@lp30, I started to see a new endocrinologist who preferred Forteo. I was only on a half dose of Tymlos due to side effects. I was unable to tolerate more because of dizziness and nausea. I had also had too much calcium in my urine with Tymlos. I had fewer side effects with Forteo, but I didn't like the fatigue and brain fog. Of course, I had to take a full dose of Forteo, which the endocrinologist liked since that was what was studied.

The ratio was 310/1440 after 6 months of a half dose of Tymlos. The 1440 is divided by 1000 so the ratio is 219. This is considerably better than 150 so is a very good result.

I just received bone marker results back. I stopped Tymlos after 2 years of a half dose, was off it for 2 months, then went back on it for a month at my endocrinologist's request. I increased my estrogen from 14 mcg to 25 mcg 2 months ago. My P1NP is now only 37 and my CTX is 171. 37/.171=216 which is still a good ratio. I think the Tymlos may not be doing anything anymore since my P1NP is basically the same as it was 3 months ago when I was not on it. I think the CTX has dropped in response to the increase in estrogen.

I also got my DEXA results back and they have improved since a year ago:

Lumbar Spine: TBS 1.377, T-score -1.1, Z-score 1.1

Left Femoral Neck: T-score -1.4, Z-score 0.5

Right Femoral Neck: T-score-1.8, Z-score 0.2

Left Total Hip: T-score -1.2, Z-score 0.6

Right Total Hip: T-score -1.5, Z-score 0.3

"Since May 16, 2025, there has been a 1/9% increase in the bone mineral density of the lumbar spine, a 9.3% increase in the BMD of the left total hip, and a 10.8% increase in the bone mineral density of the right total hip. I am very pleased with the results. I would like to just stay on estrogen, but my endocrinologist wants me to continue Tymlos. I will see another endocrinologist next week to hear her opinion.