I was diagnosed in 2000 with a T-score somewhere around -3.5. I tried diet and exercise and supplementation and gave up having DEXA scans each year, because I was determined not to use medication, so why bother? Fast forward to 2021 when I slipped on the ice resulting in a spinal fracture. X-rays showed multiple older fractures, which shocked me. The doctor said they could be silent and painless. The DEXA scan showed -4.5 for my spine. I embarked on rigid diet and exercise regimens and the next one was -4.7. So, I flew from Texas to Massachusetts to consult with Dr. Keith McCormick, who was diagnosed with severe osteoporosis at age 45 despite being an Olympic-qualifying athlete. His book 'The Whole Body Approach to Osteoporosis' is a must-read for those of us with the condition. Also, 'Rebuild Your Bones' by Mira and Jayson Calton is excellent for learning what foods help and what foods hamper bone-building. The first thing Dr. McCormick said to me was that I had no choice but to go on medication. After 22 years I gave trying to do without it. Before starting Tymlos I got a baseline DEXA and it was -5.1. My local doctor works with Dr. McCormick by ordering the blood tests for bio markers, which tell Dr. M how I'm doing. He also checks for gluten problems. I recommend to everyone not to try to guess what to do next. And I've seen endocrinologists that did nothing. You need an expert in the condition. Dr. McCormick does phone consultations.