I am 67 and never took hrt. My endocrinologist agreed to start me on hrt. About 6 weeks weeks later I started on Tymlos. I'm almost 3 months in and had a 297% increase in my P1NP. My hope is to continue on hrt on completion of Tymlos and see how I do. I did find a study on women ages 58 - 80 on hrt, that showed they all maintained bone density after 4 years. I would prefer to skip reclast if at all possible. I hope maybe there will be more info available in a year from now.