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Looking ahead after Tymlos: Reclast, Evenity or HRT?

Osteoporosis & Bone Health | Last Active: Jun 3 8:49am | Replies (34)
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@gently

I do plan on repeating Forteo. I'd like to skip the bisphosphonate altogether. And that is the reason for the risidronate suggestion the shortest adherence time, so the briefest interference with repeat Forteo. There aren't trials on longer use of teriparatide because of the original black box. My thought is to take Forteo breaks with no intervening medication. It currently looks as though a month break is too long. I have another year of Forteo.
I haven't found an endocrinologist who actually likes the idea.
I did find a pathologist (cadavers only) who thinks it's brilliant and wants me to send him my bones when it becomes convenient.

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Replies to "I do plan on repeating Forteo. I'd like to skip the bisphosphonate altogether. And that is..."
windyshores | @windyshores | May 30 6:27am

For me, Tymlos, which is of course similar to teraparatide, pooped out before 18 months. Bone markers supported this. Even if I took a break, not sure Tymlos would be active in time. I am interested in locking in my gains so far and was told risendronate was a weaker option compared to alendronate or Reclast.

I get that that's the point @gently is making: that a weaker anti-resorptive might make a second course of Forteo more effective. Its relative weakness might also mean loss of bone density in the interim. We don't know the time interval needed for Forteo or Tymlos to then make up for that loss.

Evenity and Tymlos or Forteo have reduced effectiveness after a bisphosphonate, but effectiveness is still there.

I would be afraid to lose more density by waiting for a second Forteo or Tymlos course (which might not be effective, no studies on this) or by using risendronate- thatnI would lose in terms of reduced effectiveness of anabolics after Reclast.

Just thinking out loud here. I would like more research on how a second course of an anabolic might happen.

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