@isabelle7 I posted a long response to your other thread, with articles explaining that a bone builder, not Fosamax, should be the first treatment for osteoporosis with a -3.4 DEXA. Bone builders include Forteo and Tymlos (similar drugs) and Evenity.

If his rheumatolgist has not heard of Evenity, and suggests Fosamax for 10 years, I hope he will see a good endocrinologist who is more up to date on treatments. The endo should specialize in osteoporosis if possible.

I won't post studies again here. I do not give medical advice but point people to resources and those resources are on the other thread.

My own experience with Tymlos with a similar starting DEXA score was that I went from severe to borderline osteoporosis. I personally like Tymlos because the dose is adjustable and I could start with a lower dose and move up. Reclast of Fosamax can follow the bone builders as a sequence for treatment.