I had severe osteoporosis and did an AI anyway. Most people do Reclast with it but my endo didn't want to prescribe due to another health issue. I would have done fine over 5 years except for an unwise movement that caused a fracture two years after my AI was finished. COVID interfered with my going on Tymlos before the fractures. I have now finished two years of Tymlos and my bones are better than before cancer!