Some general thoughts:

If your scores are less than, say, -3.3, or even -3.0, the advice by McCormick is not going to be different from a good endocrinologist. With severe scores, this isn't that complicated. There are 5 choices, Forteo and Tymlos as anabolics, Prolia and bisphosphonates as anti-resorptives, and Evenity as both. I think the main choice is between the anabolics Forteo or Tymlos, and Evenity. I chose Tymlos first and am now doing Evenity.

I research and come up with all kinds of complicated questions which noone, including McCormick, can answer. It's good to be informed. But in the end, I think it really is simple. The problem is insurance.

Docs are told by insurance to start with anti-resorptives, which can later affect the effectiveness of anabolics. The docs need a reason to authorize anabolics. If we qualify for free drugs or financial assistance from companies, then insurance does not dictate our treatment, but the overall policy needs to change.

For those with better scores- that is when it gets complicated, I think. Meds or no meds? And then how to approach things "naturally." McCormick, naturopaths, integrative medicine docs, dieticians, exercise experts (Margaret Martin) all are very useful in that situation and I have found endocrinologists know less about this in many cases.

I understand the issue of quality of life but as a person with several fractures, I will take side effects (if tolerable) over more fractures. But that's me. I am almost done with anabolics and hope I have earned some years without fractures! I will prioritize natural methods to keep my gains after a year or two of low dose Reclasts.

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