I personally think DEXA scores can help decide on taking meds (If under -3.0). We can also do TBS to see how bone quality is, but a DEXA under -3.0 can mean meds are needed.

The blood tests, in my experience, establish a baseline before meds to make sure meds are working as well as to guide transitions to follow up meds like Reclast.

So I am not sure your doctor was wrong. Keith McCormick, the author of "The Whole Body Approach to Osteoporosis" and the more recent "Great Bones' writes that at -3.0 and below, meds should be considered. My doc at a major urban teaching hospital affiliated with Harvard, also goes by DEXA and does not use blood markers. I see another doc as well, who does use bone markers, but my main doc has been right about everything.

One caveat: it is good to make sure PTH (parathyroid) is okay. High calcium would be suspicious for that.