@samhoward, I live in Northern Virginia and am enrolled in the Onero program of Nova Strong. Nova Strong is located in Fairfax, VA and is owned and run by Jarrett Brumett, a trained physical therapist. He is excellent and I highly recommend him. I am 73 years old with severe osteoporosis according to my DEXA scan (my REMS scan however shows low risk for hip and spine fracture). I was on Alendronate for 11.5 years (with drug holidays in between) and fell through the cracks, with doctors continuing to give me prescription without checking how long I had been on it (until that time, I did not know any better). When my doctor finally realized that I had been on alendronate way too long, he switched me to Tymlos. I had severe side effects from it, including losing my ability to walk, so he stopped me from taking it. I am currently not on any osteoporosis drugs because I can no longer go back to Alendronate or any of the bisphosphonates, can't take Tymlos or Forteo, have a long family history of cardiovascular diseases so I can't take Evenity, Evista, or Duavee, and had breast cancer in 2000, so I can't be on HRT. After my unfortunate experience with Tymlos, I switched doctors, educated myself on osteoporosis (so that I can actively co-manage my disease), enrolled in Onero, improved my diet to ensure consumption of sufficient bone-building nutrients, and am carefully managing my supplement intake. I started Onero last April 2026 (after undergoing appropriate evaluations). For additional background, I am 4'11" and weigh 90 lbs. In a period of less than four months, I am now deadlifting 55 lbs (60% of my body weight), squatting with a 45-lb barbell, and rowing with a 42.5-lb weight. I am also doing well with the balancing exercises. Last July, I took bone marker blood tests, and my CTX was 241 pg/mL and my P1NP was 35.4 mcg/L. This is an excellent outcome, which shows that I now have regained a balanced bone turnover despite not being on any osteoporosis meds. I will have my next blood tests and DEXA and REMS scans in November, and hopefully, I continue to have good results. By the way, if you live in DC, there is a gym that offers Onero at M Street and Bethesda called PureSymmetry.