Dental work while taking Tymlos?

@btichy
I am worried about the same. If I start on Tymlos I am frightened about jaw necrosis. May be at risk for MRONJ. What to do after?
Also, want to start with Fortibone either Native Path or Algecal. Algecal has loads of amino acids. Not sure about that either. I take lots of prescriptions. Help

bitchy, you might consider Forteo for the jawbone alone.
Prescribing norms for for Forteo are changing. In two years you may be able to extend use of the medication. I'm on my fourth year of Forteo and and will never need to take Reclast. Some are taking a short course of a milder bisphosphonate (like risidronate) and returning to Forteo.
Bless your choice. You sound happy with it.

@gently
Wha side effects have you exhibited on Forteo. ? Worried about brain fog too. Take blood pressure meds. I hear it can cause bp to drop. Headaches , vertigo, constipation. So scared. Want to try Fortibone too. As of Monday hope to be in gym 3x weekly

ipg, I haven't had any side effects with Forteo.
My blood pressure did and still does drop 20 (mm Hg) systolic immediately after the injection. It's less than 10 on the diastolic. It starts to rise almost immediately but takes several hours to reach my normal. I never feel it. I was careful for the first several weeks staying off ladders, staying close to the ground. Now I don't pay any attention. But you should, at least at first. You might get a little dizzy.
You can do three things that help. Take your injection when you are hydrated because upon injection pth draws calcium from kidneys, bones, and digestive tract into your vascular system. That expands your blood vessels. With so much space to flow the heart beats a little harder and faster to keep serum circulation. So you add volume with whatever liquid you take in. Caffeine and salt constrict the blood vessels. So you can lessen the expansion to lessen the effect. The endocrinologist I see says that this expansion is what cause the headache with pth drugs like Forteo and Tymlos.
The sudden calcium can causes nausea in some patients. Some have muscle pain, not sure why. Some few cannot tolerate Forteo, maybe an allergic reaction to excipients. Some develop hypercalcemia. Your calcium should be monitored, but only before or at least 4 hours after the injection.
I hope you have a good experience. It's been quite wonderful for me

Please advise-
I have risk of MRONj- what will u do after Tymlos?
Also, in researching, which drug- Tymlos or Forteo has less incident of hair loss???

@shocknot26 I’m in the middle of implants and need to go on meds. 3.5 spine back is good. This is helpful.

@gently
Why extended Forteo. After considering Forteo and dealing with the possible side effects what will I do to maintain any gain. Due to Tori in mouth may/ may not be at risk for MRONJ but don’t want to take a chance What to do?

@ipg
What do you mean about expansion of vessels. Do I take coffee ? Will I pass out? My bp is usually 110/60 and I am alone- scared

Added risk from Tori would only exist if you decided to have them
removed.The risk of MRONJ from bisphosphonates is not high and happens more
in individuals taking bisphosphonates to protect against cancer metastasis
to the bone. And in individuals who have taken the risk medications for a
long time.
I'm on extended Forteo because I like the way it works and because I don't
like the way other medications work. We lose bone because the cells that
breakdown bone have proliferated more than the cells that build bone. The
two mechanisms work together to keep our bones strong for the specific
activities we engage in and to replace bone that has weakened or fissured.
It is a constant process replacing all of our cortical bone over about ten
years, and all of our trabecular bone over two to three years.
Bisphosphonates stop the cells that break down bone from attaching to the
bone that needs to be replaced. In doing so they prevent cells that
remodel the bone from building it back up.
The pth medications, Forteo and Tymlos, increase the cells that build bone
and the cells that break down bone.
I'd rather have the newer, stronger, more vascular bone given the choice.
I watch my bone markers to ascertain that there is a balance between P1NP--
indicating growth, and CTX-- indicating breakdown.
I'm trusting those bone markers, and could be mistaken.
If the balance shifts, I might take a month or two of one of the weaker
bisphosphonates and return to Forteo.
Tymlos may be the stronger medication. I wouldn't object to a year of
Tymlos.
What to do can be difficult to decide. It was easy for me after a lot of
pubmed.
Some of us have too many side effects with Forteo or any of the medications.
Bless your choice.

@ipg,
I should have used dilate instead of expand. It is a minor dilation. It may be the way your blood pressure medications work. It happens you drink beet juice or alcohol. Calcium relaxes the blood vessels. Coffee, tea, caffeine, salt works oppositely to constrict our blood vessels.
I haven't heard of anyone passing out. But it can make some feel slightly dizzy for the first few hours after injection. I never feel it at all, but measured it excessively the first week.
You might take tea or coffee an olive or corn chip. My normal blood pressure is 90to 100/60.
I'm more comfortable with the injection in my thigh. You might try that because it slows the absorption of the medication without diminishing it. If you do feel a little unsteady, just sit for a while blood pressure starts to rise as quickly as it starts to drop.
It is reasonable, and unnecessary to be scared. You'll be surprised how easy it is. You might have someone nearby or on speakerphone with you when you inject the first time. I think you'll find it easy and uneventful. Some patients take the first injection from a nurse in the doctor's office.