment, for however many infusions (could be one) are needed, makes sense Reclast, it is said, lasts 10 years in the system.

All the studies I have seen about an anabolic after a bisphosphonate involve alendronate. I am unable to take orals though.

The whole issue of long term treatment seems understudied and we are, in a way, guinea pigs!