Windyshores, thank you for your comments on the difference between Tymlos, Forteo and Evenity . All three medications boost bone formation and is the reason why I place them in one group. I believe it is good to have information around how these medications use different pathways to achieve results.

Overtime our bones require a balance between forming new bone and the breaking down and removing of old bone (resorption). Sclerostin, which increases with age, leads to bone loss and reduced bone strength and inhibits bone formation. Evenity blocks sclerostin. When this happens new bone is built more than the loss of bone. In addition Evenity reduces bone resorption thus increasing the bone mineral density (BMD). Evenity has a very different pathway for increasing bone density than Forteo and Tymlos.

Forteo and Tymlos use a Parathyroid Hormone (PTH) to activate bone-creating cells called osteoblasts which create new bone cells. Forteo and Tymlos do not slow the resorption of older bone.

Bisphosphonates (Fosamax, Boniva, Reclast) effect the bone resorption cells called osteoclasts. These cells absorb the bisphosphonate medication. The rate at which bone cells are broken down is slowed thus slowing bone loss.

I hope this give more clarity as to how these medications work inside the body. Thanks again for your comments. Every idea sends me on a deeper dive into how this all works. I find it reassuring to have more knowledge than less.