In his “GreatBones” book, and know I have not read his first one that you indicated, he does talk about going on meds in some instances it may be necessary, but to do so with testing of bone markers before meds are started. Then follow up with periodic testing of the markers to see if the meds are making a difference or not. If not, why should you stay on them till maybe 2 years later when you have another DEXA. That makes no sense!!! Make changes as needed. However, the other thought is to always be trying to get to a place where you can be weened off the meds. If you are along the way changing your eating habits, health habits , doing appropriate exercise, etc… in other words addressing the underlying root cause of your low bone density, this may be possible. And know there are certain sequences of meds that are more advantageous than others . And some meds have to be followed by others to help maintain what you’ve accomplished, for example if you’re taking a bone builder type drug (Forteo, Tymlos) versus an antiresorptive (Bisphosphonates). Prolia is a different class on its own and with that one it’s a given you have to follow it up with another drug , however again…. he states that the bone markers need to be used to know when the transition to the new drug would be best!!! The timing appears to be critical with that. But his overarching feeling is to try to do things naturally to keep you from being on drugs, but if you need to go on them , doing so in a more thoughtful way to have them work for you while trying to , if possible, get to a place where you don’t need them anymore. Hope that helps!! I wish I knew all these things before I fractured last summer after a bout with CoVID!! I feel the coughing set me up for the bad move I made that caused the fracture. I have learned so much in 7 months time. Had I known then what I know now I would not have gotten off a horrible couch the way I did , really flexed my trunk in coming to stand. It wasn’t till I went to the endocrinologist three months after that that I was given a morsel of information started me in this learning process. I was determined though to really understand and feel good about the decision to go on meds before I did. I have an appt with Dr.McCormack in a few weeks and feel like , from what I know that that may be his recommendation . But I didn’t want to just blindly start without myself understanding all these things. But I will say, I went gluten free a month a half ago and in 3/4 days my whole digestion system and elimination changed for the better. I’ve been exercising in a way thats beneficial to osteoporosis , purchased a Marodyne LIV Platform, and was able to secure a DEXA with the TBS …. So I’ve done a lot in
7 months and know there’s other things for me to incorporate as time goes on . All of these things will build toward better bone quality and density giving me better bone strength. Sorry I got so long winded…. Good luck in all you’re doing … keep learning .. that’s the key!!!