Tymlos treatment plan - 18 months vs 24

The problem, as usual, is the health insurer. Many, perhaps all, still have the restriction "no more than 24 months of Tymlos or Forteo", unless you have shown that you are still at a high risk of fracture / T-scores still bad.

I'm impressed with your knowledge, and I probably only partially understood everything here, but I keep thinking that if you take Tymlos or Forteo, it moves the needle back on osteoporosis, but only temporarily. It eventually goes back downhill so this is just buying you a little time. I wonder if the side effects and risks are worth a temporary improvement. With so much of the population increasing in age, you would think there would be more research.

loh, this really is a risk/benefit decision. It's a little tough because we have to guess at both the risk and the benefit.
I didn't reach the same conclusion that you may have. If moving the needle back on osteoporosis two years means two additional years without fracture, I'd opt for the two years free of pain. But if a person were to decide that taking the drug is only good for two years, they might consider that without the drug in two years their bones will be much weaker than they are now. Even if you don't fracture in the two years without medication, the likelihood of fracture in the following two is much greater. It is easier to slow the loss of bone than to replace the lost bone.
Scaling the side effects of the medications appears a little different for me. The risks with Forteo are close to 0. At the very worst you could have 24 hours of discomfort. It is more like four hours. But then you can reassess and quit the drug.
On the other side of the scale is the risk of fracture. We are most susceptible in the spine. You may already know that spinal compression fractures never heal to their original shape. This change in shape can affect the function of your entire spine, providing endless pain.
The other drugs weigh heavier in possible side effects in this order Tymlos, Reclast. oral bisphosphonates, Evenity and then Prolia.
There is some interesting research. Someday we may not have to make these difficult choices.
It would be a tough choice for me if it weren't for Forteo. For very few, the choice of some of the medications has proven to be not worth the side effects.
Bless your choice with luck.

The way Dr. McCormick put it is that Tymlos or Forteo buys you time. Or, as you put it, where would you rather be in two years? At that time, then we can figure out what is next. There's no 20-year grand plan, sadly.

loh, this really is a risk/benefit decision. It's a little tough because we have to guess at both the risk and the benefit.
I didn't reach the same conclusion that you may have. If moving the needle back on osteoporosis two years means two additional years without fracture, I'd opt for the two years free of pain. But if a person were to decide that taking the drug is only good for two years, they might consider that without the drug in two years their bones will be much weaker than they are now. Even if you don't fracture in the two years without medication, the likelihood of fracture in the following two is much greater. It is easier to slow the loss of bone than to replace the lost bone.
Scaling the side effects of the medications appears a little different for me. The risks with Forteo are close to 0. At the very worst you could have 24 hours of discomfort. It is more like four hours. But then you can reassess and quit the drug.
On the other side of the scale is the risk of fracture. We are most susceptible in the spine. You may already know that spinal compression fractures never heal to their original shape. This change in shape can affect the function of your entire spine, providing endless pain.
The other drugs weigh heavier in possible side effects in this order Tymlos, Reclast. oral bisphosphonates, Evenity and then Prolia.
There is some interesting research. Someday we may not have to make these difficult choices.
It would be a tough choice for me if it weren't for Forteo. For very few, the choice of some of the medications has proven to be not worth the side effects.
Bless your choice with luck.

loh, this really is a risk/benefit decision. It's a little tough because we have to guess at both the risk and the benefit.
I didn't reach the same conclusion that you may have. If moving the needle back on osteoporosis two years means two additional years without fracture, I'd opt for the two years free of pain. But if a person were to decide that taking the drug is only good for two years, they might consider that without the drug in two years their bones will be much weaker than they are now. Even if you don't fracture in the two years without medication, the likelihood of fracture in the following two is much greater. It is easier to slow the loss of bone than to replace the lost bone.
Scaling the side effects of the medications appears a little different for me. The risks with Forteo are close to 0. At the very worst you could have 24 hours of discomfort. It is more like four hours. But then you can reassess and quit the drug.
On the other side of the scale is the risk of fracture. We are most susceptible in the spine. You may already know that spinal compression fractures never heal to their original shape. This change in shape can affect the function of your entire spine, providing endless pain.
The other drugs weigh heavier in possible side effects in this order Tymlos, Reclast. oral bisphosphonates, Evenity and then Prolia.
There is some interesting research. Someday we may not have to make these difficult choices.
It would be a tough choice for me if it weren't for Forteo. For very few, the choice of some of the medications has proven to be not worth the side effects.
Bless your choice with luck.