It sounds like you are working hard and doing a lot of reading. My view is that after menopause, bone loss is inevitable, though it is wise to check your parathyroid, D3 and calcium levels, CTX and P1NP etc.

My spine was -3.7 and after 18 months of Tymos it was -2.5. Technician errors are always possible but was pretty darn happy. I take calcium, D3 with a small amount of K, magnesium and walk 45 minutes. I don't work as hard as you!

You will probably be offered Tymlos, Forteo or Evenity. Many docs seem to be prescribing Evenity these days. I did Tymlos then Evenity (4 months) and now Reclast.

Tymlos' injection pen has an adjustable dose. I am sensitive to meds and chose Tymlos for that reason. I also read it was slightly better than Forteo for spine, but ask your doctor about that. (There are comparison charts online.)

Many of us have bought Keith McCormick's book "Great Bones" which is encyclopedic and a great reference book.