I've never understood the science of all this, not my strong suit, but my orthopod's plan is to start me on Prolia when the course of Tymlos is done, and to continue that for the rest of my days. I know a couple people on only Prolia who have had improved DEXA scores on it, including one who's fallen a couple times and done no damage. So I'm feeling fairly positive about Prolia. I guess it's like any med: some folks will improve, some won't, some will get worse, and you can't know until you try it. A sobering reality.