At 65, I had a -4.5 in my spine and osteopenia in my hips and femoral neck. My doctor told me if I didn't do something that by my mid 70s I would have a twisted spine. I took Reclast for 2 years. First year I gained 6.1%. Second year I only gained .1%. I was put on Prolia 10 months ago. I think my next step is Forteo since my insurance doesn't cover Tymlos. The order of drugs matters. If I had to do it over again, I would do the strong bone building drugs first. -3.5 is severe osteoporosis. I was there once and because I didn't do any drugs, I am having a difficult time just to get back to-3.5. I am currently-4.1.