What happens after TYMLOS ?

Please check the subheadings under Osteoporosis. There are many posts and discussion that address your concerns.

@gravity3

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Sophie, Tymlos is the best medication to be taking while having tooth repair, especially implants.
I'm on Forteo the the drug similar to Tymlos. I had two teeth extracted three weeks ago and the orthodontist espressed surprise at the speed of my recovery and the health of the implants. The parathyroid drugs Forteo and Tymlos are the only osteoporosis medications that don't have a warning for osteonecrosis of the jaw with invasive dental work. They are also the only osteoporosis medication that are given to heal osteonecrosis because the actually carry away damaged bone.
While we have do all of the things like exercise and supplements and diet to help our bones, I'm skeptical that we can regain much lost bone without the medication. But you really have to look carefully and make that call for yourself. You might look at Kathleen1314's posts. She almost has me convinced because of her own results with strontium and because of her research.
Cheers to your Rheumatologist for realizing that you don't need the steroid and probably never had PMR. I'd trust her. Anyway I think two years of Tymlos and getting those teeth out of the way is the very best bet. Your doctor may prove more flexible about the Fosamax after the two year mark. Mine did but he was threatening two years of Reclast. Now I'm finishing a third year of Forteo. I'd want to stay on Tymlos for six month before going after those implants.

Tymlos is an anabolic bone building drug so great for increasing your bone density. However, if you don’t follow it up with something to “lock in the gains” you simply go back to losing bone faster than it can be made. Generally it’s followed with a bisphosphonate, in my case we discussed either five years of Fosomac or 3 years of Reclast. I chose three annual Reclast infusions and then I will have a several year drug holiday (bisphosphonates build up in your system). After that is still TBD but osteoporosis is lifelong. I went to my dentist before starting any drugs and asked them to check for anything I might need so I could do so beforehand. My scores were worse than yours however at the age of 51 (spine -3.9 for example). I did gain 20% in spinal bone density thanks to Tymlos so I was pleased with the results and don’t want to lose the gains I had made. I had no issues with my first Reclast infusion. I will have my second in May. Bisphosphonates essentially “coat your bones” so you don’t lose bone as fast. Reclast is the stronger option, Fosomax is a pill taken daily. My mom had severe osteoporosis (broke 16 bones and lost four inches of height due to spinal compression fractures) so I always exercised consistently, ate well, made sure I got plenty of calcium and vitamin D but as my osteoporosis doc noted “genetics are a bitch” so here I am. My sister also started osteo meds at 49. My mom has been on Prolia now for nine years and is doing great. I still ski, do karate, hike, etc. none of the osteo meds are meant to be used long term, so it’s a bit of a long term planning session. My sister wasn’t as severe as me so for her it’s five years of bisphosphonates, several years of drug holiday, then likely back on bisphosphonates for a few more years (like me, her doc will do bone marker testing to determine how long of a holiday by seeing when it’s wearing off for the next step).

@misst1970 Thank you, I found your message to be very informative and helpful. I developed osteoporosis at a young age. I have lupus as well. I took four years of a fosse act from 2013 to 2017 and then was put on a drug holiday and was being watched until the last couple years when I started losing more bone and this past December’s DEXA was the worst worst so I will be starting Tymlos on Tuesday. It’s scary and it was a hard decision dealing with the change it will bring to my life mentally and physically, but I think the best choice in my case so I can rebuild back some of my bone. I am 64 and my spine was a -3.5. My 2 choices after the two years on Tymlos are Fosamax or reclast but I have a little time to think about that though I am leaning towards reclast since it has a slightly better edge than Fosamax. I have an appointment at my doctors office on Tuesday. They will help me with my first injection. Fingers crossed that I don’t have any reactions.

@cpog Hope it goes well! I did find if I was relaxed, well hydrated and stayed seated for at least 15 minutes after my Tymlos it helped (and after the first week the few minor side effects I had noticed stopped). I will say I stressed ALOT on what to do, but knew that not taking meds wasn't an option for me and wanted to build up some bone before going on something to "maintain". Once I started the Tymlos and knew I had a plan I felt confident going back to my life as usual (admittedly I'm a little more cautious in karate and skiing, but not by much!).

@gently My DR says 2 years of Tymlos and 1 Year of Alendronate...I have not started yet because I wanted to give myself a moth off of the prednisone to recover a little. I am not sure what my T scores are today and I was thinking it would be a good idea to take them along with P1np and CTX. My concern is that everyone seems to be on some therapy for soooo long. Is what my DR said about 3 years total going to work or will I just be caught up on the drug train for longer? THANK YOU!

@misst1970 Thank you so much for your comments....I am scared to death to start Tymlos after the negative statin deal and getting PMR (maybe) Now the prednisone has lowered my T scores but it also is supposed to degrade the bone you have. I do not want to be left standing at the "medication station". Everyone here is so helpful, I sincerely appreciate it!

@misst1970 my injection went really well yesterday! I had an appointment with my doctor’s office and an RN demonstrated on an example injector pen. I went over everything and then I had brought my pen so he walked me through the injection and it went really well! They made me stay there for 15 minutes in case I had any side effects and I was a touch lightheaded, just sitting there, but it may have been nerves as well and I was fine when I got up. I opted to do my injections at night so my second will be this evening. I had some minor headaches last evening, during the night and today, but Tylenol helped that. All in all, I feel really good and even did some walking on my treadmill today and some exercising. Thanks for all of your suggestions.