Help finding HRT over 10 years post menopause

@gravity3
Which anabolic you ask me? I had my initial consult visit with the Endocrinologist last week, Wed. 6-10-26. She had reviewed my maintenance Bone Density exams done at the same facility starting with:
10/2000,
02/2004,
09/2006,
08/2011,
10/2015,
11/2017, last one of L3-4
04/2022,
05/2024,
05/2026
Her thought was for me to use Forteo (teriparatide) pen, self injections for up to two (2) years, to build bone, followed by an antiresorptive agent to maintain the bone built (decided towards the end of the two years).
Her clinical observation would be supported or adjusted after the lab studies she wanted me to complete, which I did do the following week, 6-18-26.
The lab studies ordered:
Creatinine 24 hour urine, a fasting CMP (comprehensive metabolical panel), Collagen Type 1 C-Telopeptide,
IgA,
PTH,
Phosphorus,
Protein Electrophoresis serum,
TSH,
Tissue Transglutaminase IgA,
Vitamin D 25-Hydroxy.

I am waiting to hear back from the Endocrinologist office. In the meantime,I am doing my due diligence, and after I hear back from the office, I may seek a second opinion, supplying all my radiology and lab reports.
I will make no treatment decisions until November at the earliest.

Where are you, on this osteoporosis journey we share?

@countryliving

I agree. Starting hrt at that age would have bought me time. Thank you for sharing your story. You were so fortunate to have that forward thinking medical care.
It exactly the train journey I dreamt of but here we are. How about meeting in the dining car for a stiff drink!!!!

@countryliving That is a much better panel of tests than most of our doctors will order! Surprisingly to me, I see that your doctor has not included Procollagen Type 1 N-Terminal Propeptide = P1NP although CTX = Collagen Type 1 C-Telopeptide has been included. Any chance you can talk your Endo into adding P1NP in? If not you can do self-pay for P1NP as I and others have done.

You can see discussions about the importance of the ratio of CTX and P1NP with some links on this site. Your Endo may be willing to take some of the research papers into account.

Here is the IOF praising and referencing the paper in my next link below.
https://www.osteoporosis.foundation/news/joint-consensus-highlights-role-bone-turnover-markers-osteoporosis-diagnosis-and-management
Update on the role of bone turnover markers in the diagnosis and management of osteoporosis: a consensus paper from The European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO), International Osteoporosis Foundation (IOF), and International Federation of Clinical Chemistry and Laboratory Medicine (IFCC)
https://link.springer.com/article/10.1007/s00198-025-07422-3
EXCERPT: "We re-affirm the use of serum/plasma tPINP and plasma β-CTX-I as reference BTMs ..."

@countryliving

I agree. Starting hrt at that age would have bought me time. Thank you for sharing your story. You were so fortunate to have that forward thinking medical care.
It exactly the train journey I dreamt of but here we are. How about meeting in the dining car for a stiff drink!!!!