Hi! Based on the bone mineral density test report of spine and hips, you have low bone mass in the hips which is suggestive of an early osteoporosis. Fosamax (Alendronate) is a bisphosphonate drug which acts by inhibiting the osteoclastic resorption of the bones and hence commonly prescribed in the treatment of osteoporosis (thinning of the bones) thus preventing fractures. Since it is known to cause esophagitis (inflammation of the food pipe ) or oesophageal ulceration stomach resulting in oesophagitis it should be taken along with plain water on an empty stomach at least 30 minutes before the first food, beverage, or medicinal product. You should not lie down until after their first food of the day which should be at least 30 minutes after taking the tablet. It should not be taken at bedtime or before arising for the day. Other beverages (including mineral water), food & some medicinal products are likely to reduce its absorption hence should not be used. You should not crush or chew the tablet or allow the tablet to dissolve in their mouths because of a potential for ulceration in oral cavity or pharynx. You can take Levothyroxine 30 minutes after taking Fosamax. Other prescribed medications may interfere with the absorption of Fosamax and reduce its effectiveness hence can be taken later on. Hope these answer your query. Wishing you best of your health.