@nycmusic Not sure you can call this guidance but I can offer my own decision and why. I haven't started on Reclast yet but intend to when my Forteo is finished. Most people take Prolia or Reclast to chase an anabolic. Both can have very nasty side effects. I don't know if more people suffer bad side effects on one versus the other, but my sense is that most people don't have serious side effects on either. Maybe someone can point to studies that show otherwise. The main determinant for me is that I don't like that you can't just stop Prolia. You have to "wean" off of it by following up with a bisphosphonate like Reclast anyway. Otherwise you're at very high risk of suffering a fracture. It's called the rebound effect. The osteoclasts (bone "killers") are suppressed while you're on Prolia but when you stop they go into overdrive and you end up worse off than before (worse than baseline). You might need to stop because you might have side effects that you can't tolerate even if you don't have the worst ones. Or because your insurance no longer covers Prolia. Or because we have another pandemic like COVID and you can't even get in to see a doctor to administer it. Or or or ... who knows. But when you stop for whatever the reason, you HAVE to take a strong bisphosphonate afterwards. Then what if you can't tolerate the bisphosphonate?You're back to fracture risk. I've been on alendronate (bisphosphonate) before with no issues so I have a pretty high (perhaps misplaced?) confidence level that I would do OK on Reclast. To me going on Reclast for a year after Forteo (assuming I've had good gains and don't have to try another anabolic) is the shortest and safest route to the drug holiday that I hope to take. I'll have to monitor my bones with BTMs and DEXAs and go back on something eventually, most likely. But in the meantime I get a break (ha ha, hopefully not literally). Maybe when I'm 80 or 85 I'll change my mind and take Prolia if I'm going to be on it for the rest of my life and won't have to worry about transitioning off of it (and hope I don't have any intolerable side effects). It just seems to me to be a drug best left to later in life, if at all. I'm sure other people will have different opinions on that.