Update on post Evenity treatment

Terrible results from envenity. Didn't work. My doctors office gave me the shots - it was covered under my supplemental. Now I gave to go on Tylemos - not a happy camper

https://pmc.ncbi.nlm.nih.gov/articles/PMC5399468/
@awfultruth
@mayblin

This study makes me want to do the Risendronate, if only we knew it was strong enough to hold the Evenity gains? I had my last injection was 7/19, I have an Endo visit scheduled for 9/4. Could not get it sooner. I'm still concerned with my hip at -2.2. This study says Alendronate will surely blunt some anabolics. Not much help from the medical teams, many think "well, what's convenient for you?" That s the last thing on my mind. If not for the help in here many would be in the dark on this trip.

@rola, were your Dexa results comparing 2025 vs 2024, or 2024 vs 2023? It sounded like you just wrapped up Evenity. And if you don't mind me asking, what kind of improvement did you see in your TBS?

You've made great bmd gains - you are in osteopenia range now! Are you thinking about doing another round of Evenity sometime soon? One way to check if gains are "locked-in", imo, is by checking bone turnover markers. That said, there doesn't seem to be a universal agreement on what counts as good CTX suppression. Some go by percentage drop, others look at absolute number.

Fosamax generally shows a slightly greater CTX reduction compared to risedronate, especially in the first 6-12 months of treatment. But because of Fosamax has a longer retention time in the bone, it tends to suppress bone turnover for more extended period. This might be one reason risedronate is seen as a better short-term bridge between 2 anabolic rounds. For bmd maintenance, I'd probably go with Fosamax or Reclast, and maybe even HRT, as long as a proper risk assessment is done.

@awfultruth, do you know what CTX level is generally considered a good sign of suppressed bone turnover? It seems you weren't too happy with it being in the upper 300s.

@rola Thanks for that study. Seems especially relevant if one is interested in using Risedronate as an interim med with the desire to use any of the anabolic meds after an interim med.

@mayblin, Thank you for your insight. I would love to try and target my hip, but I don't know if I have the strength to convince the Dr to do another round. It's an update hill battle, was not even able to convince my last Dr to do bone markers.

My DEXA was 3/6/24 and the latest after treatment was 8/2/25.

TBS in 24: 1.221
Degraded: (< or 1.230)

TBS in 25: 1.326
Normal: (>1.310)

Was done at the same facility, this is exactly how it was reported.

Thanks again. I have this little window to decide and should accept be thankful for what I have and lock-in.

@awfultruth, You're welcome and best wishes on your move and treatment plans.

@mayblin I cannot find my notes on this right now. Nor can I access my Quest Diagnostics test results as they have added crazy extra security on my blood work. Anyway from memory and for me personally I think I was usually 300-400 on CTX but with one spike up to 700. Unfortunately, some of those tests were not taken early morning following whatever other rules I have written down. Now I always do early morning at roughly the same time.
I believe I was losing bone at anywhere from 300 to 400 though there is uncertainty here and I've always been losing bone since my first DXA in 2019.
So for me I'm trying to keep below 300 at least and probably better at 200 or below. While on Risdedronate anyway. At 400 I'm guessing I have to take Risedronate more often. I think the CTX scores while taking Evenity are much more complicated.

I suppose one needs ideally to know their CTX when not losing bone, when losing bone, and on different meds. And look at how much change any med causes in the CTX score. Even though one CTX score may not work for every person in terms of when they would maintain or lose bone I think that it's unlikely that anyone would be losing bone at 200 and that many would be losing bone at 600. And for any given individual I'm guessing that they could take a lot of CTX tests and get a good idea of when they are gaining or losing. Like maybe one could figure out based on their history and a combination of CTX's and DXA's that they are ok at 250 but not 350 or maybe for them they would be ok at 350 and not 500.
I'm just doing a lot of speculation here.

Thanks for sharing your results - it's really great to see such strong numbers across the board. I can see how it'd be frustrating to have to push for bone marker labs or deal with uncertainty around re-treatment, especially now that you're in the osteopenia range (which is a great place to be!). You've clearly put in a lot of effort to get here, I hope your success continues!

Thank you for the reply - I appreciate your perspective and the insights that you shared on CTX changes during different circumstances. It's helpful to consider how we can interpret the labs to make the most effective use of them.

Yes, and the truth is no two of us are alike, just so many variables in play. Thanks for all the insights both of you. Take care.

Tried Tymlos, could not tolerate the heart palpations after each injection. Switched to Evenity. 2 shots in, and another in a week. Thinking about quitting. Dexa was -2.5 in January.

My hair is falling out in clumps. Joint pain in fingers and right hip.
Read something about high does of Reservatrol supplements as a potential bone builder.
Anyone have severe hair loss on Evenity?
Anyone switch off and go on Reservatrol supplements?