Worried about starting Tymlos Wednesday and question about P1NP score

Posted by hopeandhope @hopeandhope, Oct 14 11:59pm

Hi! I am supposed to start Tymlos Wednesday and I am nervous and scared and worried that it means I will be starting a lifetime of these drugs, so I want to share some background and get some assurance if I am doing the right thing.
Background:
Secondary osteoporosis due to ideopathic hypercalciuria (under control now)
61 years old
No broken bones
Good diet and supplements; active and regular walking (spotty resistance and strength training which I am seeing a PT to get a good daily regimen that I will stick to - much motivation here)
DEXAs - osteopenia hips and femoral neck; spine -3.2 in 2017 - started raloxifene and spine went to -2.4, then -2.5, and in 2024 -3.2. Raloxifene seems to have stopped working.
Current labs - D, Calcium, Protein, and all others in the metabolic panels and more that my endocrinologist ordered are normal and healthy range; no red flags here; 24-hour urine test is normal
First time having these tests - P1NP is 29 mcg/L (reference range for female to 60 years is 20-108 mcg/L; no reference above age 60) and CTX is 271 pg/ml (reference range for female to 49 years is 50-465 pg/ml; no reference above age 49)
Goal: My goal is to get back down to osteopenia level, stick with consistent diet and exercise, and go off meds as long as I can after Tymlos (and whatever I have to take immediately after to lock in the gains - I'm more worried about the drug to take after Tymlos). So I am thinking that jumpstarting bone growth with Tymlos will be a good start.
I think that's a pretty comprehensive picture of what I am looking at.

Does this plan sound reasonable? Do my P1NP and CTX scores justify starting Tymlos? My endo didn't answer other than saying she sticks with her original recommendation of Tymlos.
Thanks for any comments or advice!

Interested in more discussions like this? Go to the Osteoporosis & Bone Health Support Group.

@hopeandhope

Hi @bluebonnet242! Yes, it's controlled by hydrochlorothiazide. My diet didn't have anything to do with it - always consume plenty of calcium and low sodium. The human body is complicated and often a mystery - there's still so much we don't know. Could be genes or mutations - it's idiopathic so unknown cause.

Jump to this post

Thank you. I had read about taking hydrochlorothiazide for hypercalciuria before so glad that has worked for you and that your doctor tested you!

REPLY
@esb13

Great about your spine improvement with Tymlos! What are you doing (did) to lock in these great results?

Jump to this post

I remember you mentioning improvement in your hips as well. Would you mind sharing your hip dexa scores? My hips are worse than my spine.

REPLY
@esb13

Great about your spine improvement with Tymlos! What are you doing (did) to lock in these great results?

Jump to this post

@esb13 2 years Tymlos, 4 months Evenity, two Reclasts so far (low dose)...

REPLY

I stopped Tymlos due to hypercalciuria, which was really disappointing. I just started on hydrochlorothiazide. I would like to try Tymlos again if the hctz can keep Tymlos from raising the urine calcium again. I would love to hear how it goes for you! I had no other side effects from Tymlos.

REPLY

@hopeandhope
how was your Tymlos experience yesterday.

REPLY
@marymj7

I stopped Tymlos due to hypercalciuria, which was really disappointing. I just started on hydrochlorothiazide. I would like to try Tymlos again if the hctz can keep Tymlos from raising the urine calcium again. I would love to hear how it goes for you! I had no other side effects from Tymlos.

Jump to this post

I meant to tag @hopeandhope in my comment

REPLY

I told 3 doctors about the high calcium in my urine with Tymlos, and none of them were concerned. They said that my body was doing what it is supposed to do, eliminate extra calcium. I didn't have the 24 hour urine test until after I was already on Tymlos. It is interesting that a diuretic is given to help with this problem. I have been complaining about very frequent urination. Maybe my body is doing what it's supposed to do? My blood pressure is way too low for me to take hydrochlorothiazide. I am afraid of kidney stones though.

REPLY
@hopeandhope

I agree, jennirdh, that this site is great! I also just found it - two days before starting Tymlos :). I'm sorry you had some compression fractures - to get on my soapbox, osteoporosis is generally considered an older woman's disease and thus has not been studied as much as it should have been. I mean, the first osteoporosis drug was developed in 1995! So it frustrates me that the information to treat and manage osteoporosis is spotty and often unclear. My endocrinologist says everyone is different, but that does not negate the fact that treating this disease is not straight-forward. I do think the medical profession is getting better at addressing osteoporosis but it is not nearly where it should be. Even trying to find out what type of medical professional to see can be confusing. So, we end up doing a lot of research ourselves to figure things out and to rely on others' experiences and knowledge through a forum like this. I had to ask to get the bone marker tests after reading a lot about osteoporosis, but my endocrinologist did give me a lab order to do so. All this to say, I sympathize with you - how frustrating to have those fractures after doing so much to treat your osteoporosis.
My doctor was alarmed that my Dexa spine score decreased by such a large percentage so she thought the bone-building drug would be best first in order to try to prevent fractures as she feels I am high risk for fractures. I know I have to go on something else to lock in the gains from Tymlos, but we haven't gotten to that point yet so I don't now what she will suggest or give options for. I really don't want to be on drugs forever and. hope after this I can at least take a break, but we will see.
Good luck starting Tymlos! I hope you experience minimal or no side effects!! Cross fingers 🙂

Jump to this post

I’m so relieved to hear from everyone, thank you so much for all your advice and stories. I started the Prolia partly because my sister was on it w great gains, but I have reminded her not to ever stop it without a GOOD plan, better than mine was. I started the Tymlos 2 days ago, at 2clicks, then 3, and I’ll work my way up. So far it’s ok, but I realize I’m taking a baby dose lol. Has anyone heard of Osteostrong? It’s a method (place) that helps you build bone density and strength and balance, once a week you go and do the machines, red light therapy, etc. Someone told me about it and there happens to be a location very close to me. I’m thinking of joining, the instructors all have been on this osteoporosis train as well. Google it if you haven’t heard about it, pretty encouraging.

REPLY
@jennirdh

I’m so relieved to hear from everyone, thank you so much for all your advice and stories. I started the Prolia partly because my sister was on it w great gains, but I have reminded her not to ever stop it without a GOOD plan, better than mine was. I started the Tymlos 2 days ago, at 2clicks, then 3, and I’ll work my way up. So far it’s ok, but I realize I’m taking a baby dose lol. Has anyone heard of Osteostrong? It’s a method (place) that helps you build bone density and strength and balance, once a week you go and do the machines, red light therapy, etc. Someone told me about it and there happens to be a location very close to me. I’m thinking of joining, the instructors all have been on this osteoporosis train as well. Google it if you haven’t heard about it, pretty encouraging.

Jump to this post

@jennirdh there is a thread here on Osteostrong.

Make sure to refrigerate Tymlos pens if you are not doing full dose, so you can use the pen past 30 days. You will need more needles too.

REPLY
@marymj7

I stopped Tymlos due to hypercalciuria, which was really disappointing. I just started on hydrochlorothiazide. I would like to try Tymlos again if the hctz can keep Tymlos from raising the urine calcium again. I would love to hear how it goes for you! I had no other side effects from Tymlos.

Jump to this post

Hi @marymj7! I don't know when my doctor will order it but I will post when I have a 24-hour urine test to say if there's any impact from Tymlos. I haven't been able to find any information regarding whether Tymlos has caused worsening of pre-existing hypercalciuria that has been controlled. The doctor and everything I can find online say it is a possible side effect of Tymlos (no one can answer how it affects pre-existing hypercalciuria). The hydrochlorothiazide works well for me so I'm hoping it continues to keep my urine calcium down! Good luck - I hope it works for you too!

REPLY
Please sign in or register to post a reply.