I was on alendronate for 3.5 years before switching to generic teriparatide/Forteo (on both depending on what my insurance formulary covered). I went from -3.8 in spine to -3.5, a 4.6% increase. I was hoping for better. No change in left total hip (-2.2) or left femoral neck (-2.6) I'll never know what the results would have been had I not taken alendronate first, but the studies indicate I would have seen more improvement than I did. Since my spine score is still pretty low I want to try Evenity next.