My numbers are where yours are after a 20% improvement last year adding magnesium, lots of pt, etc. Then, I lifted my 60 pound dog in a dead lift from the ground. Three attempts, I fractured. I am now on hormones and still considering tymlos strongly. My endocrinologist first said no in the hormones concurrently, but finally agreed that I needed them for other things. I am tapering up estrogen, testosterone, and progesterone. So, yes, you can break at those levels and need to be careful. I was told never to bend forward or to twist, or to lift greater than 20 pounds. Not unreasonable to have another dexa, but then try to stick with same machine for future dexa scans. Good luck! Super hard decisions! I told my dr. If bone drugs give me side effects sufficient that I can’t exercise, that I’m done. There is no point. Read the absolute risk reductions and dexa improvements. Relative risk is just that, relative, and can be pretty meaningless.

Be very careful with HRT. Especially if breast cancer runs in your family. Or ovarian or uterine cancer. It feeds the cancer if it is estrogen positive. Which mine was.