I have read that strontium works too slowly for severe osteoporosis. And since it replaces calcium in bone, and is denser, it can throw off DEXA scans and make things look better than they are.

I had severe osteoporosis with fractures. I have been told and read (my doc and Keith McCormick's new book "Great Bones") that it is better to do a bone builder first. Tymlos, Forteo and Evenity are bone builders.

My doc follows up with a bisphosphonate like Reclast or Fosamax. He avoids Prolia because it is so hard to get off, without a plunge in bone density. Reclast does not have that problem.

I chose Tymlos because the dose is adjustable. I started low to let my body adjust. I also have varied the dose at times. I had great gains with 3/4 dose for 18 months.