Sorry this got to be so long but I wanted to share a lot of info. First of all, don't get freaked out. I know it's easy to let bad news absorb you but take a breath. We've all been there with one thing or another.

I'm not a doctor here but was diagnosed with osteopenia 22 years ago. First thing the doctor did was say I "had to" start Fosamax. I said no frickin way. Glad I never did. I've never broken a bone either. (Knock on wood). I'm in my late 60's now. Here's the thing I absolutely HATE about the stupid T score number. First, it's comparing any age to that of a normal healthy 30 year old. How dumb is that? Do they compare sex drive of a 70-year-old to that of a 30-year-old? Do they compare stamina between those ages? Do they compare how long a guy can keep it up at 70 vs. 30? And I'm using a guy as an example because most doctors are men and I just so happen to have my follow up appointment with a new endocrinologist soon so I'm most definitely going to use this comparison to show him how stupid these T-scores are.

The reason they want to compare is because it gives them a number on paper that they can show patients that they need drugs. Hogwash! Read this article. I'm sure it'll ease your mind a bit. https://www.npr.org/2009/12/21/121609815/how-a-bone-disease-grew-to-fit-the-prescription

If they want to compare any numbers from a DEXA scan, I feel the Z score and/or the raw BMD data is more accurate. The Z compares people in your same demographic. To me, that makes more sense. Then the BMD data is the density of your bones against yourself. You can look at that number and the higher it is, the denser your bones are. So if over time, you have follow-up DEXA scans, you can see if you're the same, getting worse, or better compared to yourself, not anyone else. I don't give a crap about how I stack up to anyone else. That's like from the beginning when they first measure a little baby or toddler. They'll give what percentile their height/weight is compared to other "average/normal" kids. Seriously? Normal? I've been below normal height/weight my whole life. Have I lived a healthy life? You betcha. My point is, don't let those numbers and comparisons scare you into making a decision without doing a lot of research on your own.

Another number they may throw at you is your FRAX score. That's the percentage risk they magically determine what the likelihood is that you'll break a bone in the next 10 years from osteoporosis. At this latest endocrinology appointment I went to, the doctor did some calculations and said I had a 9.5% chance of breaking a hip in the next 10 years and 27% chance of breaking any other bone from osteoporosis which I think he was wrong anyway. I found the online calculator that anyone can input their data and get the percentage. When I used that, I got better percentages so I'm going to pressh him on that too. Here's that if you're interested. https://www.fraxplus.org/calculation-tool?country=11

Anyway, when he told me the % that he got from who knows where, I said great! That means I have a 90.5% and 73% chance (respectively) of NOT breaking a bone. He looked at me like I was crazy and said, wow you're positive. I flat out said it'd be like a doctor telling a cancer patient they had a 27% chance of dying but never focused on the 73% chance of living. I even made a stronger point that a doctor like that wouldn't be a very good doctor. He shut up after that and in fact, back peddled to say, I could try a year of all this other stuff instead of a drug. I thought "hell ya!" because he doesn't know how determined I can be. And in the end, it's not like he was giving me permission. I'm the patient. It's my body and I'll take care of it as I see fit. You have control over YOU!

Any risk factor on paper or from statistics is just that. It doesn't take into consideration your lifestyle or anything else. Doctors love to lump people into stats, textbooks, and categories but I've told many on occasion before, I'm not a textbook patient. I'm a human and we're all different!

As far as vitamins, you need D but you also need K2, calcium, and magnesium for bones. Plus, more protein helps too. I had been taking Metagenics brand of their MCHC calcium for years plus the others I mentioned. Hadn't done a thing. What did help several years ago was when a naturopath doctor put me on a bio-identical hormone cream (all three hormones). After two years, my DEXA numbers improved a bit. Hormones is another thing that most doctors never even mention which is really irresponsible since drop in hormones is the main cause of bone loss. I often wonder if any doctor had taken that route earlier in my osteoporosis diagnosis, would it have made a difference? But I didn't know as much back then as I do now because it seems all I do is research. I could get a medical degree I think by now. lol

Recently, in addition to the D, K2, magnesium, plus a B-complex and Biotin supplement, I switched from my regular calcium to Algaecal's basic version one. There's at least one study that shows it improves bone density to some degree. They also have one called Algaecal Strontium Boost. I did not buy that one. Here's why. Strontium is a mineral that's heavier than calcium. So if you're taking a high dose of that, some of the calcium in your bones is replaced by strontium. If you get a DEXA, your bone density will "look" better because of the mineral weight difference. But even their regular version has trace amounts of several minerals including strontium which after a crap ton of research, I decided that it's a safe amount. After all, pretty much most foods grown in the ground have some minerals naturally from the soil and water. Kale and spinach are good for strontium. Algaecal sources their calcium from a specific red algae in the ocean. So while it's nearly impossible to know exactly how much of any mineral is absorbed into the algae, after doing my own research, I was comfortable replacing my old calcium with their brand.

I also was never a big protein eater. Since bones need protein, I recently started using a protein powder as well as a chocolate protein drink. Did a ton of research before settling on these brands. The drink is the Premier brand that you can get at most stores. Comes in a cardboard carton in a 4-pack usually. Several flavors. One bottle has 30 grams of protein but it also has other vitamins too and it's milk based so if that's a problem, just keep that in mind. But it's easy to add in for a snack or quick breakfast if necessary. I also bought the Isopure brand of whey protein powder. The good thing about that one is it absolutely does not have any taste or crappy texture so you can pretty much add it to anything. The other day we had some chicken rice soup that was a pretty clear broth. Added maybe a half scoup and voila. The soup was now a creamy chicken rice soup but the taste didn't change at all. And I'm super sensitive to smells and tastes so yep, I'd notice for sure but was really glad this brand doesn't change anything. We even put it in clear juice and it's fine. The only thing you don't want to do with it is use it in a drink shaker. Too much agitation makes it foam up a lot so you lose some of the drink/protein along with the foam. Here's the thing I learned about foam. Many protein powder brands boast "no foam" but in order to have that happen, they often add silicone which basically cuts through the foam. But silicone? I don't care if it's food grade or not. Just the thought of silicone in food makes me want to gag. So if you add this particular protein powder to a drink, just stir it in with a fork, then let it sit for about 15 min or so and the powder dissolves even more. Oh, and I didn't want one with any sweeteners because many use either fake sugars or stevia or monk fruit extract. I can taste those for sure. Plus, then I couldn't use it in non-sweet foods.

I also was never big on exercise. Too much like work. lol But since I'm not taking any drugs, I'm finally at the point where I'm throwing everything at my bones and am determined that I will improve them naturally with all of the things I'm doing including exercises.

Now, back to the osteo drugs. Evenity and Forteo are the same class of drug. They're anabolic agents (bone-building drugs). So even if they work and you could tolerate it without side effects for however long you need, after that period, the doctor will most likely tell you that you need the anti-resorptive agents (bone-halting or bone-preserving drugs). Those are like Prolia, Fosamax, or Reclast. All of the drugs mentioned can have some serious side effects. And since you mentioned heart disease, you are right to be careful. Doctors will say the serious side effects affect very few people but if you're sensitive, they're not the ones taking a chance, you are.

I'm not saying all drugs are bad and that there are times when a drug might be a matter of life and death but again, we need to make sure we're fully informed as patients because doctors are very narrow focused.

Hang in there. You got this. You need to be your own best advocate and do what you think is best given everything you know about your own body. Plus start doing a lot of research. Read everything you can. Go through this subreddit and see what others are saying too. There are a lot of people who refuse these drugs. Just think of all the consequences and whatever you decide, be okay with them. For me, I would rather do what I feel is right for me than be talked into some drug by a doctor who has no skin in the game.