Hi @bayhorse, choosing the right treatment can feel really complicated when you are managing other health issue at the same time. It can definitely feel overwhelming - I know I would if I were in your shoes. The key is to work with a physician who is well versed in both medications and your underlying medical conditions. I know even finding the right doctor can be a challenge in itself!

Have you watched the YouTube video on osteoporosis drugs and cardiovascular diseases?

at 27:51, the presenter discussed romosozumab's (evenity) effects on cardiovascular risk. The information comes from 2024 Santa Fe bone symposium and may be useful to you.

There have been studies on bmd loss after discontinuation Forteo without any follow-up antiresorptive therapy. On average, the lumbar bmd declines about 4-7% within the first year, with continued loss thereafter. Most studies showed a return to baseline within 24-30 months if no antiresorptive follow-up. However, the monthly rate of decline wasn't calculated or was difficult to track (may not be linear), so it's hard to say exactly how long one could wait before taking any action. There seems to be a lack of direct studies on Tymlos in this area, however, teriparatide (Forteo) offers the closest available comparison.

I truly hope you will soon find a path forward that you feel comfortable with, with the help of your physicians and any other specialists. Wishing you all the best!