Hi @jennirdh , I am very sorry to hear that you suffered vertebrae compression fractures related to prolia rebound. Hope you have a speedy and great recovery that lead to minimal aftereffects.

Your bone makers are very interesting and thank you very much for sharing them. Since you had 5 shots of prolia then followed with boniva for 11 months (please correct me if I got this wrong), your bone markers may still reflect some tailend effects of prolia cessation, in other words, they might reflect the combined effects of prolia cessation (end stage) and early stage of tymlos' therapy.

To me, the good news is CTX is stabilizing. I have a neutral view towards your latest two p1np readings as you don't have a baseline. Some people get p1np increase only in early months of tymlos treatment as shown in clinical studies. So your p1np 112 might be the "spike" but there is no baseline to compare with - let's hope this is it! I agree with you on the importance of a baseline. I don't have any either prior to my forteo treatment. Later when I needed it, it was too late. I could've easily used a double dose of estradiol after Forteo which clearly was proven not necessary by bone markers as well as dxa results.

Curious, was your CTX monitored during Boniva?

Wish you the best, and a great success with Tymlos!