Glad to know I'm not alone. I did start taking HRT at the same time of starting Tymlos and I am 63. I am glad I am on HRT. The more I read the more it makes sense. I mainly did it to combat some of the effects of Tymlos. I do believe it helps but like I said I am only 4 months into Tymlos at a steady dose of 7 clicks. I will not go up to 8 clicks. I am also "considering" raloxifene after Tymlos because I also do not want Reclast or Prolia. I do not want a "years worth" of medicine in my body all at once. I am upping my weight lifting and just forcing myself to do it even if I'm tired as I do not want to give in to the fatigue and belly fat. I was at -3.7 spine and -2.7 hip with a Dexa done on 8/2024 but I just got a REMS scan that stated I was osteopenia with good bone quality so I do not know what to believe!! It is more confusing than ever. Which is right Dexa or REMS?? I based my medication selection on the Dexa. I plan to do another REMS and maybe Dexa too in 6 months.