I recently finished my two years on Tymlos and went through a lot of debating on next steps for after. My doc recommends Reclast as the best option to lock in and hold the gains I've made. My spine density increased 16% with Tymlos and I want to make sure I don't lose all the gains I made so am moving forward with the infusion on May 14. I have read many of the horror stories and it's terrifying as I know if I am in the small percentage with the long term side effects I'm stuck for a while. I did talk pretty in depth with my bone doc about it, as well as a PhD that oversees many of the studies on the drugs. The future plan is currently three annual Reclast infusions and then I will have several years off of all drugs with testing bone markers to know when it's time to start another step. As an alternative I could consider a weekly Fosomax dose for five years instead, but it doesn't seem to hold the gains quite as well as Reclast. My mom was diagnosed young as well and has broken 16 bones, so, to me, the risks are hopefully worth the rewards. Of the four individuals I know personally that have done the Reclast infusion, none of them had issues beyond the first two weeks post infusion (two had flu like symptoms for a few days, one had no side effects and one had bone pain off an on for the first two weeks). My doc did note that he would be more hesitant if I had underlying conditions, particularly any autoimmune issues, calcium or kidney issues (He did require additional testing before determining whether he thought I was a good candidate for it or not). I certainly don't dismiss those that have had the terrible long term reactions (it terrifies me and has kept me from booking the infusion for several weeks), but I know not taking meds isn't an option for me. As my mom was diagnosed young, I have always been obsessive about exercising properly and ensuring plenty of Calcium and Vitamin D as I really didn't want the osteoporosis future. At 51 I got a DEXA scan and was, unfortunately, already well into Osteoporosis (-3.5 spine average). My doc noted genetics are a bitch. My sister was diagnosed at 49 with osteoporosis as well. I am very active - ski, hike miles every day, do martial arts, eat healthy, etc and I want to ensure I can continue to do all the activities I enjoy well into my old age. I was terrified to start Tymlos, but I had no issues and got some nice gains that I want to keep. I would note that if you read the reviews of all these drugs, almost all of them are negative. I kept putting off making a next step decision based on reading everything on these forums, but finally decided to trust my doc and his recommendations as doing nothing is a no go. I did specifically ask how many cases he has personally seen with long term issues on Reclast and he noted in the thousands of patients he has treated at least 20% had issues in the first two weeks, but that he'd only had two patients with more severe long term reactions to the medications (he also said both had additional underlying conditions). I asked if he ever recommended it to his mom (I know from our initial meeting that was one of the reasons he went into this speciality years ago), he noted he did indeed, that she had several Reclast infusions as part of her treatment protocol and experienced mild flu symptoms the first one and very few on the other two). I also talked to the PhD who oversees the clinical trials for osteoporosis drugs and she also recommended Reclast as the best option to lock in the gains (and had taken it herself in a similar situation). I know it's a risk and that I could be one of the minority with the long term issues (I am usually sensitive to medications), but I know there are long term issues with broken bones and compression fractures so here I go taking the plunge! My infusion is in 10 days, I was terrified to schedule it but a certain amount of relief to have a decision made for next step. I will make sure I'm well hydrated, will be taking tylenol day before, day of and day after and I scheduled the longer 60 minute infusion rather than having it completed over 15 minutes (all the items recommended to reduce side effects). Hopefully I'm not one that has an allergic reaction to it (fingers crossed). I'll follow up post infusion recovery and "hopefully" I'll be able to share a positive result.