Insurance has denied Evenity

Watch Dr. Ben Leder's video on YouTube on Combinations and Sequencing. it is excellent. Forteo then Prolia added with the two together (I forget the actual details) was extremely effective but then the problem of getting off....

@windyshores I had no idea that Forteo affects cortical bone density negatively, that's helpful to know.

@rola please check that out with your doctor. I am gettijng different info from different providers, including McCormick. I watched Dr. Ben Leder's vido on Combinations and Sequencing and he mentioned cortical porosity with Forteo so I was concerned the same was true of Tymlos. My endo told me last night that this was a concern with Forteo, not Tymlos, but I hope you can make sure this is true.

Thank you @windyshores, I will keep this in mind and play it safe when choosing. Always appreciate you sharing with us what you've learned, so very helpful. Ty again.

If there is a “big gap”, meaning, say, 10 yrs, between taking bisphosphonates and Evenity (ex. last zoledronic acid infusion in 2020, plan to take Evenity in 2030) if the bisphosphonates still reduce the effectiveness of the Evenity, or will enough time have passed so the bisphosphonates are “out of your system”?

From pdr.net.

"Pharmacokinetics
Alendronate is administered orally. Transient distribution into soft tissue is rapidly followed by redistribution to bone or urinary excretion. Alendronate is approximately 78% bound to protein in human plasma. There is no evidence that any metabolism takes place. Once alendronate is bound to bone, the half-life is more than 10 years. Inhibition of bone resorption diminishes after completion of treatment, suggesting that not all the alendronate sequestered in bone is biologically active.
Bone resorption in individual remodeling units normally continues for approximately 2 weeks. Due to the long half-life of alendronate in the bone, weekly administration of alendronate should inhibit bone resorption and provide benefits on bone mass and strength to a similar extent as daily administration.

Oral Route
Absorption of alendronate is poor, with oral bioavailability of less than 1%. Cations (e.g., calcium, magnesium) reduce bioavailability. If alendronate is taken within 2 hours of breakfast its bioavailability becomes almost negligible. Even orange juice or coffee can reduce bioavailability by about 60%. To achieve maximum possible bioavailability, alendronate must be taken in the fasting state and at least 2 hours before a standard breakfast. Estimations suggest that the amount of alendronate released from the skeleton daily, after 10 years of daily dosing with 10 mg of alendronate, is 25% of that absorbed from the GI tract.

Intravenous Route
Elimination of alendronate from plasma is rapid, falling 95% within 6 hours of an IV dose. Approximately 50% of a single IV dose is excreted in the urine within 72 hours. "

Depending on what your doc says and bone markers tell you, Evenity will still be helpful after bisphosphonates. I read that effectiveness is 60% for spine- sorry can't cite.

Given that bisphophonates should NEVER have been prescribed for me—I don’t have elevated bone turnover but my endocrinologist never bothered to check before pushing bisphophonates—and that I saw little to no improvement in my bones after taking bisphophonates, I really hope that my “doctor” didn’t blow my getting the maximum benefit from Evenity, if/when I have to take it.