I have been told by my MGH doctor that it is first necessary to "lock in" the gains from Tymlos with Reclast, but he said for me he would do 1/4 dose. After the first dose or maybe second, he said I could go off and they will monitor me. McCormick, who wrote the book on Whole Body approaches, did exactly that. DEXAs can be used but also blood tests to measure turnover/rate of bone loss can monitor things. I am avoiding Prolia because I don't think breaks are possible without another med.