Prolia slows resorption. The natural bone building process continues. The two together make for increased bone density.

I don't recall all the tests the doc ran other than that before I began treatment there were a lot of them to rule out any other medical issues (none) and be sure I was in good health. There were some specific bone tests, too. My osteoporosis was most likely due to family history and menopause. My density has always been on the low side of normal.

I was referred to two specialists by my internist. Both had specialties in treating osteoporosis. One was a nephrologist and the other was an endocrinologist. One was in my health system the other was not. I feel I got good advice.

Re diet and exercise: I use a nutrition app (My Fitness Pal) to be sure I get enough calcium every day. It's very hard to know if you are getting enough if you don't keep track. I also take vitamin D every day. In more recent years I've also added daily Vit K-2 and magnesium which have roles in bone building. I try to get as much as I can naturally and supplement with calcium citrate as needed. (You can buy a powdered version from NOW foods which is great if you only need a little, instead of a big 600 mg pill.) My main exercise is walking and strength training (at home). My doc always recommends Pilates as good for bones, too. There are some yoga poses that have also been shown to improve bones.

I was a little afraid of Prolia when it was first recommended. I hadn't even heard of it. I did a lot of research. Ultimately it came down to this: the chance of a serious side effect was about 1 in 10,000 while the chance of a fracture was 1 in 100. I live alone and need to be able to take care of myself. I read some posts from women who had fractures that altered their ability to live as they wanted and that was enough for me.

Hope this helps!