It’s not just the PCP’s that don’t know a lot, the specialists only act like they do but they’re no great shakes either. It’s not their fault, it’s that the options aren’t great.
The truth is that, as Celia mentioned, there really is no ideal therapy because all the meds have their issues and there’s no going around it.
I believe I mentioned the British study of weight bearing 4 or more hours a week. Past exercising while you stand up it’s very nebulous and needs to be individualized to the patient, so no one will be super at managing it, PCP, specialist, no matter what they do it will never be a perfect fit because the options for treatment realistically are highly imperfect.
The calcium thing is also very, very controversial because there have been some new studies not only showing that it doesn’t really help long term fracture risk much or at all, but that it could calcify your arteries causing circulatory disease. And again, there are no certainties there, just shades of “could, would, might (sometimes combined with the word NOT)”. Maybe the 100lb skinny minnies might benefit more from calcium. Maybe it could lead to the premature death of the 200lb plumpers with sleep apnea and diabetes from heart attacks. And being overweight in general could protect you from osteoporosis, but it also hardens your arteries and gives you diabetes (which hardens your arteries) and high cholesterol (which hardens your arteries) and high blood pressure and sleep apnea (which harden your ateries) so the flip side is being fat will ruin your circulation, and bad circulation will starve the bones giving you the osteoporosis anyway on the back end. No can say for sure. Plus calcium has side effects too.
Just make sure that other potential secondary causes are being ruled out of which there are many but they are not hard to find if you order the right testing and that’s a question for your wife’s doctor(s), anything from thyroid to celiac, other hormonal issues, urinary/kidney issues. What was that old adage on hyper-parathyroidism, bones, stones, moans and groans? It’s complicated, ask someone who is qualified to look into it should the problem get worse faster than you expected. The younger you are when osteoporosis is diagnosed, the more you need to rule out the other causes.
Also make sure to eschew any toxic habits like tobacco or excessive alcohol consumption and keep all chronic illnesses as best controlled as possible. If you already are hypo or hyperthyroid, make sure you and your doc are super on top of that as the only thing that wrecks your skeleton faster than excess thyroid hormone will be (cortico-)steroids (as opposed to sex or anabolic ones like Testosterone or Estrogen). Then again most illnesses that require (cortico-)steroids are so debilitating or will just kill you so if you’re on prednisone, you’re probably stuck anyway. Again with this controversial crap!
Agreed it’s not that bad, could be worse. Most women will have a lot of bone weakening as they age. All the ladies in my family did but no one ever had a problem from it except my almost 90 year old grandmother with all her broken back bones and her recent injections of polymer in her back, she is like Lazarus that keeps coming back from the dead but again, that varies.
The older you get the more problems you will have from it but that’s just age, find me an organ system that doesn’t do that. Ageing is awful but it sure beats the alternative! My brother in law’s sister just buried her husband last year who died of a ragingly aggressive Multiple Myeloma at age 51, talk about bad luck. I gave her a canoe cart for Christmas because she couldn’t take her canoe out to the lake any more as it was too heavy.