Thanks @windyshores for your response. I had a DEXA in May and it showed an increase from -2.9 on 12/21 to -2.2 for lumbar spine. Left femoral neck stayed stable at -2.3 and right femoral neck stayed stable at -2.7. So with these results, I think that there is improvement in my spine. Unfortunately, REMS results are worse. Spine was -3.1, left femur was -3.3 and right femur was -3.4. I wonder if staying on 40 will show further improvement or just trying to get to 60 would be tolerable. I don't know if Forteo is really that different from Tymlos? I am trying to drink a lot of water and will try salt.