@cathyf31 I had 5 years of bisphosphenates a while back. Two years of Actonel and three years of Reclast. The last one was 5 years ago. My doctor was about to start me on Tymlos when I asked if it was strange that my CTX and P1NP (that I had to request) were so low. They noticed that my alkaline phosphatase is also low. At that point, they suspected that I have hypophosphatasia (HPP). We did a genetic test and it turns out that I do.

Because bisphosphates are risky for people with HPP, I now can’t take Tymlos because we can’t follow it with a bisphosphenate. So I’m out of luck! I also have to stop calcium and magnesium supplementation. Now my only tools are diet and exercise.