Which one to choose: Evenity, Tymlos or Forteo?

ninglike,
I recommend Forteo. Some prefer Tymlos and Tymlos does seem by the literature to have a bit of an edge on bone density gains. Forteo is a lower dose and I think has side effects in fewer individuals.
In deference to your fear of side effects, both Forteo and Tymlos leave your body quickly usually within 24 hours. So you can stop taking either after a day of misery. Evenity will keep you suffering for a couple of months before leaving your system.
Forteo is sometimes used to speed the healing of bones even in those without osteoporosis.
I'm sorry about your L1 compression and hope it isn't painful.
I don't like Evenity at all. I don't like the way it works, the black box for cardiac events and that it makes some people ache.

Drea gently,
Thanks a lot for your sharing!
I'd appreciate it very much if you could enlighten me more about why you prefer Forteo than Tymlos.
Again thank you sincerely for your caring!
Best regards
Ning

I could not tolerate Forteo at all, and was grateful to get on Tymlos by starting at a low dose after the full dose also caused me problems. I moved the dose up to nearly full dose over a few weeks and my body acclimated. The Tymlos pen has "clicks' that measure doses.

I did 4 months Evenity after two years Tymlos then on to Reclast. At the time, I was told I could do Evenity after Tymlos but not the other way around. Evenity was approved 2019 and I went on meds 2021 so it was new.

I had some fractures and read that Tymlos could be helpful with healing, My spine went from serious osteoporosis to borderline a 19.1% gain, in 18 months on Tymlos.

Dear windyshores,
Thanks a lot for sharing your experiences which are really helpful!
Could you please elaborate more about the reason you "could not tolerate Forteo"?
Also why you only took Evenity for 4 months instead of 12 months?
Thanks a lot in advance for your help!
Best regards
Ning

You can't make a decision based on personal stories. Here you have one person saying Forteo, the other saying Tymlos. Everyone is different. The majority of people do just fine with either one. You won't know until you start.

I'm on Tymlos. One thing I like about it is that it doesn't have to be refrigerated, so it's a lot easier to travel with it as opposed to Forteo.

Ning,
I'm a little wary of pharmaceuticals. I chose Forteo because it is a lower dose of medication 20mcg compared to Tymlos 80mcg.
Forteo has been in use longer than Tymlos which made the research more thorough.
While Forteo is less convenient because it requires refrigeration, Tymlos contains a preservative that some people have allergic reactions to.
Either medication would be a very good choice.

njx,
I would be far less comfortable offering my opinion if I didn't know Windyshores was just around the corner.
We make the best decisions based on each other's experiences. Essentially, that is what clinical trials are.

I guess the reason I post is to demonstrate a variety of experiences, not to advocate for a particular choice.

Tymlos was approved April 2017 by the FDA. Forteo in 2002 (generic version 2023). Evenity in 2019.

From Save our Bones:
(Tymlos) activates the same parathyroid hormone pathways as Forteo (teriparatide), and thus functions in the same way. The key difference is that while Forteo is a recombinant human parathyroid hormone analog, Tymlos is a human parathyroid hormone-related peptide analog.

I have wondered whether the difference in mechanism accounts for some of the dosage differences. I liked Tymlos because the dosing is adjustable. I have seen studies that Tymlos is slightly better for spine results. There are comparison charts and the two are pretty similar in results.

@ninglike I have no idea why I could not tolerate Forteo. I went to an immunologist to get desensitized and she basically said my immune system had "gone awry" and that we had failed. My heart sped up, I was out of breath and felt extremely faint, and I had icy stabbing pain in my lungs. Most people don't have this. As I wrote elsewhere I even tried a 10% dose at home (my doctor was amused) by shooting a dose in a sterile cup and using my kid's insulin syringe to draw up 10%. Same problems so not dose dependent. May have been an allergy.

Full dose Tymlos was also tough to handle but I went back on at 20mcg and moved up slowly, eventually staying at 70mcg (full dose is 80). If you don't do a full dose, you do need to refrigerate it so it will last longer, and you need extra needles.

It makes no difference which you choose honestly. Flip a coin! @gently and I are a tag team. She posts Forteo and I post Tymlos, maybe cancelling each other out but letting you know that this decision is not a crucial one in terms of these two drugs.

I really only planned on doing Evenity for the stronger bone-building months (4) and wanted to still have some months left (8) for the future. That said, my doctor was on board because I had some burning sensations that were difficult. I have lupus and high antibodies to scleroderma and have a 20 year history of neuro sensations so this may have been particular to me though a couple of other people have mentioned it. Note I had already done two years Tymlos. Most people do fine on Evenity with few side effects (and tend not to come on forums!).

My endocrinologist has recommended that I take Forteo, and I will wait until my next bone density results to decide whether or not I'll take it. But in regards to traveling, I did read that there is a handy insulated thermos that keeps the drug cold for several hours and even has a USB port that you can plug-in.

I only know Evenity. I had no side effects and got a 16 3/4% gain. I saw a cardiologist before starting to be sure he saw no problem. I am 75.