I am pretty pro-medication on this forum but I wonder if you need meds yet. You got a 4% increase without meds. How does the doc account for that? I don't know much about male osteoporosis. Have you done something to correct the actual cause of your osteoporosis?

Keith McCormick, the chiropractor expert on osteoporosis often quoted on here, writes about both "whole body" approaches and medications in his two books, "A Whole Body Approach to Osteoporosis" and the more recent, 700 page "Great Bones." I wonder what he would say about your situation. You can do a consult with him ($300) in person or by phone. He is also a male who had osteopororis, did Forteo then Fosamax and continued with holistic approaches.

If you do do medication, you could do Tymlos (great for spine) or Forteo (similar) or Evenity and then a brief Reclast to lock in gains. I would bet that is what MccCormick would recommend if he doesn't recommend waiting on meds. Let us know what you end up doing!