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Thanks so much for your excellent question! When one has osteopenia, there is often considerable discussion and even disagreement on the best course of action -- and whether that should include prescription medication. In this situation it is important to consider other factors in addition to DXA score, such as risk factors (such as, do you smoke or drink excessively? what is your exercise level? do you have a family history of fractures and/or osteoporosis? what is you age?) In addition, doctors can now use a new tool falled FRAX to calculate your potential risk of fracture (read more about FRAX elsewhere on this site). At the end of the day it is a judgment call best made in close consultation with a specialist. And regardless of whether you continue with Actonel, calcium plus Vitamin D is definitely a great suggestion on you chiropractor's part.