Post Evenity DEXA numbers

Are you between two rounds of anabolics also? If you don't mind me asking, how did your CTX change with Actonel? I read it can lower CTX by up to 50% around the 3-6 month mark. Were you on the daily, weekly, or monthly dose? I'm on HRT at the moment, and it's brought my CTX down to the low 100s. Actonel seems like a pretty interesting bisphosphonate. Sorry to hear it's been giving you some troublesome side effects. Hope you and your doctor decide on something that's a better fit soon.

Actonel took my CTx from the mid 400’s to 86 is less than 6 weeks.
I was on Tymlos 2 yrs snd needed a follow up medication.
It was discovered that Tymlos actually decreased the cortical bone in my feet- and I had had over 8 foot fractures already and my feet were now crucially affected by the Tymlos. Evenity was prescribed which does better with Cortical bone

I was on Tymlos 2 years with severe Osteo with 8 foot fractures. Tymlos did a great job on my spine ( mostly trabecular bone) but reduced cortical strength in my feet to the point they were severely vulnerable. I was put on actonel which reduced CtX from 400’s to 83 in less than 6 weeks ; at the same time my p1np plummeted too.
I needed more anabolic support so went on Evenity. I feel it is working well and will also hrlp cortical bone

Hello everyone who suffers from osteoporosis and fractures. I started reading this site in April after I was prescribed Tymlos. It was long time wait for insurance approval. During waiting time I developed horrible back pain and found out that I have a bulging disc which greatly affected my stenosis ( didn’t know I had one). Pain was so unbearable that I decided to have steroid injection. Which didn’t help a bit. Actually, made it worse. After all I found out that insurance delayed because my endocrinologist didn’t submit right paperwork.( My spine T- score -4.9 and I already have 4 fractures). Besides, he never returned my calls. So, I decided to find someone else. I did find NP who specializes in osteoporosis. So far she is great. She prescribed Evenity and insurance approved already. I suppose to have my first injection at the beginning of July. I am scared a bit because I have a lot of pain already. Especially in my back and I know that one of the side effects could be a joint pain. I am still willing to try. I appreciate any thoughts or experiences. @sunny65

Oops, missed your new post! So you already on evenity after 6wks of actonel. Would love to hear how things go if you're tracking bone markers. Hope things go smoothly, and that evenity really compliments the areas where tymlos was falling short.

Whoa, I'm guessing you didn't expect such a dramatic shift - unless your baseline CTX (rx-naive state) was already on the lower side before starting treatment. Both Tymlos and Forteo can lead to increased cortical porosity, but some studies have shown they might also boost cortical volumetric BMD, which could help offset some of the risks, depending on the site. Sounds like your foot bones took a hit, though - really sorry to hear that.

Raloxifene is definitely on the milder side when it comes to antiresorptives. That said, some practical ways are suggested to help lower the clotting risk if you go that route - like staying active, avoiding long stretches of sitting, and keeping well hydrated etc. I've even read that some people skip a dose or two during long international flights, just to play it safe.

I'm curious how long someone typically needs to be on an antiresorptive before switching to Evenity, and whether going straight from Tymlos to Evenity could work too. Have you come across any pros and cons of either approach?

Would love to hear how things go for you. I'm sure your experience could be super helpful to others going through something similar.

Hello everyone who suffers from osteoporosis and fractures. I started reading this site in April after I was prescribed Tymlos. It was long time wait for insurance approval. During waiting time I developed horrible back pain and found out that I have a bulging disc which greatly affected my stenosis ( didn’t know I had one). Pain was so unbearable that I decided to have steroid injection. Which didn’t help a bit. Actually, made it worse. After all I found out that insurance delayed because my endocrinologist didn’t submit right paperwork.( My spine T- score -4.9 and I already have 4 fractures). Besides, he never returned my calls. So, I decided to find someone else. I did find NP who specializes in osteoporosis. So far she is great. She prescribed Evenity and insurance approved already. I suppose to have my first injection at the beginning of July. I am scared a bit because I have a lot of pain already. Especially in my back and I know that one of the side effects could be a joint pain. I am still willing to try. I appreciate any thoughts or experiences. @sunny65

These are very impressive gains— congratulations!

I've read that a few members on this forum followed a similar path: they used Evenity first, then transitioned to Prolia for 2-3 injections in hopes of achieving further BMD gains. Based on their posts, they're planning to switch to Reclast after completing the Prolia doses.

Your endocrinologist makes a valid point about taking a one-year "sabbatical" from Evenity. I believe it was during last year's Santa Fe Bone Symposium that several specialists mentioned the idea that "bone doesn't want to keep building" indefinitely.

There is a clinical study (small) that looked at a sequence of Evenity → 2 Prolia injections (1 year) → Evenity. BMD outcome is shown in the graph below. The full publication link:
https://pmc.ncbi.nlm.nih.gov/articles/PMC6877701/
Keep in mind, though, that this study used a shorter duration of Prolia than what your endocrinologist is proposing. As many of us now know, the risk of rebound bone loss increases with more doses of Prolia. If you end up having four injections, will Evenity's antiresorptive effect be strong enough to counteract a potential rebound? That's definitely something worth discussing with your endocrinologist.

Are you able to take a bisphosphonate orally?

I've had two injections of prolia following Evenity. Prior to that forteo then alendronate.
I am 77. Too soon to go on prolia til I die. Thinking about low dose reclast to counter prolia rebound. Then what? Thoughts, ideas? My endocrinologist is not very creative in his thinking. I have until November to decide. Thanks everyone.