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@babs10

@awfultruth, I was wondering if you would please share more about the hips being a big factor when choosing meds. It seems like it's a challenging area to specifically target and, of course, that's where I have OP. I don't want to hijack the thread so feel free to message me privately if you prefer. Thanks.

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Replies to "@awfultruth, I was wondering if you would please share more about the hips being a big..."

@babs10 @awfultruth can answer but just wanted to interject that although the parathyroid analogs are not supposed to be great for hips, better for spine, I had a 9% gain in total hip score on Tymlos. I was told Evenity might be better for hips....

@babs10 @windyshores I thought there might be an easy answer but if so finding it has eluded me. I know I have seen stated a number of times that Evenity is better for the hips than Forteo and Tymlos. And I remember a statement by Ben Leder MD maybe in an Osteoboston interview that he would be hesitant to prescribe Forteo to someone with a t-score less than -2.8 (I'm just guessing at the number here but something to that effect). The idea was that Forteo could diminish hip density at least initially I believe? OTH I found a Korean paper that held that Forteo was strengthening to the hip even if density decreased. "Even though TPTD increases the cortical bone porosity of the proximal femur, the bone strength does not decrease as the majority of the porosity is located at the endocortex; further, it increases the outer diameter and thickens the cortical bone."

And what about Prolia and the bio-phosphonates and their effect on hip density and fractures? I think there is a general consensus that the anabolics beat the bio-phosphonates in improving bone density and decreasing fracture risk overall. I saw the same conclusion about Prolia in one or two papers. I think that overall view extends to the hip, but to really answer your question would take a lot more effort.

And then there's individual differences like Windyshores who got great hip gains with Tymlos.
Myself I'm taking Evenity and hoping for the best as I need help in all bone areas.
It would be great to pose the question to an expert panel.