I'm a bit confused. What do you mean sometimes the osteo drugs don't work?

Hi @rete. Thank you so much for your very thorough response.

I can certainly understand not wanting to start a new medication. There are many people here who have chosen that route. There are some who are happy with that decision, and some who regret it. You can do a targeted search here to find those posts.

When you say you "would just like to talk to someone about options" are you referring to medications other than Tymlos-->Prolia? If so, let us know as there are options.

I myself chose to start treating my osteoporosis with medication after I experienced an atraumatic L2 spinal fracture. I woke up with severe pain and went to the ER. CT also showed prior fractures of T12 and L1 from which I had not had any symptoms. I also concurrently had atraumatic bone marrow edema and fractures in my right foot and ankle. The outcome was that I was bedbound for months and my quality of life plummeted. Initially I was put on Fosamax, but luckily I was referred to a metabolic bone specialist who started me on Evenity. I did that for one year, then Tymlos for one year and just had my first Reclast infusion in May 2025. So far, so good! That being said, I can appreciate that this route might not align with what you want for yourself. I also appreciate that you seem to have an open mind and are interested in being proactive in the choices you make regarding your care.

Best wishes to you moving forward!

@rete it took me a while to get an understanding of those DXA scan numbers. I mean how do those numbers relate to my risk of fracturing. I do not know if there is a chart somewhere that illustrates that? It's simple to say osteoporosis starts at -2.5 but how much does the risk increase when it goes down from there?
My take on this is that yeah -2.5 is the starting point for Osteoporosis but it's not so awful bad. But when you start moving down to say -3.0 or -3.5 you have moved into even more serious fracture risk. And above -4.0 is definitely red light flashing territory. Some people fracture at -2.0 but as your numbers go down the odds of fracture get worse. Once you are around -4 you are definitely at seriously high risk.
For the hips either a Total Hip or a Femoral Neck around -3 is definitely serious risk.

I'm just saying all this to perhaps give you more perspective on your numbers. I would suggest getting another DXA hopefully on the same machine with the same technician.
And I would suggest that medication wise considering Evenity over Tymlos and a bisphosphonate over Prolia. That is if you decide to do a med. Evenity simply builds more bone faster than Tymlos.
Best of luck to you!