Connect
← Return to Prescribed Tymlos after Evenity
Discussion
Prescribed Tymlos after Evenity
Osteoporosis & Bone Health | Last Active: Aug 27 1:13pm | Replies (112)Comment receiving replies
@gently, @windyshores, @mayblin, I'm now able to update how the Evenity - - >Tymlos sequence has worked for me thus far. After one year of Evenity followed by four months of Fosamax, I will complete one year of Tymlos on 3/15/25. I had my DEXA and TBS yesterday (3/10/25). DEXA results indicate no apparent changes currently except for in my R femoral neck which went from -3.2 to -3.8, and my TBS went from 1.359 to 1.370. My new doctor was planning on starting me on Prolia for two years, followed by Reclast. I will meet with her tomorrow, and was thinking I would press for continuing Tymlos for another year, but at this juncture I don't know if that's the best option. I don't want to go on Prolia. To be honest, I have multiple comorbidities that have made the past year very challenging and I'm exhausted. I don't know if Tymlos has contributed to that, but I'm looking forward to finding out over the next month of being off it! I will discuss all of this with my doctor, but I don't know what to ask for. If you have any suggestions for me, I'd really appreciate your input.
Replies to "@gently, @windyshores, @mayblin, I'm now able to update how the Evenity - - >Tymlos sequence has..."
@hollygs thanks a lot for the updates! Great TBS score btw! You are among the very few exploring this evenity -> tymlos sequence. The information you provided could be very useful to some of us.
The fosamax you took could delay tymlos' effects for a few months or dampen its effect somewhat. If you had bone markers tested, they may give you a clue.
Was there a discordance in T scores at left and right femur neck from your previous dxa? The one-sided femur neck decrease in bmd is puzzling. It makes one wonder if it was a scan error, or due to a biological reason, or if it is an existing discordance becoming more prominent.
The choice between prolia and reclast is very personal. Some endos use it to further bmd gains before locking in with reclast. If baseline CTX (prior to any osteodrug treatment) is low-ish, I'd definitely avoid prolia if I were you. We know one either stays on it or relays to reclast/fosamax, which may result in ctx over suppression in degree and length. With a bisphosphonate, one can at least take drug holidays when needed. If one has comobidities with reduced immunity, prolia is a concern too. The easier and less complicated one seems to be reclast or an oral bisphosphonate. When needed in the future, you can always use an anabolic again after bisphosphonate (+/- drug holiday).
I'm keen to learn what you and your endo decide. Best luck to you!
Does anybody ever get off of these meds once you’ve started them?
Connect
hollygs,
I'd go for another year of Tymlos. The TBS increase makes me suspect that the next year will yield greater bone mineral density. The right femoral neck is concerning. There is sense to be made of it from the type of bone that Evenity produces. And from the important canaliculation that Tymlos initiates.
Fatigue is one of the common side effects of Tymlos. I speculate the fatigue results because the dosage is too high-- probably not a good subject for conversation with your physician tomorrow. Most are so opposed to lowering the dose. Elevated calcium can also cause fatigue. Part of the mechanism of action for Tymlos is to increase serum calcium briefly. But in some people it can cause sustained calcium elevation.
I would ask for serum lab orders. P1NP and CTX, calcium, d and pth.
Thanks for posting the Evenity to Tymlos results. Very helpful.
Post us how your appointment goes.