Advice about Osteoporosis treatment

hi deborahla, in your situation I would take Tymlos for two years and skip the Prolia. Evenity is easier (provided you don't have adverse reactions) but Tymlos creates the strongest most integrated bone. Prolia is tricky because you may not be able to take it for the rest of your life. There is the risk of osteonecrosis of the jaw, and the risk of atypical femur fracture. There isn't a good way of stopping Prolia I think it best to start with a medication that remodels bone (Tymlos or Forteo) and follow with an antiresorptive, Is the lowest score in the spine or in the hips.

I'd see another doctor, preferably an endocrinologist who is part of a hospital that specifically treats osteoporosis. To tell a patient that the only option is to take Evenity/Tymlos followed by a lifetime of Prolia tells me this doctor is not the right person.

OP: two years on Tymlos could get your score down to -2.something, at which point there are options other than Prolia. One of our posters likes to direct people to a video by this doctor re: strategies for medication:

The video just posted is by Dr. Ben Leder, a researcher and endocrinologist at Mass. General in Boston. I really like Dr. Ben Leder's video on "Combination and Sequencing Approaches to Osteoporosis" also on YouTube.

Thank you to all who commented.
To @gently, My Lumbar spine T score is -3.8. The T score of the left femur was -3.8 and right femur -3.5.

To @njx58: I live in Nashville, TN and Vanderbilt is the teaching hospital and the one with best reputation. For some reason osteoporosis is treated by a Rheumatology doctor there instead of Endocrinology (my Doctor was a Vanderbilt physician). Thank you for the link. I have watched Dr. Leder and it was helpful.

To@windyshores: Thank you for the link. I have watched it and it is excellent. I am going to do further research but will appreciate any further suggestions on this forum and will ask more specific questions as I come up with them.

The You Tube posted was full of valuable information. I had adverse reaction to Fosamax, was referred by my Internist to a Rheumatologist that started me on Prolia. I had to take a brief “holiday” recently due to dental implant. Unfortunately, the day I was scheduled to start back on my Prolia injection (I’m on year 5) I was diagnosed with an l-1 compressed fracture.
Very painful but 3 weeks later I am well. I start PT this week.
I am anxious to talk with my Rheumatologist about Prolia, continuing or changing. Trying to think of a delicate way to suggest she watch this YouTube. If anyone in this group is living in Houston I’d appreciate any information regarding doctors and or treatment.
Wishing all good luck!

Another resource is the 700 page book "Great Bones" by Keith McCormick, a chiropractor expert on osteoporosis. It can be used as reference or relevant sections can be read as you go.

Thank you so much for this, Deborah

Hmm. Thank you for sharing