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Tymlos results from DEXA scan after 12 months
I finally got my DEXA scan results, and am so relieved. As some of you know I had an earlier post where I was very worried when my REM scans showed consistently decreasing bmd at the 6 month and 12 month marks.
Region Exam Age BMD T-score BMD Change BMD Change
Date g/cm2 vs Baseline vs Previous
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AP Spine (L1-L4)
07/08/2026 61 0.786 -2.4 0.074 (10.4%)* 0.074 (10.4%)*
04/04/2025 60 0.711 -3.1
Total Hip(Left)
07/08/2026 61 0.719 -1.8 0.016 (2.3%) 0.016 (2.3%)
04/04/2025 60 0.703 -2.0
Femoral Neck(Left)
07/08/2026 61 0.592 -2.3 -0.022 (-3.5%) -0.022 (-3.5%)
04/04/2025 60 0.613 -2.1
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My bmd at the Femoral Neck did decline (3.5%) but that effect has been observed in studies. According to Gemini:
"Why the femoral neck dropped: This is a very common, temporary phenomenon during anabolic therapy (Tymlos/Forteo). Because the femoral neck is made of dense cortical bone, the high-turnover drug temporarily increases "bone remodeling space" (microscopic porosity), making it look slightly less dense on a DEXA scan. As you finish Tymlos and transition to Reclast, this newly remodeled bone will heavily mineralize, and your femoral neck score should catch up and rebound."
Another takeaway is that the REM scans do not accurately assess BMD while the bones are actively remodeling.
Thanks so much for everyone's support here. I hope this info helps. And for those of you who are struggling, please don't give up. There are different avenues for treatment.
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I am using REM scans to determine my bone health while on Tymlos injections, now completing month 10. My latests REM scan a few days ago showed continued bone loss in the lumbar spine. There is not a great deal known about REM here in the U.S. May I ask where you learned that bone density cannot be accurately measured while bone is actively remodeling? Are there any other little known facts about REM that might be of interest? American doctors seem to be mostly out of the loop on this technology and DEXA cannot measure my badly damaged spine or my bi-lateral hip replacements. Thank you.
At the bottom of this post is the info from Gemini on the REM Scans. I don't think REM scans are accurate. My
endocrinologist told me she has never seen anyone not improve while on Tymlos so I was very upset when
I got my REM scan results showing a decrease! Fortunately a few weeks later I got my DEXA results which showed the increase. Did your doctor have your P1NP marker tested? If your P1NP marker is elevated that means
Tymlos is active in your system and your bone density is increasing. Please don't just stop taking Tymlos. There
is a very good chance it is working in your system, especially of your P1NP marker is elevated. I know this is a really emotional rollercoaster. Best wishes to you.
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A notable study addressing the limitations and output variance of REMS (Radiofrequency Echographic Multi-Spectrometry) technology is:
Study: Chan et al.
Published in: Osteoporosis International (March 2026)
Key Finding: The study evaluated the algorithms behind REMS output and found that over 90% of the variance in REMS bone mineral density (BMD) results was explained by demographic inputs—specifically the patient's age and weight alone—rather than direct ultrasound measurements of unique skeletal differences.
In clinical practice, Dual-Energy X-ray Absorptiometry (DXA) remains the established gold standard for diagnosing osteoporosis and tracking treatment response over time because it directly images bone density and structural changes.