I have been doing a lot of research on this disease Osteoporosis

Linders, can you tell us a little more, like how you got the fractures in your spine. Some offices are really slow, the busy ones, I guess. You might ask your doctor to give you a copy of the referral and process it yourself. Call the referred doctor and send them the referral. Lab work and dexa with TBS scan will give you a better idea of how to proceed. If you are on Medicare you might not need a referral to see an endocrinologist or spine specialist.
You already understand the need to have those fractures assessed (because of pain?), but there is some advantage in ASAP as often vertebral fractures aren't stable.
Supplements are usually not sufficient with osteoporosis.
You might call the office and ask the staff what the status is of your referral. If you know the doctor's name you might call that office and ask what has been received.
The wait time to see an endocrinologist is around 4 months where I live. You can almost always get in sooner by calling that endocrine office and asking for cancellations.
What is your research telling you?

Hello @linders,

As @gently mentioned, once a person is diagnosed with osteoporosis, supplements alone are not typically sufficient in maintaining of slowing bone loss. Unfortunately, there are lots of companies out there promising osteoporosis reversal through supplements or their expensive exercise programs, but results are not always scientifically backed. Some are outright scams. Knowing the difference can be really difficult. Here are some links from Mayo Clinic that talk about diet, lifestyle changes, exercise and medications and how they all play a role in bone health:

"Osteoporosis treatment: Medications can help"
- https://www.mayoclinic.org/diseases-conditions/osteoporosis/in-depth/osteoporosis-treatment/art-20046869
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"Osteoporosis: What Mayo Clinic experts wish you knew"
- https://www.mayoclinic.org/connected-care/osteoporosis-what-mayo-clinic-experts-wish-you-knew/cpt-20561803
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"Bone health: Tips to keep your bones healthy"
- https://www.mayoclinic.org/healthy-lifestyle/adult-health/in-depth/bone-health/art-20045060
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"Mayo Clinic Q and A: Osteoporosis and a bone-healthy diet"
- https://newsnetwork.mayoclinic.org/discussion/mayo-clinic-q-and-a-osteoporosis-and-a-bone-healthy-diet/
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"Mayo Clinic Minute: What women should know about osteoporosis risk"

@linders, if you are comfortable sharing, were you diagnosed with osteoporosis? Is that what contributed to your spinal fractures?

@gently Can you tell where an endocrinologist fits in with regards to treatment for osteopenia/osteoporosis? I know for women (I'm a 78 a year-old male) the hormone replacement therapy/diagnosis is well developed, but for men, I'd like to know how to ask my endocrinologist what he can do to prevent my onset of osteopenia.
I have a DEXA scan next week; my first one was 2 years ago. The one 2 years ago was OK and I wasn't into the osteopenia stage as yet. Trouble is, they do not relate the DEXA results to males, it's just females and children. Then, later this month, I have an appt with the endocrinologist who is a really nice man, but not an assertive doctor in terms of treatment. My concern is that I have a hip that is bone and bone, but oddly enough gives me no pain. However, I do not want it to progress into being osteoporotic.

hi, laughlin. It might be nice to know that statistically patients with bone on bone hip arthritis don't also have osteoporosis. The best thing for the arthritis is to develop the muscles and ligaments around the joints, but by non-impact exercises walking and swimming and physical therapy.
To answer your real question though is the endocrinology guideline of not prescribing testosterone for men who aren't hypogonadal which would be a total testosterone level of less than 300ng/dL. The reasoning is because of the increase risk of thick blood and cardiac issues and prostate cancer.
It is fairly easy to get prescriptions for testosterone from clinics many of which advertise their use of testosterone.
It would be good to have a discussion with the endocrinologist, though, to become more thoroughly aware if risks and the importance of subsequent testing.
Osteoporosis is an endocrine disease. Endocrinologists are the most well trained to handle osteopenia and osteoporosis. For both men and women the primary cause of osteoporosis is loss of estradiol.
It's an interesting fact that you point out about the undeveloped use of testosterone replacement for male osteoporosis. Part of the reason for this is that the primary cause of osteoporosis in men is in the use of ADT for prostate cancer. Because testosterone gives prostate cancer fuel there has been a worry about replacing it after radiation or surgery in the worry about recurrence and metastasis.
Most dexa machines are programed with comparisons including sex. So your T score probably compares you to 30 year old males.
This article is interesting, but maybe not enough for you to read. https://pmc.ncbi.nlm.nih.gov/articles/PMC4275049/
I had trouble finding this link it's been so many years since I read it. It might not fascinate you, but supports the first sentence of my post. Making preventing the development of osteopenia not a good argument for testosterone replacement. "A negative association has been reported between osteoarthritis and osteoporosis." https://pmc.ncbi.nlm.nih.gov/articles/PMC1004483/ 1991 I must be old with a good memory.

A word of caution about relying on research studies more than 5 years ago. Medical research is usually 2-3 years behind by the time of its publication date. The rule of thumb is not to cite research that is more than 5 years old. Regarding a negative association between osteoarthritis and osteoporosis there is more current literature that challenges that assumption by gender specific studies. Contemporary research demonstrates these conditions in men are non-linear and lean heavily on diagnostic parameters. The studies demonstrate a shifting from a positive association in mild disease to a high co-occurrence of OP in end stage severe OA. Studies can be found on PubMed Central.

@gently and @laughlin1947 I want to correct one thing: "It might be nice to know that statistically, patients with bone-on-bone hip arthritis don't also have osteoporosis." It didn't make sense to me. AI backed me up. (yes, we all know it can be incorrect) But I agree in this case -- having had my hips replaced and having osteoarthritis. An orthopedic surgeon will look at an X-ray they do in their office and verify.

"Most of the time, when a person is diagnosed with hip arthritis, they have osteoarthritis.
[1] (https://my.clevelandclinic.org/health/diseases/hip-arthritis) Understanding Hip Arthritis and Osteoarthritis.
Most common type: Osteoarthritis is a degenerative joint disease caused by regular wear and tear, making it the leading cause of hip arthritis.
[1] (https://www.youtube.com/watch),
[2] (https://my.clevelandclinic.org/health/diseases/hip-arthritis)

The wear-and-tear process: Protective cartilage in the hip joint slowly breaks down over time, which can lead to bones rubbing together and causing pain or stiffness.
[1] (https://www.orthoinfo.org/diseases--conditions/osteoarthritis-of-the-hip/),
[2] (https://www.youtube.com/watch)

Other possibilities: While osteoarthritis is the most frequent diagnosis, hip arthritis can also stem from inflammatory or autoimmune conditions like rheumatoid arthritis, psoriatic arthritis, or post-traumatic injury.
[1] (https://my.clevelandclinic.org/health/diseases/hip-arthritis),
[2] (https://orthop.washington.edu/patient-care/articles/hip/osteoarthritis-of-the-hip-hip-arthritis.html)

@laughlin1947 You will need to see different doctors. The endocrinologist will deal with your aging and bone loss condition. The Orthopedic hip surgeon will deal with your hip replacement and any fractures. Let me be clear about this - sometimes DEXAS are flat out wrong and sometimes bone doctors can't see fractures until they open you up.
Also - hip issues don't directly PROGRESS to OA. Its likely the other way around!
The bone meds most of us are on, who come here (you might want to scroll around that section) are on the bone meds. My "opinion" from being on BHRT (bioidentical hormones) and the bone meds is that they are the BEST way to counteract deteriorating bones due to arthritis. Any arthritis! A lot of it (form what I have observed over the years is due to hereditary genetics.
To help ease your mind - the DEXAs are a general assessment. I had them 30 years, every year and the last one said I was out of osteopenia in 2023. During my cervical spine surgery my C5 fell apart in the doctors hands. That was when I learned that not all bones are created equal. Talk to an orthopedic surgeon. Prepare yourself with questions (to use time valuably). you are medicare age so you can go without referral. It IS best to have current MRI and Dexas but they can tell mostly everything from an xray done in their office!

Hello linders @linders , let me cover something not already well covered by @gently and @JustinMcClanahan -
not all spine fractures are dealt with in terms of surgical repair. Fractures often heal on their own just fine and are better left without intervention! That is a good question for an orthopedic spine surgeon. My "opinion" is that the "bone meds "(Mayo Connect has a great section here, which most of us are involved in) are the best support for that healing and bone density/strength you will be looking forward to. You are on Medicare, so you can self-refer to a spine surgeon (to assess your fractures) AND an endocrinologist for info on the bone meds. This is not the same for everyone because there are PCMs who will do the bone meds and also look at your fractures. I am in a system where there is an entire department (UC Health) where they manage the bone meds. I feel I trust them best. I know people who use their PCMs to do the bone meds, and from what they share, I do not think a general doc can do it properly without a team for the two types of meds needed and the personalized care needed.
One we are compromised, good eating and EXERCISE play a huge role in maintaining what we are now stuck with but any rebuilding takes superhuman efforts and/or the bone medications only offered by trained doctors. Supplements don't yield the results you might be in need of. A professional will tell you for sure!

@loriesco, we elders need to stay up to date. My intention is to say that osteoarthritis and osteoporosis are two different diseases. Do you think that osteoarthritis can cause osteoporosis. There I would have to object. If you tell an endocrinologist that you want to prevent osteoporosis by treating osteoarthritis, your argument won't be effective.

Just as an aside, your first link is not to be found (eliminated because of obvious, admittedly unknown, inaccuracies?), none of the following links address a relationship or ratio between osteoporosis and osteoarthritis in the hip. So we're back to AI which is fun, but constantly makes statements unsupported by the links it offers. Not that that should undermine your objection to my original statement. I willingly yield to your greater knowledge on the subjects osteoarthritis, hip surgery and osteoporosis. I'd be happy to have someone holding our toes to the fire, if mine weren't burning.

@gently The links worked for me. Additionally, you will find both directly and indirectly they address/support what I stated. This one specifically was clear and credible:
(https://my.clevelandclinic.org/health/diseases/hip-arthritis) I'll copy it hear if you missed it: "Hip arthritis is USUALLY osteoarthritis, a degenerative disease that affects the cartilage in your joint."
I don't post AI stuff that I don't already think to be valid. It is more than fun -- I use it as a legitimate tool to validate my assertions. I do check for mistakes before I post. I am, however, always willing to be challenged! I approach using it in the way I've written my academic papers - in a scholarly manner. This is SERIOUS business! 😉 (I probably could have posted less for clarity.)
OA is one REASON for disease in the bones. It is one of several reasons people can find a basis for the disease of "osteoporosis." Osteoporosis is simply a term for "porous bones." OA, RA, gout, and 1200 other arthritis conditions are part of a constellation of osteoporosis - and some affect other body parts besides bones (ligaments, connective tissue).
Logically speaking, osteoporosis and OA can be the same. The point of my taking you to task is that MOST osteoporosis sufferers are aggravated by OA (as opposed to gout arthritis, erosive, RA and immune - like lupus) type diseases.
Also, you wouldn't tell the endo doc that you want to prevent osteoporosis by treating osteoarthritis -- you'd ask that of the Orthopedic doc! 😉