@anewyorker
so glad you asked.
The Fosamax may have saved you a fracture from 2010 to 2020 because it stays on your bone for ten years or so. Denosumab is not effective. You can't take Evenity. From your experience with Fosamax, Reclast probably won't increase your bone density. Tymlos really works for you.
If you have segmental spine measurements, I'd be curious to see the numbers, especially on L1, because I want to blame Prolia,
but really on each segment to see how effective Tymlos really has been.
Reclast is much stronger than Fosamax, so you may reconsider. But otherwise I don't see much of a choice. Forteo is more effective in the spine. but another year of Tymlos would probably be a good choice.
Would your prescribing doctor agree to another year or to Forteo