I believe but confirm with doctor or specialty pharmacist that Tymlos is slightly better for spine and causes less porosity in the hip. When I started Tymlos they were pretty much neck and neck in charts I could find. I chose Tymlos because the dose is adjustable. Some like it because it does not need to be refrigerated but I refrigerated it.

I based this on the recommendation of my rheumatologist who believed it would be more effective than Forteo primarily because my osteoporosis is in my spine. It is a more powerful drug than Forteo and as @windyshores noted there are other benefits as well such as, it does not need to be refrigerated the entire time; just upon receipt of the medication. After the first use it can be kept at room temperature. My scan came back with such an abrupt decline from the previous, that I needed the biggest boost I could get.