Looking ahead after Tymlos: Reclast, Evenity or HRT?

I too concerned about Reckast, possible debilitating side effects including osteonecrosis of the jaw. I am on Tymlos for nine months. My forearm bone density has decreased significantly. This worries me. Dr. McCormick suggested Reclast. I’m fearful of this medication. Wondering what my other options are. Any suggestions from our knowledgeable group members most appreciated! Thank you.

I too concerned about Reckast, possible debilitating side effects including osteonecrosis of the jaw. I am on Tymlos for nine months. My forearm bone density has decreased significantly. This worries me. Dr. McCormick suggested Reclast. I’m fearful of this medication. Wondering what my other options are. Any suggestions from our knowledgeable group members most appreciated! Thank you.

Thank you for taking the time to reach out and share your knowledge. I had a DEXA eight months after starting Tymlos and my lumbar improved significantly, from -3.9 to the -3.1. That’s great news. L hip from -3.0 to -2.9. The R hip, L and R femur all stayed the same, in the -2.3 to -2.4 range. The forearm however, which I’ve never tested before, came in at a whopping -4.8. I don’t have a prior number on that because they never tested it before but I’m assuming that this is a decrease. This scares me because it will potentially get worse the longer I stay on the Tymlos, and even though we’re more concerned about breaking a hip and thigh, I really don’t want to break my forearm either. I spoke with McCormick who said that the forearm bone will not grow back. He said because my numbers are actually pretty good, I could cut my losses, preserve my forearm and switch to Reclast. I’m worried about the Reclast and some of the other meds because of the potential jaw necrosis. They say “don’t get a tooth pulled while you’re on it” but how can you avoid that if it’s needed? Wait a year? And some of the side effects of Reclast sounds horrible. I know that it’s uncommon but what if I’m one of the small percentages? All of the options are frightening honestly and it’s hard to make a decision. My endocrinologist basically disregarded my forearm concern. “Do some wrist exercises and continue on Tymlos”, she said. Sorry about the long-winded message. I don’t hear many people talking about the forearm concern. This seems like a big one to me. Am I missing something? Thank you 🙏🏻

@kaa1, I understand your concern. I have broken my elbow, wrist, hand, foot and ankle twice. These bones are mostly cortical. The anabolics help mostly trabecular bones, such as the spine. I was on a half dose of Tymlos for 10 months and am now on a full dose of Forteo. I have improvement in my spine which is wonderful, but no improvement in my hips. They wouldn't test my forearm, but I'm sure with the kinds of breaks I've had, it probably isn't good. I have seen 3 endocrinologists and all want me to stay on Forteo. (I couldn't tolerate any more than a half dose of Tymlos). I figure that 60mcg of Tymlos may be equal to a full dose of Forteo. It appears that no one really knows the comparison though. I will take the Forteo for 6 months and have a 3rd REMS Echolight and possibly another DEXA scan. Someone on this site wrote that Medicare will cover a DEXA once a year if you are on osteoporosis medication. I have had to pay cash for the REMS so far.

"Someone on this site wrote that Medicare will cover a DEXA once a year if you are on osteoporosis medication"

That was me, and it's that Medicare will cover *more* than one DEXA a year if you're on osteoporosis medication. Even the facility I went to double-checked it, because at first the technician said "you were last here just under a year ago, this isn't covered." Then she checked with the staff who confirmed that it's covered because I've been on meds.