@magicwoo Tymlos is an anabolic bone building agent that is not known to cause osteonecrosis of the jaw. I have implants and was very clear about that when I was researching my options. I also ran it past my very knowledgeable oral surgeon who gave Tymlos the thumbs up. As for side effects...most of us on Tymlos experience them in varying degrees early on in the treatment but most of us stop having those side effects after our body adjusts in a few weeks. I had bone pain in my arms but I also have carpal tunnel and the meds did wake it up somewhat. Also mild headaches. After 2-3 weeks, the side effects abated. Now in my 8th month and no side effects for quite some time. I only took 70 mcg for most of that period as I am 109 lbs and was hesitant to take the full dose. In the 4th month my P1NP rose to 98. Happy with that number and I have actually bumped up to full dose after learning my severe osteoporosis resulted in a pre-Tymlos neck fracture that needs surgery. Can't use surgical pins and hardware in my neck without better bone quality, so I am grateful for Tymlos. As for the co-pay, there may be some patient assist programs available thru the manufacturer, Radius. It's a big ticket, for sure. For some people, Medicare is covering it after the annual co-pay of $2,100. Private insurance is probably less generous.