Thanks @mayblin, @gently, @lbrown742 and everyone -- I am OP (the unfortunate 64 yr old Tymlos user who turned up with a giant kidney stone July 4 after completing 20 months of Tymlos, couldn't pass it, and had surgery to remove it and a few other tiny ones in one kidney on July 14).

I just had the follow-up with my endocrine doc yesterday (I have been dying for this appointment because I'm at the crossroads of osteoporosis, kidney stone adventures and an esophageal autoimmune disease called EoE that has kept me from eating much the last 6 months up till I went on a low dose PPI every other day recently).

He wants me to stay off Tymlos till we can see the results of my 24-hour urine calcium test to see if I'm spilling calcium out that way (which would explain why I formed a stone if I do have high urine calcium). I have several unopened boxes of Tymlos in my fridge that have 2+ years till their use-by dates and I'd like to start another bone-building era that includes their use in the future.

He gave me HRT 6 months ago at my request, apparently not realizing that I had asked for it for its bone-preserving qualities and not "menopausal symptoms." So he acted confused that I was trying to explore using HRT as my follow-up to lock in my Tymlos gains. He didn't seem to remember (or notice in my chart) that I'm quite reluctant to do an antiresorptive any time soon and I don't want to do Prolia till my 80's (because he said we should do Reclast or Prolia).

We started running out of time and I could tell he was worried about his next appointments (he had run 55 minutes late getting to me in the exam room, unfortunately). So I hurried and asked for a serum E2 to see how I'm absorbing my estrogen patch (and to see if my E2 numbers are up in the 70-100 range that allegedly indicates the possibility of bone growth rather than mere bone density retention). I don't think he agrees that he should consider calling my HRT my "lock-in" step even if my estrogen is nice and high from my .05 patches, but he was in a hurry and trying to be kind so he hurried and put the serum E2 order in and I'll seek to get increased to a .075 patch if my serum E2 levels are quite low and unlikely to be doing much for actual bone growth.

When he was leaving and had his hand on the doorknob, he did say he'd be open to my doing just one dose of Reclast for a quick lock-in since I indicated I really wanted to keep my bones receptive to future anabolic bone-building in the future. He didn't seem to agree, but rather to be willing to humor/honor my preferences, but (in my experience) if I can show up with some studies at our next appointment (and if he hasn't been running late) it's not unlikely that he'll take in and consider what I'm shooting for and why. Last of all, he hinted that he MIGHT be open to future anabolic use because he concluded by saying, "after all, while antiresorptives do MUTE the effectiveness of anabolics, they don't fully neutralize their use again in the future." POST NOTE: He doesn't use bone markers at all --likely because none of the insurance companies in our state pay for them.