Remember that bone density and bone strength are two different things. Dr. McCormick, who is often mentioned here as the author of "Great Bones", has a long history with osteoporosis including multiple fractures, even though he's an athlete. He's 70 or 71 at this point, and *still* competes in triathlons. Anyway, his spine T-score is something like -3.3. He uses nutrition and exercise to improve bone strength. When I asked him about his score, he said "I don't care if I have osteoporosis - I only care if I fracture."

It's useful to get a DEXA with TBS so that you can get a measurement of your bone quality.

The anabolics (Tymlos, Forteo, Evenity) are good because they are taken for a limited time. The problem is that you have to follow up with a biphosphonate to preserve the gains, and that is where you can have issues with GI, jawbone, etc. But, even that can be overblown. The jawbone risk is really for people who have taken it for five years. The current thinking is to take a drug "holiday" every so often so that you're not continuously on the drug year after year after year. Maybe that would work for you.