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Tymlos results after 2 years
I just did my dexa following 2 years of Tymlos. I don’t have the official report yet but I glanced at it and saw that the T-scores didn’t really move so when I saw this I was extremely disappointed! but then I walked into my doctors office and she said I gained 5% bone density in my spine . She said she looks at another measurement to determine this.
She said 5% increase in spine is actually a decent result from Tymlos . Curious what anybody with expertise here thinks about the 5% spine improvement? Also why wouldn’t my T score improve if I had a 5% change? Confusing.
Note: The hip didn’t really budge/improve at all from Tymlos but my hip density isn’t that bad to begin with.
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The 5% measurement might be for the actual bone density reading. A T-score doesn't measure bone density; it just compares you to other people. Also, your DEXA shows bone density for the L1-L4 vertebrae. The T-score is an average of those four, but maybe one of them improved?
Had you been on another medication prior to taking Tymlos? It isn't as effective if you were previously on a biphosphonate.
I was never on a bisphosphonate prior to Tymlos . Only did HRT prior to Tymlos
The percentage change on a DXA report is calculated from the raw BMD (bone mineral density in g/cm^2) measurements, as njx58 pointed out.
When you receive the full report, you can check whether the 5% increase was derived from the 2026 vs 2025 BMD values or the 2026 vs 2024 BMD values. Typically, the average BMD of the lumbar spine (L1-L4, minus any exclusions) is used, but you'll only know for certain once you see the complete report.
A 5% increase in BMD usually raises the T-score by about 0.2 -0.3 based on baseline BMD - a lower baseline BMD produces a smaller absolute T-score change for the same 5%. Completely flat Tscores would be a bit unusual.
A change is considered real (statistically significant) when the difference in BMD between the 2 scans exceed that machine's least significant change (LSC) for that site. For example, if the spine LSC is 0.022 g/cm^2, and the spine BMD rose by more than 0.022, the gain is real rather than machine noise. LSC is usually included in a full DXA report
Have you had your bone turnover makers (P1NP and CTX) checked while on Tymlos?
In general, after a certain age bone density declines. So even a plateau can be an improvement.
You are very knowledgeable. Thanks .
I had never had bone marker tests but today I asked for that and will be tested before the end of the month. Meanwhile the doctor says I must start a drug - she suggests fosomax.
I asked about Actonel - she said let’s try fosomax first since it’s a bit more effective and if I have any gerd she will switch me to Actonel
@2024tymloshelp , consider getting on a Boniva type product with a bone builder, bone saver combo. A bone saver like Fosamax would be your last drug and you can't really reverse the order. Here's the video: