If you stop Prolia, there is a sudden and sometimes severe loss of bone density and increase in fracture risk. This "rebound" can be mitigated by going on Reclast. One expert, Keith McCormick, says that the timing of this transition is tricky and you need to do blood tests (especially CTX) to determine the best timing. Fosamax is sometimes used but not as potent as Reclast.

If I were 90 years old I would consider Prolia because there would be no need to come off... My doc jokes he might prescribe it if retiring so he doesn't need to deal with anyone getting off!

That said, it is a pretty effective medicine and Dr. Ben Leder in a You Tube video on Combinations and Sequencing talks about combining it with Forteo. The thing is, your scores aren't that bad, especially your hip.

Usually people do better with a bone builder (Evenity, Forteo, Tymlos) first. Not sure if you would get insurance for that, but worth a try. Reclast or Fosamax is used to lock in gains with those too.

Tymlos is very good with spine. Maybe you could do one year and save a year for later. You could do IV Reclast to save your GI system vs Fosamax.

I don't know much about male osteoporosis but you don't have to deal with estrogen deprivation, so maybe that is why your bones are pretty stable. I wonder if your doc would agree to you continuing as you are with some more attention to "whole body" approaches. You could look at McCormick's new book, "Great Bones" for further info.

Do you have GERD?