Fearfracture. Once again thank you for the additional info and your insight. My DXA results are pretty extensive and I believe they include TBS. I don't see a "TBS Score", however, they include xrays of individual vertebrates, hip, femoral neck, forearm with BMD and other info in great detail. None of it is good. I have not fractured yet but feel I may be close to fracturing if not careful. Everything I've read about HRT indicates it may be an option for postmenopausal women in 40-50's, but the risks are much greater for older post menopausal women. Between my previous PCP and current PCP we've assessed the usual secondary causes and my tests have been normal. I do think my diet and exercise is significantly lacking and has been for 15 or more years. I eat whole foods in general, however, I a very picky eater. I've been keeping a food log and was shocked that I was not getting the necessary nutrients for bone building. It's not just calcium and D. It's actually 20 essential vitamins and minerals. And you really need to ensure your eating the right combination of foods to allow your body to absorb and process the nutrients. You can't go overboard on any one nutrient because your body won't absorb them and you end up with bone loss. As example, a diet high in phytates (beans, nuts, seeds) leads to bone loss. Spinach is oxalic acid that doesn't allow calcium to be absorbed. Apple cider on dark green leafy veggies allows the nutrients to be easily absorbed. I could go on and on. My point is a balanced diet is key and with the right mix of nutrients (at each meal) that allow your body to take them in and support bone building. I think a nutritionist is key to my overcoming this challenge. Most probably with osteo meds for a while. I just want my doctor to work with me e.g., bone markers prior to meds, so we can monitor this is one more data point (other than just DXA) to we jointly can make the same call whether this is working or not. I'd be interested to hear how you make out with HRT. Like everyone else, I'm doing a lot of research trying to figure out why this is happening to me.