@chrisdietrich I did have good gains on Tymlos after 12 months on it and presumably that continued until I stopped at 18 months (my endo wanted me to do 18 months, not 2 years). From everything my endo has said and I have read, after Tymlos a bisphosphonate is important to hold the gains since the bone remodeling gets a bit skewed on Tymlos so the bisphosphonate brings more of the bone remodeling pattern back. And diet and exercise are important during and after meds. After the bisphosphonate, I guess the hope is to not be on more drugs but to stabilize with a good diet and exercise routine. Whether that is realistic, I don't know.