which bisphosphonate after Tymlos with the least side effects?

@nelluna17 I also wanted to add that I understand your fears. I was one of the few that suffered on my first dose of the Reclast. The infusion department did not prepare me by telling me to drink fluids and take Tylenol before the infusion. They also could’ve slowed the infusion down which they’re going to do next time. I have it. I was also three weeks out of a DOUBLE cervical spine surgery, where my bones fell apart in the surgery! The risks of me NOT being on bone improving medicines far outweigh the price of the side effects. I have endured. The side effects are very short-lived and can be eliminated with Dr. team supported interventions. I am two years into what will be a five year TOTAL inconvenience. At this stage, I have zero side effects and I feel terrific. I can rest easy knowing now with trending tests that I’m building bone density and losing less bone. I loved that I stayed with it and I got over the hump. I loved it that the medicines Which were selected for me (TYMLOS and RECLAST) where medicines that I could have dental work on because indeed I had to have dental work! It seems that resistance exercise, smart eating habits (eating nutritional foods), transdermal HRT and the bone medicine is the best combination to utilize if one finds they are aging and their bones aren’t staying strong. It is also important to know that DEXA scans can be misleading as they create averages and the bones can vary when they open you up During surgery. The doctors can find a very different situation despite what 25 years of DEXA have indicated, as they did in my case. I am 68. I just saw my orthopedic surgeon last week and we discussed what my options might be in another 10 years.My surgeon feels that in another 10 years. I won’t have many of the options that are available to me now because aging and the way you age has a bearing on what The surgeons can remedy at a later stage as well as the success rate.
Knowing everything I know, I am proud of myself for doing this now because in 10 years I can’t build back the bone I can build back now. And you at 63 may be able to build backbone better than the possibilities at 73. Hindsight is 20/20. I encourage you to get more information until you can get to a “yes.“ With the right doctors at your side.

I've been avoiding starting weekly Actonel. I've read that biphosphonates stop osteoclasts from cleaning up the old bone. So osteo blasts alone work ( which build bone) the problem is the drugs stay in the bone /body for many years so the user is left with old bone. Whilst it gets denser it can end up old and brittle in quality and break easy. So short term gain can result in longer term problem. I'm just reticent to take any and worried about it all. What to do ? And women still seem to be told half of the information we should hear. Interested in everyone's input.

rubina, I agree with everything in your comment. The only thing to do is to take the medications that remodel bone: Tymlos or Forteo. Seriously, though brittle bone is better than broken bone. The longer you live without fracture the happier you'll be. If a person were on the verge of fracture, it might be more quickly preventative to some of that thick avascular bone provided by Prolia or Evenity. If a person were at risk of metatastic bone cancer Prolia or Zometa could be the best choice.
In the olden days all we had were the bisphosphonates. In 2003 Forteo was approved. I hold the opinion that is is the best medication available to build the strongest most integrated bone. It encourages those osteoblasts you mentioned and they in turn call up more osteoclasts. They form units that remove and replace bone.
I'm avoiding taking bisphosphonates like Actonel, too. But I'm not taking any risks. I'm on Forteo.

May I ask why your doc said 5 years was your limit on hrt?

We simply have to do our own research and ask questions

I don’t actually know why he stopped me on HRT at 5 years - other than his fear of breast cancer which his wife had .

I personally know two friends who have done reclast and said they had no side effects which gives me a bit of courage in case that’s what my doctor recommends after I’m done with Tymlos in 2026.
As I posted earlier I’ve been disappointed in my one year mark dexa result on Tymlos - zero gains !
I questioned my doctor about this who says if I hasn’t been on it this past year my numbers would’ve likely gone down since I had stopped HRT. She says at least the Tymlos has held my numbers steady .
Still , I’m disappointed . You would think based on the drug ads for Tymlos that I’d have had a bigger bump showing on dexa.
I think I’ll listen to the dr and do the full course of 18-24 months even though I hate taking anything ! And then I’ll do one more dexa and then maybe do recast if that’s what my dr recommends . BUT I will ask for all the pre-treatment precautions mentioned in this helpful group( slow infusion, stay hydrated, etc)
What appeals to me about recast is the quick treatment and then going on with your life for at least a year . I hate the thought of daily or weekly or Monthly pills and all the bad side effects of the other bisphosphonates.

Just to let you know I was on actonel several months ago - and it really ruined my esophagas- had terrible reflux -could not swallow food - had to go to the ER and now take medication for this. Really bad the Drs. don't inform you of the horrible side effects of these drugs. I never had any gastro issues before this. Same thing with Prolia-terrible joint pain, bleeding gums and hair loss.

So sorry you've had this happen. Hope you are healing well.

Wow I really appreciate your sharing this and your honesty. Seems like every single bisphosphonate can have bad effects and it’s all individual.
We really are Guinea pigs