@wagsofbevis Research the drugs available before you make your decision. Research a drug's "absolute risk" not the "relative risk" of fracture prevention. For example, "According to the review conducted by the ACP (American College of Physicians), the relative risk reduction of hip fractures with bisphosphonate treatment for at least 3 years is 36%; however, the absolute risk reduction is only 0.6%. Framed as number needed to treat, 167 patients need to be treated for 3 years to prevent one hip fracture."

If Fosamax didn't help you, I wonder whether Reclast would help since it's also a bisphosphonate. From what I've read, bisphosphonates offere minimal benefits as far as fracture prevention. They slow down the loss of bone but also slow down the formation of new bone. Your DEXA may appear better, but you could have older, more brittle bones. I wouldn't want to take Prolia because of the high fracture risk once you stop taking it. It must be followed by a bisphosphonate to lock in your gains.

Here are some articles that may be of interest.


https://www.amjmed.com/article/S0002-9343(24)00101-3/pdf

https://www.consumerreports.org/cro/2012/04/popular-osteoporosis-drugs-come-with-mounting-concerns/index.htm
Check out Brick House Bones on Facebook by Dr Lisa Moore, a PT specializing in osteoporosis. She offers a lot of free exercise videos and other information.

Also, check into information in this support group about high doses of Vitamin K in the forms of MK-4 and MK-7 which have been shown to help osteoporosis when taken with Calcium and Vitamin D.