Very confusing indeed...and, tillymack, I may finally have to research another doc, bone clinic, etc. as I feel that my current endo isn't doing enough for osteoporosis, not that he is wrong or uneducated but...and as I have read that a lot of us get yearly DEXA (gold standard, so great test right? and how about getting one with TBS) I cannot understand why I can't get one paid for through this doctor. I had to ask for BTMs after initial diagnosis and being on Fosamax for a year, although apparently even doing BTMs is not always done by the doctors. I was told to do weight resistance exercises (like what? I've been doing aerobics with weights for decades) and given a printout of high calcium foods but nothing specific. Told "no benefit" to vitamin K. Vitamin D2 50,000/week for 2 years (finally off that as I have been around 50 for 1 1/2 years and was having side effects from the long term mega dosing). It is just so difficult to go doctor shopping! Gently- thank you much for your insights - always informative; I was somewhat aware that P1NP is more for those of us on anabolic; which are becoming more a first-choice therapy. I however was started on bisphosphonate Fosamax followed by reclast so changing now may be trickier? Since bisphosphonates blunt the effect of anabolic? For me a lot of this is mental health; I am exhausted worrying about my "terrible" bones, how I must be so very careful with every step, change your lifestyle, you could break your leg getting out of bed (!), drugs are NOT pretty, on and on and on! My doctor said that it isn't that big of a deal to get another machine for DEXA; in real life osteo patients move, technicians quit, machines are replaced. Preferred but not required.