Good evening, @gently, and thanks for your response. I am sure that my endocrinologist knows why he chose alendronate two years ago. And with my positive response after two years, it is probably wise to continue with a medication with which I have had no issues in addition to ending the first two years with positive results.

However, I am also interested in how medical professionals choose the medication that will yield the best results. Let's remember that he did have the following information:

First attempt: Boniva.
Age: 80
Family history: I know of no response from female family members, including my mother and two grandmothers. My mother never mentioned any relationship with osteoporosis.

Results: Jay and I were staying at Hope Lodge for 30 days while he was receiving daily proton treatments after prostate surgery. I had painful symptoms and bothersome reactions to my first doses of Boniva. My PCP stopped the Boniva and sent me to an endocrinologist. She showed me two choices ......Forteo or Tymlos. I chose Tymlos partly because it was less expensive.

At the end of the two years on Tymlos and after updated scans, she recommended Prolia. By that time, I knew a little more about osteoporosis. Immediately, Prolia began to cause annoying and painful side effects, which resulted in another visit with my PCP. She suggested a consultation with
Dr. Wermers at the Mayo Clinic. ......and the rest is history.

During my rather short relationship with Prolia, I made a daily chart with symbols that described my negative reactions. That seemed like a sufficient exploratory experience for him, and that is how alendronate was chosen—based on real evidence.

I hope this is what you wanted to know about how the decision was made. It is still working as I start on year three.

May you be safe, protected and free of inner and outer harm.
Chris