Six months ago, I chose Tymlos (endo recommended any of Tymlos, Forteo, or Evenity) because the Tymlos pen allows you to deliver less than the standard dose (titrate) if the side effects are too hard to bear.

I spent the first month on Tymlos powering through side effects at full dose (8 clicks) then took off a week in despair. I spent the 2nd month working my way back up to a full dose (+1 click every few days) and am carrying on with it (side effects are present but milder and bearable with a bedtime shot). DEXA won't happen for 2 years, but here are my P1NP/CTX values (endo requested and Medicare paid for). Looks like it's working so far (cross fingers)...

Date : CTX/P1NP Ratio
06/05/26 : 1295/198 153 (3 months on Tymlos)
03/01/26 : 1117/211 189 (1 month on Tymlos)
01/01/26 : 985/107 109 (before Tymlos)