Thanks for sharing. Unlike bisphosphonates, estrogen's effect on bone turnover is mostly reversible once it's stopped, usually about 6mo +/- depending on the source. Since you stopped HRT 5mo before starting tymlos, it's unlikely estrogen would still be having a major impact, though individual variation is possible.

In situation like yours, bone turnover markers checked at baseline and again a few months into Tymlos could give some useful clues. Too bad that's not part of standard care yet.

I really hope it doesn't cost you an arm and a leg to stay on Tymlos - pun intended, as the whole goal here is to reduce fracture risk and keep bone safe.

Please keep us posted on your decisions and how things turn out. Wishing you the best of luck with next steps.