@2024tymloshelp , I’m following your question because I just found out I have HPP. I have no symptoms but my alkaline phosphatase levels are very low, as are my CTX and P1NP. The genetic testing shows I have the ALPL mutation.

Was about to start Tymlos but we are now regrouping in light of the issue you mention. Anti-resorptives are typically prescribed after Tymlos to lock in gains and are riskier for people with HPP.

I have an appointment with my endo in 2 weeks. Will let you know what I learn.

In the meantime, would love to know if anyone else has had experience with this.