First, as you have read, Evenity, Forteo and Tymlos apparently work best if used first.

I have been told that Reclast at a lower dose can be used to "lock in" gains from Tymlos but then I can take breaks as long as I am monitored. This would mean less chance of ONJ or atypical fractures. (Also the anabolics provide better bone quality, not just density, so the foundation is stronger.)

My doc may also save the second year of Tymlos OR a year of Evenity for use later if my bone loss worsens.

I agree that if one starts at, say 60, and does two years of, say Tymlos, followed by, say, Reclast (I would not do Prolia because it cannot be stopped w/out another drug) that by the time one is 67-72 or so it would seem you have run out of safe options. Meaning two years Tymlos plus 5-10 years Reclast.

I am hoping to follow McCormick's lead in doing meds (Tymlos, partial dose Reclast) and then try natural methods to maintain. When I was on cancer meds a natural approach was not wise. I have no idea if that is possible and I will do whatever is needed to avoid fractures since I have 7 in my spine.

ps We can apparently do Evenity after Tymlos or Forteo. Also the time limit of 2 years has been lifted for Forteo and it is probably it will be lifted for Tymlos as well since patients are not developing bone cancers.