Interesting and confusing. Based on other comments I have read in this support group and Dr. McCormick's book, Forteo was considered slightly better for the spine. Here's one comment as an example: "My research has told me Forteo is better to increase density of the spine versus Tymlos . And Tymlos does a little better than Forteo at the hip." (I copy and paste various pieces of info from these boards and put it into my osteoporosis Word doc that I am compiling, organized by subject matter, since I could never remember it all.) I just received my copy of Great Bones, and on the chart on page 556, it says 10 to 12 percent approximate increase in spine BMD during first two years and 1.5-2 percent increase for total hip BMD during first two years. For Tymlos, it says 9-10 percent spine BMD during first two years and for hip 2-3 percent. (Copyright 2023).

In the end, it is a moot point for me because my insurance only covers Forteo (actually the generic teriparatide by Alvogen). My hip is only slightly osteoporotic; my main concern is my spine (-3.9 after nearly 4 years of alendronate, same as it was 4 years ago). So I think I would have been happy with either drug, actually, as I am hopeful either would work better for me than alendronate. I'm prepared for results not as great as I would have liked because of having been on alendronate first, but any increase is welcome. Just hoping I don't have any unmanageable side effects (none at all with alendronate). My first dose is this Thursday.