Your scores aren't terrible yet @lisawa. I have kept a chart of my DEXA's since 2001 (!) and they jump around quite a bit, but since both your left hip and spine got worse and by -.5 (statistically significant with -.5 change) I get the concern.

I never know what to think about situations like yours. If I were you I would consult with Dr. Keith McCormick, the chiropractor expert on osteoporosis who wrote "Great Bones." Many of us consult with him and you have time to wait for an appointment. He also wrote "A Whole Body Approach to Osteoporosis." The question is, when to start meds, what meds, and what order.

Will your insurance cover an anabolic like Forteo or Tymlos with scores like that and no fractures? I hope noone will convince you to do Prolia- very risky to get off of it and people post on here about multiple fractures when they stop (even after gains while on it). If you do Reclast or Fosamax, which are often used for early osteoporosis, they are known to reduce the effectiveness of anabolics, so just be aware.

The problem we all face is how to extend treatment over time. Each med has a time limit. We need to sequence them strategically for maximum effectiveness and also think about time limits. So Tymlos is two years, Forteo can be longer but effectiveness may not extend past 18-24 months. Reclast is limited to 3-5 years to avoid atypical femur fracture or jaw necrosis. Evenity is one year.

So hypothetically (not likely with your scores) at 61 you could do two years of Tymlos, one year Evenity, 3 years Reclast . That takes you to 67-and then what? That is what we are all dealing with. Hopefully a long drug holiday whatever you do.

Talk to your endo, maybe get a copy of "Great Bones" and hope you can consult with McCormick. Margaret Martin at melioguide. com is the best for exercise. Above all take your time with decisions! Your scores aren't bad, it's just that their density is declining!