My osteo specialist just prescribed HTR for me. I'm 63, and my dexa numbers are relatively low. She didn't mention it on my first consultation with her. After asking for an appointment to discuss htr, she prescribed it. She emphasized that htr is a drug, a treatment.
That it can slow bone loss. I'm not sure if she actually recommended it, or was giving me what I asked for... I still have lots of questions for her that I didn’t have the time or presence of mind to ask.
The first time I saw her her recommendation was to go live my life and retest in a year and when I hit Medicare age, if necessary, to consider and anabolic. She likes Evenity.
About HTR, I did ask if by taking it I would live forever... She assured me I would still die---but hopefully would live in good health.
The prescription is taking a long time to get filled. I don't know if my insurance will cover much of it, and I'm still not sure if I'll take it. She said if I didn't like it, or had issues, to just take off the patch....

Best of luck with your functional medicine doc. Hopefully, he or she is well versed in HRT. You may already know this but transdermal estradiol is safest and if you have a uterus, you must also take progesterone (micronised bioidentical is best) generally given in an oral capsule at 100 mg if you are taking it daily or 200 mg if you are cycling it.