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@gently

You've figured out this use for bone markers, very clever. I'm impressed. I would repeat the bone markers now.
With -3.8 in the vertebra, you are presently at risk for fracture. If you fracture, your life will change in ways you not only can't imagine, but would never agree to.
A good endocrinologist would fight the insurance denial, but you might be better off financially with insurance refusal. A PCP generally doesn't have the experience to challenge insurance denials successfully
https://therxadvocates.com/ https://www.lillycares.com/assets/pdf/lilly_cares_application.pdf
I suggest Forteo because I'm so happy with the drug. Tymlos would be my second choice.
Stopping the PPIs was a good move, but it won't rescue you. Bone building is slow without the anabolic drugs. And (I think) even the injectable bisphosphonates are too slow.
If you decide against the pharmaceuticals, you'll know whether stopping the PPIs was helpful.
And if you are able to get help with the cost, those same bone markers will serve as a measurement for the success of the medication.
You might consider finding an endocrinologist, but you have a prescribing doctor for now. I would take the fastest route to an anabolic medication.

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Replies to "You've figured out this use for bone markers, very clever. I'm impressed. I would repeat the..."

Thanks for your perspective and kind words. I will look further into your link, but my experience so far is that the pharma assistance programs do not cover people on Medicare.

I did see an endocrinologist who bills herself now as a functional medicine doctor. She was of no help, proclaiming I did not have OP at all because my T scores were decent. She doesn't take Medicare or commercial insurance, so that was a very expensive appointment to hear a doctor re-define OP!

Like many people with medical conditions I find myself spending a lot time, energy and money doctor shopping. I am hopeful that having the REMS test will make decisioning easier. Either it will confirm the OP diagnosis, or will find I am not as bad off as I thought. I am going to see Dr. Bush in NC, and he has worked a lot with OP patients the last few years. My guess is I would have a better chance of getting the meds I need .... if I need them ... thru him. He is an orthopedist.

I am not too clever! I knew enough at the start of this journey to sign onto support groups like this one, and learned a lot from people like you. I also learned a lot reading Dr. McCormick's book on OP.

I have fallen three times since the DX, including one time straight on my butt and that hurt! But x-rays confirmed no fracture. That is why I am not certain that my DEXA scan tells the full story, and that the REMS ultrasound may provide better context.

I appreciate your saying to get the comparison test. Thank you again for sharing your perspective.