Your bones are not that bad, honestly. Your spine is really good. You could wait until you pass -3.0 according to Keith McCormick's book "Great Bones." I wonder if you could do a consult with him. He also wrote "The whole body approach to osteoporosis." I am pro-med for osteoporosis that needs meds but you seem to be in a gray area where he might be helpful and supportive.

The thing is, if you do Reclast or Prolia now, what comes next? Tymlos, Forteo and Evenity will be less effective. And you really don't want to do Reclast or Prolia for years. The sequence is all off and so is the timing. Unfortunately insurance only approves of the stronger meds if you have failed the anti-resorptives, or fractures, so PCP's and NP's start off with them. It is not their fault: they are following protocol and insurance requirements.

I am not a doctor so am not giving medical advice. But I hope you can find a doctor or NP more in line with your preferences. I did that with cardiology (didn't want to take blood thinners). I would strongly suggest an endocrinologist if you don't have one, and one who gives you some choices, including waiting for meds.