Tinnitus With Alendronate

Me too. I had it before but it worsened after Tymlos. I stopped the medication because of severe leg cramps which have stopped now that I'm not taking Tymlos. I'm supposed to switch to Forteo but there is such a long list of risks and side effects that I can't bring myself to do it. I feel so much better off the Tymlos, although the tinnitus has not decreased at all.

@loh , like you, I experienced tinnitus while I was on Tymlos. I had been on alendronate for many years (with drug holidays) and never had any ringing in my ears during that time. Last year, while on a drug holiday from alendronate, my doctor prescribed Tymlos. During Tymlos treatment I developed gum infections, among many other side effects, and a periodontist prescribed antibiotics to treat the infections.

The tinnitus began suddenly: after the first day on antibiotics, I woke up around 3:00 a.m. to a very loud ringing in my ears. That intense ringing eventually stopped, but I’ve had persistent, lower‑level tinnitus ever since.

I honestly don’t know which of the three — alendronate, Tymlos, or the antibiotic — or what combination of them contributed to the tinnitus. I only know that the symptom began during that period when all three were part of my medical history.

@yds it’s hard to navigate all this. I am due back for my annual physical in a couple weeks and will likely get a Dex scan. I’m dreading the doctor telling me to go back on medication!

@loh, I see that you are anxious about being asked to go back on medication. In another Mayo Clinic chat, I wrote the following, in response to a question about what to do when faced with managing osteoporosis. This is based on my own journey, which I hope you find helpful:

"I agree that doing nothing is not an option. I’m not a doctor, but I’d like to share what I’ve learned from my own journey with severe osteoporosis as an older adult (I am 73 years old).

I’ve come to believe that whatever you decide to do should be grounded in science‑based and reliable information about all the options available to you. When I started my osteoporosis journey in 2004, I had no access to good information about the long‑term use of alendronate, and no doctor was really tracking my 12‑year use of this drug (with drug holidays, but still longer than I should have been on it).

In June 2025, my doctor started me on Tymlos. He insisted I stay on the full label dose of 80 mcg, despite my 90‑pound body weight and very small frame. I quickly developed severe heart palpitations, unbearable joint pain, tinnitus, mouth infections (which later led to a tooth resorption that now requires extraction), and significant hair loss. One day, I even lost my ability to walk. After four months, in October, he finally decided I should stop Tymlos—but he still refused to let me taper; I had to stop abruptly. I have since left that doctor and committed to educating myself.

Through my research and listening to experts who have devoted significant amounts of time learning about osteoporosis, I decided I would no longer take osteoporosis drugs, given my specific risk profile and history:
I can’t safely return to bisphosphonates because I used them longer than recommended;
I can’t take Evenity, Duavee, or Evista because they increase cardiovascular risk, and heart disease runs deep in my family;
I refuse to go back to Tymlos or Forteo after my experience;
I can’t take HRT because I’m a breast cancer survivor; and
I can’t take Prolia because there is no clear, safe follow‑on drug after stopping it.

I also learned about REMS scanning and had one done. Despite my very low T‑scores (similar to yours), the REMS showed that my actual 5-year fracture risk for hips (3%) and spine (5-10%) is low, especially for my age. That was a turning point for me.

From there, I changed my diet and filled the gaps with supplements. I discovered ONERO, a science‑based osteoporosis exercise program, and enrolled in a once‑a‑week class. Less than three months after starting ONERO, I can now deadlift a 50‑pound barbell, back squat with a 35‑pound barbell, and row pulling 40 pounds (I can't do overhead lifting with greater than 20 pounds because I tore the rotator cuff on both shoulders). For someone with severe osteoporosis, that has been incredibly empowering.

I also learned about bone turnover markers and found an endocrinologist willing to support me by ordering the necessary blood tests. My CTX is 241 and my P1NP is 35.4, which together suggest a good balance between bone formation and bone resorption for me.

In short: I truly believe you should do something—but that “something” should be based on educating yourself as thoroughly as you can, so you can ask the right questions and make the best‑informed choices for your own body, history, and risks. You deserve a plan that is tailored to you, not just to the average patient."