Tymlos blood pressure side effects etc. very nervous! Help…

osteopatient2026,
from what little I pretend to know, your response to Tymlos is stunning. Your body is building bone like a skilled mason. Your ratio is 1.4 CTX pg/mL to P1NP ng/ml. I'm content with a ratio of 3 or 4. Specific ratios are considered experimental by some, though we know that the best bone is made by units of CTX and P1NP. Lets ask Mablin.

@countryliving, good choice between two excellent choices. I like bone markers CTX and P1NP to determine spine improvement. Partly because it takes longer for the pth drugs to manifest with bone mineral. But also because, for the very few, the medications aren't effective. And who wants to spend two years on a drug, (hopefully, not) tolerating side effects if the medication isn't effective for them.
You might be procure the new biometric CT, covered by Medicare starting in October in lieu of dexa. https://ondiagnostics.com/about-on-diagnostics/about-on-diagnostics/
Otherwise they will compare the bone mineral content with your last dexa in the areas last measured including L3 and L4. You might find this video interesting https://www.youtube.com/watch.

osteopatient2026,
from what little I pretend to know, your response to Tymlos is stunning. Your body is building bone like a skilled mason. Your ratio is 1.4 CTX pg/mL to P1NP ng/ml. I'm content with a ratio of 3 or 4. Specific ratios are considered experimental by some, though we know that the best bone is made by units of CTX and P1NP. Lets ask Mablin.

@gently
Really? Is that ratio good? So the lower the ratio the better?
You were a great comfort when I started. I love your measured but positive vibes. Thank you.

@osteopatient2026, If the ratio is too low you are likely adding bone that isn't remodeled. Modeled bone doesn't remove the older fissured bone but lays down new bone on top of the older bone.
Some of the modeled bone with the pth drugs is new bone where there was no bone. The drugs can recreated the cartilaginous structure needed to capture calcium to make bone repairing lost trabecular bone.
I haven't read but suspect that some maybe Lucas or McCormick might say that the ratio shouldn't be close. I want my bone markers close and high.
Part of that mindset comes from the time when the only medicine we had to prevent bone loss slowed down bone turnover.
The endocrinologist I see uses bone markers, but doesn't think they can be deciphered in any ratio.
If you haven't you might want to look at what Lucas does with the markers.

@memuno1stborn Thank you for all that information. It sounds like you have found some wonderful doctors over the years. I'm sorry you have to find another one, they are hard to come by.
I am 18 years postmenopausal, and the literature says not to begin HRT past 10 years postmenopausal. If you started within this first 10 years, common practice says it's ok to keep going. It's the start date that is preventing me from starting it so late. I will look into BHRT and see what my doctor thinks about that. I wish I had started when I was 49, because that was already early for menopause, and it's a long time now without the hormones, and having osteoporosis. Thanks, and good luck.