I just learned that forteo no longer carries a black box warning since it has not been determined that there is an increased risk of osteosarcoma associated with its use which was a previous concern. They have also removed the 2 year lifetime max of usage which is also reassuring. Tymlos is a newer drug and it works similarly. Tymlos does not need to be refrigerated which may be of benefit for those that travel a lot. Might be worth exploring both of these options to see if one might suit you better than the other (or another med that you feel more comfortable with). Wishing you the best of luck in this difficult decision and I hope that whichever way you go, you feel reassured and achieve the results you are looking for.