Dental work while taking Tymlos?

@gently
You seem very knowledgeable about everything. I believe I am limited to my choices. Would I switch between Tymlos and Forteo if need be, possibly if I had limited side effects. Other than that , I feel that I am buying time till new meds come out, as all that would be left is Evista. I guess I’m confused about two issues- Whereas some drugs give you a 5 year span and then a drug holiday, I believe with Forteo and Tymlos , it may be we will be on it forever? And the issue with the mice, I wonder if we are on it forever, would there be a build up to where the mice developed cancer although studies never were involved at it leaves your system quicker? Can you explain again to the best of your ability. Thank you very much

ipg,
I see luck in being trapped between the two very best osteoporosis medications.
Rats given the equivalent of the 20mcg dose in Forteo were treated for 70% of their lifetime without developing bone tumors. https://journals.sagepub.com/doi/pdf/10.1080/01926230490462138
Evista slows down bone resorption. It is said to be equal to alendronate, except that it doesn't seem to protect the hips.
There is a lot of hope for new medications, and it is reasonable to think about buying time. as long as you don't risk fracture meanwhile. It's good that you are examining and questioning everything.
Forteo gives your bloodstream an intense jolt of part of the parathyroid hormone. The half life is about 1 hour but it is gone from your bloodstream within about 4 hours. So these poor rats were inbred to lead to an identical line of rats and they upset trials for 50 years (not just in osteoporosis trials, because they lack the genetic diversity to prevent spontaneous tumors. The tumors didn't happen in response to exposure to teriparatide.
I think bisphosphonates are the only osteoporosis drugs that give you a holiday. With Evenity, Forteo, Tymlos you lose the increase in BMD usually in close to a year. With Prolia you lose more than the increase and most people fracture within the first year.
The trouble with Forteo and Tymlos is that they can stop being effective at around 18 month.
If anything make you wonder, I hope you ask. I'm enjoying our exchange.

@ipg, I don't think that has been Evista has been trialed for more than a year after either Forteo or Tymlos. Buying time so we don't have to graduate to the other medications sounds good to me. The deep funding cut for grants and and the NIH research lengthens the time we need to buy, but there's hope.

@gently
First, I commend you from your extensive research. Do you have a medical background? I guess my concerns are based on longevity, MRONJ and side effects. That’s everyone’s concerns. Do you anticipate being on medication for the rest of your life? My friend is considering Reclast- 3 yearly and done. The dental concerns I know will interfere with the Drs. I am now do for a dexi. 2 years ago it was -2.9. I am choosing to wait a little longer just so I can check on my other medical conditions and make sure I have nothing else that I must treat first. Early 2027. Someone wrote in she didn’t want 1 dexi to determine medical treatment. My dr says “just don’t fall”. I’m as careful as I can be . I was in aqua pt yesterday followed by an exercise class. On my weigh to a trainer. Do you use any of the Fortibone products? You have been very helpful. I’ll be 70. Your age??

@ipg I am (a bit nervously) awaiting my first shipment of Tymlos. It is scheduled to arrive tomorrow. I will do the Tymlos (fingers crossed no unbearable side effects) and see how that helps, and then my endocrinologist shared the plan of something “other than Prolia so as to give the patient a drug holiday in the future.” I like that idea of not being on these meds forever, if that’s ever going to be possible. Right now, I decided on the drug treatment mostly because I am so young. But I debated because I am so young not to as well. It was a tough decision. In addition, once my ortho surgeon tells me my L1 fracture is healed enough (hopefully early July’s appointment) I plan to start pt with a Bone Certified PT (I am lucky enough to have one in my area) to learn all the tricks and tidbits that I can to assimilate into a new normal lifestyle to get many many more years of good health. I just was lucky enough to retire three years ago and I have SO MUCH I want to do! What might I be missing? LOL. I appreciate the discussions here.

@renich I've read that it actually has a decreased risk of osteonecrosis too.

@shocknot26
Good Luck to you. Why Tymlos over Forteo. My concern is that bc of the risk of MRONJ I think
I’ll either buy time or maybe choose Evista although not thrilled either. BTW, remind me, you fractured 2x from heavy lifting? May I ask your age.? I’ll be 70 in September

@ipg My endo allowed me to choose between Evinity, Tymlos, or Forteo. After researching, I chose Tymlos for reasons personal to my health and situation. RE—I travel a lot and having to keep refrigerated was an issue (Forteo), having to be close to office to go for injections (Evenity) vs injecting myself. It was more of these “selfish lifestyle” reasons as to why I chose Tymlos; simply felt it was the better fit for me. We’ll see once I start. 😬🤨🧐

No—I fractured only once L1 while carrying a cast iron griddle up some steps and fell HARD straight down on my butt. (STUPID, I KNOW—BUT I used to do these things with my eyes closed—daughter nicknamed me “Hercules” early on) and I am only 57 and have always been very physically active.

I find myself wondering if I hadn’t fallen would I even be considering meds? My DXA (I’ve had 3 since 2021) scores have been declining but are still in penia range. My mother had full blown osteoporosis and has lost 4 inches in height. Thoughts?

Thanks. I’m 69. Have only had 1?dexi showing osteoporosis. If you have osteopenis , they still want you to go on meds? Yes, refrigerating Forteo could be annoying. Good luck to you. I don’t think I had a fracture. I’ve knee had severe pain just due to stenosis, herniated disks and scol. I guess that’s enough! Were you in slot of pain and have you fully recovered?

@ipg yeah they said as soon as you fracture anything, your diagnosis automatically is treated as osteoporosis, no matter what the DXAsays. I hope you never fracture! Yes LOTS of pain—worst ever pain. Worse than childbirth. lol. One of (if not the worst parts) is how LONG it takes to heal. I am still healing (9 weeks since fracture) and I will know my progress in early July at a follow up X-ray with ortho surgeon. Thanks for the well wishes. You take lots of good care of yourself too!!!