Tymlos at 70+ - Pros & Cons with severe osteoporosis

@dj7
Tymlos does not have that potential side effect. It is not a biophosphonate and does not work by slowing down the shedding. It is one of very few medications-anabolic- that actually stimulates new bone growth. I have been on it for almost 2 years with no side effects and a 10% increase in bmd in my hips. Tymlos is a new medication and I believe one of the best available. The injections are not painful. Ask for the ultrafine needles-you will barely feel them-and at least give it a try.

I'm 84,and have start some type of osteoporosis meds. Im considering Evenity however the side effects scare me. 1 year of 2 injections a month and,aftercthat 3 years of
Fosomax. Is it worth the worry.
My T score is -2.5

I am 70 and started Tymos 4 months ago. Shots are easy (and I’m a big baby!), but the side effects were bad for the first 3 months (back pain, diarrhea, racing heart and pulse) but they’re all gone now. I will persevere but wish I’d known you didn’t have to start with the full dose right away! Doctors done seem to know enough. My friend had no side effects and great bone growth. Hoping my bones will also build 🤞. Good luck!

I have been on Tymlos for 18 months. Side effects are minimal and manageable. Recent bone scan showed 18% increase in strength in my lumbar back. In my opinion the daily injections and mild side effects are worth it.

@carolynfoster, I'm glad to hear that you are offered treatment that builds bone.
In your situation I would take something to lessen the risk of a fracture, because fractures can ruin your many remaining years.
No one can know if you will fracture, but comparing your earlier dexas and looking at your fracture risk would give you a better idea.
I would suggest looking at Forteo rather than Evenity because the side effect profile is better, and because it leaves your system rapidly so you aren't trapped with many months of side effects, if it doesn't agree with you.
Evenity adds bone more rapidly than Forteo, It's the darling of the osteoporosis prescribers now because it is the latest. The cardiac warning is off putting since most of us will die of heart disease.
Mainly, I recommend Forteo from the bias of taking it and not having a single side effect with it.
In my opinion Forteo (and Tymlos) build the best bone by removing fissured or otherwise damaged bone before laying down new bone.
If you look at all the medications and decide which would be the best for you, you might still decide to risk fracturing.
The trouble with compression fractures, the most usual osteopenic fracture, is that they never heal back to their original shape. Most with spinal fractures don't return to their former quality of life. Some spend the rest of their lives looking for relief from pain.
Bless your choice with luck.

@roseincalifornia
Thanks so much for your support and words of comfort!
Much appreciated.

I truly appreciate your feedback. I would go with Tymlos over Forteo only because Tymlos doesn't have to be refrigerated after it's been used once (meaning each pen). This would make it easier for traveling.
I have yet to start the injections and I'm required to do all kinds of labs first, and the 24 hr urine calcium test. Is that common?
Anyway, I will hold my breath and push through the treatment as so many strong women are doing!

@bozley Those tests aren't unusual if your doctor knows what he/she is doing.

Probably the only people who don't think that Tymlos is a better drug than Forteo are me and anyone allergic to the preservative (phenol) that makes Tymlos easier to travel with. Tymlos is said to be less likely to cause hypercalcemia. And it builds a little more bone in the hips.
The 24hr urine is cautionary as is the serum pth. Are they ordering bone markers P1NP and CTX.
I'm glad you are determined to power through and hope it proves uneventful.
If you do encounter problems there's always Forteo.
Best wishes

Hi, I'm 79 and have been on Tymlos since November 2025 in preparation for a spinal fusion. The neurosurgeon ordered a bone density test prior to surgery. That's when I learned that I have severe osteoporosis. The surgery was postponed for 3 months and I was immediately placed on Tymlos. The monthly price of $3K for Tymlos is outrageous. I retired 1-1/2 yrs ago and now completely understand the term "limited income". Who can afford $3K/month? I'm fortunate to have insurance options and during the customary open season (Nov-Dec), I reviewed a number of insurance plans and found one that, combined with Medicare, helps cover the expense. All this being said, I find Tymlos to be easy to use once you overcome the idea of a daily injection. Injection is the easy part, Tymlos causes temporary issues: racing heart, nausea. For these reasons, I take it before going to bed and found this to be the easiest way to work through these issues. Although, I did lower the dosage on advice of endocrinology NP because the racing heart and nausea were far worse with the originally prescribed higher dose. I have been experiencing abdominal pain and some hair shedding. Family doc had me tested for diverticulitis because of abdominal pain. Thankfully, this test turned out negative. I have since done some additional reading on Tymlos and found that abdomen and hair issues can be side effects and should be discussed with doctor. I have a scheduled meeting with neurosurgeon next week and will be discussing these problems wih him. While Tymlos is the best option for severe osteoporosis, IT IS a powerful medication and with it comes limitations on long-term use that cannot be taken lightly. I'll end this message with an amusing story: When first learning of the daily injections requirement, I didn't think I could do it and didn't want to do it. So, the nurse asked me, "At this stage of life, you've probably done a lot of hard things" to which I answered, "yes". "Well then", she said, "this is just one more". I laughed, and still laugh, about that interaction--because she was right! You can do it, too 🙂