Hi @undetectable I’m sorry that I’ve veered a bit off the purpose of the thread. While some here may have professional backgrounds, I think the purpose of this forum is to share support, information and ideas rather than to give/receive formal medical advice. As a fellow patient/member, here’s what I’d be thinking about:

The lumbar spine area is usually less prone to scan error than hips or femoral necks, so such a big change up then down there is unusual. Having a radiologist review all the scans could be helpful. A good first step is making sure the measurements were done for L1–L4 and not L2–L5, since that can make the results swing.

Average BMD gains during the first three years of Reclast are about 6–7%. Your first-year gains, if accurate, are really an outlier - which is another reason it may be worth a second look at the scans

It could be useful to talk with your endocrinologist about whether to continue another year of Reclast or consider switching to an anabolic therapy. Bone markers aren’t a standard part of care everywhere yet, but some doctors do use them, and they might help guide the next step.

In the end, it probably depends on how comfortable you feel after hearing both your endocrinologist’s and radiologist’s analysis, a second opinion may or may not be necessary.

Wishing you get things sorted out soon! Please keep us posted about your journey.