Thanks to everyone for your thoughts.

Gently, you're going to be sorry you asked. I thought you raised some good points, so I went back and made a chart (it's the compulsive organizer in me) of both what meds I've been on and DEXA scores. You're quite right that I didn't improve on Prolia; the only med that's had an impact is the Tymlos (saints be praised).

I am totally bumfuzzled and without a clue as to what comes next. I really prefer to avoid Reclast, understand the concerns about Proolia, and don't see a perfect option. I will see what I can find out about Forteo as the only other viable option.

Here you go:
Treatment:
Raloxifene 60 mg daily from 1998 to 2006, discontinued due to blood clot
Alendronate 70 mg weekly from 2006 to 2010, discontinued due to duration of use with subsequent "drug holiday"
Denosumab 60 mg SC in February 2020, August 2020, March 2021, September 2021, March 2022, September 2022
Alendronate 70 mg weekly from March 2023 to October 2023 (discontinued due to GERD; compression fracture 10/23 after bad trip and fall)
Denosumab 60 mg SC in November 2023
Abaloparatide 80 mcg SC from January 2024 to present

DEXA spine T scores:
5/2010 -2.5 (after four years of Fosamax)
2/2020 -3.2
2/2021 -3.3
2/2022 -3.2
2/2023 -3.3
3/2024 -3.2 (not including L1 bec of compression fracture 10/2023)
2/2025 -2.6 (excluding L1)

Thanks so much for your help, everyone. I guess if there were a perfect option there would be no need for this forum. Maybe someday . . .