@rileyf Overall, I am pretty pleased with my DEXA results on Tymlos. My lumbar spine went from -2.7 to -1.5, although my hips didn’t move at all and have stayed at -1.5 (my PA said Year 2 is when hips improve so we will see). Bc my osteo will likely keep progressing, I plan to fight for Evenity to build more bone before doing Reclast. Otherwise, when I have to build more up in the future, drugs like Evenity and Forteo will be less effective bc of sub-optimal sequencing. Best of luck to you and everyone else on this journey.