@zingsong, so sorry to hear of your diagnosis. So many of us go through the same response as you; shock, dismay, confusion and overwhelm. I was diagnosed at 57 and like you, I was active, fit and ate a very healthy diet so it came as a devastating shock. It sounds like you are taking the bull by it's horns and learning all you can so that you can make informed decisions and move forward constructively.

One thing you might consider now is HRT. Since you are in the safest time window, it might be a good option for stemming the loss. We lose the most bone in the first years of menopause so it might buy you time and bone while considering all of your options. A transdermal estradiol patch is considered the safest method along with 100 mg of oral micronized progesterone (rather than synthetic progestin) to protect your uterus. No need to test your estrogen levels. If you are in menopause, they are low.

You mentioned that you were tested for autoimmune markers. Wondering if you might tell us a little bit more about that. Did you test thyroid antibodies, celiac, gluten sensitivity and were they all negative?

One thing I can tell you from personal experience is that it is unlikely you will regain your bone density with a natural approach. It's just not the way nature works. When I was first diagnosed I was determined not to take meds so I doubled down on my health protocol, increasing my exercise, got a standing desk, weighted vest, calculated calcium intake and all nutrients, daily prunes, etc. You name it, I did it. I took a full 2 years to see what I thought would be impressive results and to the contrary, they were devastating. I went from -2.8 in my spine to -3.2. At that point, I knew I had to embrace a medical approach so I went on Forteo. No side effects and a modest gain. After Forteo, I needed to do something to lock in the gains and I chose HRT. I was 62 at the time so not within that optimal safest window but I was about 10 years out of menopause. It felt like the most natural option to me since it's something the body produces, recognizes and uses to protect bone. I've been on them for about 5 years and have mostly stabilized. Banning any health issues, I plan on staying on them for the rest of my life as once you go off estrogen, you lose bone once again. If I end up in that situation, I'll make my decisions then on an appropriate medication to stabilize.

So, the good news is that you've discovered your osteoporosis early. Like you, if I had not insisted on a Dexa at 57, I shudder to think what my bones would have been like at 65, the standard age for recommending a bone density scan (ridiculous!). And like you, I look around at all of my sedentary friends who eat anything they want and their bones are just fine. Some of us are just faster losers than others.

Your questions and concerns about safe movement are appropriate and smart. It's a really good idea to learn how to move and exercise safely. It's a reeducation on what to do and what not to do and it seems you are already thinking very logically about that. I would highly recommend Melio Guide as a reference. Margaret Martin is a physical therapist specializing in osteoporosis (and she has osteoporosis and as an aside, she is on HRT). She clearly lays out a protocol for safe daily movement and exercise. Along with Dr McCormick's book, you'll have all the tools and information you need to make these important decisions and changes to keep yourself fit and safe.
https://melioguide.com/health-guides/
Wishing you the best of luck. Keep us posted!