Began Tymlos 4 wks ago; flying solo till I see Endo in 3wks... advice?

I started Tymlos a month ago as well and I have done both thighs and stomach. I didn’t know stomach was better, my doctor said with was fine and the box shows both?

@loh for insulin stomach is better. That influenced me but it doesn't mean it is true for Tymlos!

@annie208 none of us just stop anabolics, at least in my experience with MD's and other resources. I have been told to "lock in" gains with a bisphosphonate and after a year or more, drug holidays are possible with monitoring . At the point we might be able to rely on holistic approaches for awhile at least.

I was told that regardless of the fact that my first fractures were from a very traumatic fall, my risk of further fractures was high due to those initial ones. Even regardless of DEXA scores and other tests. The spine is less stable after even one fracture. That is what my MD told me.

Hi windy, thanks for bring this up. I think we are looking at the same link. I'd like to post the link here just in case anyone is interested in reading it. Many thanks to the original poster @gently :
https://journals.lww.com/menopausejournal/fulltext/2024/05000/use_of_menopausal_hormone_therapy_beyond_age_65.3.aspx
The authors provided extensive information in several tables as well as a statement of conclusiom. I actually brought a printout with me to discuss with my obgyn. Regarding breast cancer incidence tabulation, the % increase risk looked scary. However we need to know they are relative risk increase. The absolute increase in risk is roughly 0.1%. Interesting to note that mortality rate did not increase at all, probably due to early detection and treatablity. With the use of estradiol (bioidentical) with or without progesterone (bioidentical), topical route and appropriate dosing, the real risk increase is yet to be revealed with future well designed clinical studies. As for now, doctors tend to recommend against using hrt for those who have/had breast cancer, or a family history of breast cancer in general.

Well (OP here) my self-requested bone turnover marker results came back and one more snafu reared its head... For whatever reason, CTX labs were not run at all -- only P1NP came back and it was 96 ng/ml (with the reference range listed as 10.4-97.8). I had fasted and gone in early in the morning, but I guess I failed to clarify with the phlebotomist that I was there for CTX, too (darnit).

My appointment with new endo (my first endo ever :-)) was moved up to this coming Wednesday, so I guess I'll just let him order CTX if he is one who uses it.

I don't know what to make of P1NP being 96 after 4 weeks of Tymlos... I wish I had a true pre-medication baseline, but hopefully this will still be useful to him.

In response to posting by annie208 @annie208, Dec 3, 2024:
I really appreciated your extensive description. I start Tymlos next week (March 31, 2025) and my doctor said that I am to gradually increase the dose and after 18 months he wants to put me on Reclast. Reclast terrifies me and I am wondering what your decision is regarding your follow-up drug will be?

Hope your Tymlos start goes smoothly next week! I got to the stage of taking the full dose very quickly (I believe from Day 15 on has been full dose and I just started my 5th pen --I personally am too thrifty and risk tolerant to throw away medicine so I choose to refrigerate my pens and I get 38-39 days out of each of them, but I am not a medical professional so that's just me explaining why I'm only on my 5th pen!).

I have been busy getting major dental things taken care of in anticipation of finishing up with Tymlos in 18 months. My PCP and Endo both plan for me to inject it for 24 months (at which time I will have accumulated 8 extra pens, by the way), so you and I will be finishing about the same time.

I don't have any side effects and I inject it about 2 pm each day (weird time, but it works for me). As mentioned, my push is to get my dental work thoroughly caught up during this era and THEN to research what comes next. I am not terrified of Reclast, but I am humbled by the fact that it stays in one's system for a decade or so, so I will be deep-diving research in about a year and will definitely be forming opinions about what drug and protocol should be next for me.

There are some VERY savvy vets on here who are amazingly generous with their info, so definitely put your questions out to the greater board. Good luck again and let's stay in touch!

Thanks so much. I would be so grateful if we could stay in touch and I could learn what your follow up drug decision is. I had read that the preservative in the pen does not last more than 30 days, but that might just be the company's strategy to sell more product. Are you on auto refill or do you re-order each month?

In reply to @annie208
I meant to also ask you if you are increasing Vitamin D and decreasing Calcium supplements because of the reported impact of Tymlos on those elements in our bodies.

Most people need extra vitamin D, especially outside of summertime. It doesn't hurt to supplement it. Mine was low last year, 27, but then I started taking 3000 UI a day, and now it's up to 50. I'll probably taper off to 2000 IU and see how that goes.

I would stick to your daily calcium goal. Let the doctor's blood tests determine if your calcium level is concerning. Mine went from 9.3 to 10.0, but then I decided to get calcium from food instead of pills. I have a bowl of cereal and a glass of milk every day, and there are some miscellaneous sources. On my last blood test, my calcium was back down to 9.6. That's after a year on Tymlos.

I'm on Medicare, and I've reached the $2000 drug limit, so all my Tymlos pens will be free the rest of the year. I personally would not use a pen much beyond 30 days. If it hasn't been tested, then why test it on yourself? How do you know how effective the drug is? You can't just guess.