@rjd
My DXA was in late October and my T-scores were as follows:
Spine -2.9 (REMS -1.7, fragility score 27.7/100 which is green/good)
Femoral neck -2.4 (REMs -1.6, fragility score 21.6/100)
Hip -1.6 (no REMS) - lengthy and more expensive

Fragility score is ability to absorb force and is not measured by DXA or related to T-score. You only get this with examination of the trabecular layer with REMS.

Cost of REMS was $275.

I insisted on a CTX and P1NP tests from my GP for bone mineral in blood and urine to corroborate the DXA and they did not return results aligned to severe osteoporosis which furthered my decision to do REMS.

I started doing research about reversing osteoporosis and read Igor Klibanov’s book - a great starter, found Dr. Doug on YouTube and appreciate the free version of OsteoCollective, and found Dr. Nick Birch on YouTube- I can’t give link - look up “Understanding bone health a deep dive with dr nick birch” for a good intro. I do use medical journals and sports medicine journals only for research backed decision making, not any articles I find online.

I have been supplementing with collagen, k2, boron, magnesium, manganese, calcium, d3, vit C, and soy isoflavens prior to going on HRT. My GP finally agreed to HRT with the osteoporosis diagnosis but women shouldn’t have to wait for that. I also increased my protein intake to at least 100 grams a day (I know that’s a lot but protein is the building block of bones).

Being completely dismissed by the endocrinologist when I brought up exercise and diet, I chose to find a naturopath MD. He ran multiple mineral blood tests and Celiac’s disease (apparently symptoms aren’t always obvious and Celiac’s can deter the absorption of critical bone minerals leading to osteoporosis). I am waiting for my next appt and expect to add testosterone to my HRT regime.

I also made the decision to work with a personal trainer for a few months to make sure the weight and impact training I do is safe. Two things about that. One, I am fortunate to be able to push aside some things to make financial room for personal training for a few months - it is expensive. Along those lines, I took some time at 3 gyms to ask trainers what they understood about osteoporosis before making my decision on who to work with - it is expensive and I want it to make an impact. My focus is on building up to heavy weights and proper form. If you don’t feel comfortable talking to the trainer or you feel they are unprepared for the meeting, I’d say run the other way.

I currently do weight training 3x/week and do heel drops (still with shoes on), step off stair, and hip bumps for impact training 2x/ wk - biggest bone builders but must be done with caution as they can cause stress fractures.

Good luck in your journey and don’t let the docs get off with their checklist approach.