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.