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'Step' requirement for meds and Tymlos
Osteoporosis & Bone Health | Last Active: Nov 25, 2025 | Replies (29)Comment receiving replies
@gently Yeah, I've researched the meds pretty exhaustively (one way to deal with massive anxiety, heh) and it seems clear to me that that's correct. I'm in the Hopkins system and so far it's been PA's - I actually tend to prefer them. I have an appt. with an endocrinology PA in February and I'll see if she agrees with that and if so if she'll at least try to get Medicare/Medicaid QMB (dual coverage) to pay for it. No reflux but I do have jaw issues and need bone replacement - that might also help toward indicating an anabolic, though I intend to get all of that taken care of first. Medicaid likes generics and there's no generic for anabolics I think, so it's $$ also. How well did you tolerate Forteo? Thanks so much for swift reply, it's all truly complicated and scary.
Replies to "@gently Yeah, I've researched the meds pretty exhaustively (one way to deal with massive anxiety, heh)..."
@beccac
Doesn’t forte o have a generic now?
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@beccac
the jaw issues should clinch the recommendation for an anabolic. The Hopkins endocrinologist might suggest Tymlos or Evenity over Forteo. Evenity has the risk of osteonecrosis, and the follow up medication is usually Prolia or Reclast. So it seems kind of like a dead end road to me, but if your -4 in the hip looks likely to fracture. Evenity would be the fastest way to give it support. Tymlos is thought to work better in the hip than Forteo. Forteo giving the advantage in the spine.
I'm having the easiest time with Forteo--no side effects, a little slow on the bone density increases. But I'm more eager for the structural changes which are only known with the PTH medications.
Those of us with massive anxiety have the advantage in gathering massive information Good work. I do wish you were starting medication now. Any chance of getting the PA to start the work of getting approval for an anabolic.