No, I didn’t have to twist his arm. If your doctor isn’t willing to do “secondary” testing to make sure you are receiving the correct treatment, the only option is to look for another doctor. Rheumatologists also treat osteoporosis.

Note, I’m being treated for 2 conditions, hypothyroidism and osteoporosis. Hypothyroidism effects bones.

The pathetic part is I can get my endocrinologist to order labs but he is so incompetent that he can’t help interpret the results so I’m left trying to figure things out for myself.

Someone in another osteoporosis group recently posted, “I asked my rheumatologist about "normal" BTMs, which I have, and bisphosphonates. Specifically, my CTX (bone reabsorption marker) was in the 200-something range. He said he wouldn't advise them for me.”

I think my interpretation was correct, meaning my BTMs are not elevated and bisphosphonates therefore are probably not the right option for me. The mind-blowing part is taking bisphosphonates before anabolics reduces the effectiveness of the anabolics so my endocrinologist screwed this up. Highly annoying.

The only thing stopping me from letting him have it is that I don’t want to take any osteo-meds. I’m leaning towards trying HRT. I spent yesterday reading
https://www.themenopausecharity.org/2022/04/19/starting-or-continuing-hrt-many-years-after-your-menopause/
and
https://theros.org.uk/information-and-support/osteoporosis/treatment/hormone-replacement-therapy/