@michelem I have lupus and my docs won't prescribe Prolia for me. Other arguments against Prolia from my doctors and from Keith McCormick's book "Great Bones": there is a rebound when you go off Prolia (the longer you go the worse it is, they say) meaning without an effective follow-up with Reclast (or Fosamax) you can end up worse than you started.

Prolia is not a bone builder. It is an anti-resorptive that works by reducing bone turnover. It increases density but not with new bone. Forteo and Tymlos are bone builders, and Evenity is for the first half. This is what has been explained to me.

If you need a bone builder later, Prolia may also affect the effectiveness of those other drugs to some extent.

I am curious why your rheumatologist suggested Prolia. Did they feel it was best in the context of PMR and steroid use? Are you considering seeing an endocrinologist?

Another good resourse is Dr. Ben Leder's YouTube video "Combinations and Sequencing Approaches to Osteoporosis>"

I tolerated Tymlos well be starting at a low dose and moving up. The pen has adjustable doses. The needle is tiny. The half life is one hour so it leaves your body quickly.