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.