@sallyj2 I had a 9% gain in hip and 20% gain in spine. Many side effects go away after a few weeks. I minimized mine by ramping up slowly and doing whatever dose I could tolerate, which ended up being 7 out of 8 clicks for much of the time. If I had something important to do on a given day I did less. Exercise was not only possible, but, for me, it helped with side effects. I felt worse if I stayed in bed. I did it in the morning and for me, side effects were better that way.

@cat714 Evenity was very new when I started Tymlos two and a half years ago. I did a masterclass with Dr. Lani Simpson who mentioned the sequence issue. The only think I have read is that Evenity "turbocharges" growth so there is less left for Tymlos to do. I also wonder if the anti-resorptive effects of Evenity reduce the effectiveness of Tymlos (similarly to bisphosphonates and Prolia). You can try Tymlos after Evenity and do blood tests- CTX and P1NP- and let us know if it is working for you!!