So I read all the studies posted above. The first link indicates there are are studies going on on lower dosing. That is encouraging.

That first linked study description mentions that lower dosing could have a beneficial financial effect and increase access for those who are challenged financially. Interesting.

The third study linked concludes that the conventional dose of 4mg is superior to the 2mg dose and they stopped the study. The difference in results was not large.

The issue of whether side effects are dose-dependent seemed to have been addressed in that study as well: "There was no difference in the occurrence of adverse events between the two groups (P = 0.63)" Meaning between 2mg and 4 mg. This seems to be a crucial point for us.

I was wondering about one thing in the NEJM article, which says it has long been thought that bisphosphonates are deposited on osteoclasts but that they found deposits also on osteoblasts. What does this mean? The bisphosphonates are slowly released from bone. We need studies on how long we should wait so that anabolics can work well again. And are lower doses better in that regard?

I am going to talk to my doctor about all this, since he has the training to evaluate all this and is no doubt up on the most recent studies.