@kshea2 I'm so sorry to hear about your fall and fracture. I hope you are not suffering a lot of pain. This is a stark reminder of how fragile and vulnerable we are often without knowing. Your REMS Echolight scores are interesting. The difference in your spine T score compared to DEXA is similar to my initial Echolite spine score compared to DEXA. Mine was .5 lower than the dexa and yours .6. My femur neck T score however was the same as the dexa score at -2.6. My second Echolite 10-months later showed my femur neck at -2.3. When I was initially diagnosed with osteoporosis in 2019 with spine T score -2.8, I took calcium and vitamin D for the next 4 years but still rapidly lost bone to a level of -3.5. However I was taking high dose prednisone during 2019/20 for a year for an autoimmune condition. I began many other supplements and diet changes, including increased calcium from food sources, increased protein, K2 Collagen...suggested by Keith McCormick in December of 2023. I find the nutritional and supplement counseling another benefit of the N.A. Menopause Society naturopath. I provided her records of all my DEXAS, Echolight, CBC lab tests, including urine calcium, CTX, vitamin D etc. My blood tests were mostly fine, including vitamin D, calcium and urine calcium. My CTX was at 670 which the naturopath and osteoporosis doctors surprisingly said was okay (Lab test shows 100 to 1000 is acceptable) However Keith McCormick says this number is too high and should ideally be below 400. So it will be interesting to see the result of my follow-up CTX next week. I have heard that HRT can reduce the rate of bone turnover (confirmed also on chat GPT). I consulted with an internal medicine doctor specializing in osteoporosis in May of 2024. She recommended Evenity. I said I would like to hold off to see if I could stop the progression of bone loss first and consulted with the naturopath in July of 2024.