@blblbl27 Research shows it is better to start with a bone builder like Tymlos, Forteo or Evenity. If you take alendronate first, it may affect the effectiveness of these bone builders in the future, according to my doc. You can watch Dr. Ben Leader's video online about Sequencing and Combinations, or get Keith McCormick's book "Great Bones" at your library or online.

It depends on your scores and fracture risk of course.

I chose Tymlos because I could start at a low dose and move up. The injection pen has "clicks" to measure dose and 8 clicks is full dose. I started with two and got up to 6 or 7 for most of the time I was on it. I have done a few full doses. I had a 20% gain in my spine and went from severe to borderline osteoporosis there.

This may be a good route for anyone who is scared. You can follow up in 18-24 months with alendronate and at some point maybe take a break, my doc says.