Tymlos/Forteo next steps

Posted by njx58 @njx58, Oct 6 2:16pm

@windyshores You are very knowledgeable on the topic, and I'm basically catching up. Let's say someone is taking Tymlos or Forteo for the first time, and no previous meds. What is the current set of options for what comes next? Between Prolia and Reclast and Evenity, it's getting confusing. I want to be able to discuss this intelligently with my doctor next year.

Interested in more discussions like this? Go to the Osteoporosis & Bone Health Support Group.

windyshores | @windyshores | Oct 6 7:02pm

@njx58 my doctor only uses Reclast-or Fosamax- after Tymlos and Forteo.

I convinced him to let me do Evenity but I was the only patient in either of my enodcrinology offices to be doing that. On this forum, more seem to be doing that. My doctor said there was not enough data yet but I have heard a lot of anecdotal evidence (doctors cannot go by that!)

As for Prolia, my doctors don't use it unless absolutely necessary due to rebound. McCormick, the author of "Great Bones" and some on this forum, are now doing Prolia after Forteo or Tymlos but stopping after 1-3 shots so that Reclast (or Fosamax) can safely handle the rebound.

To make things even more complicated, some on here are discussing Evenity after Prolia and there was one study showing that its effectiveness was reduced but it did stop rebound. That was just one study.

Finally, Dr. Ben Leder, in his YouTube video "Combining and Sequential Approaches to Osteoporosis" has an interesting section on starting Prolia while still on Forteo or Tymlos and doing it for some months afterward. That video is very informative and clear I think.

Sorry- no straightforward easy answer and there is still a lot that doctors don't know. Plus, Evenity came out in 2019 and is pretty new so protocols are still being developed.