Humidity, hydration, exercise, natural sunshine, and a good diet. Will help with your pyramiding. It worked for my sulcata and is working on my redfoot....
His main diet consists of dandelions, endive, romaine, radicchio. The occasional clover, viola, rose petal. Rare fruit and sometimes tortoise repti pet store food as a treat , also rare. Then a calcium D3 powder.
UVA is really important too, UVA light will reduce the tortoises stress by allowing them to see in the UVA long wavelength, this helps them related to their environment and food better.
Reptile Vision and UVA Light
Humans see three colors - red, green, and blue. Reptiles see these colors as well, but they can also see UVA long wavelength light between 320 and 400 nm. This allows them to see colors and patterns in ways that humans can't.
Seeing UV light allows them to recognize other reptiles of their same species and detect movement. It also stimulates appetite by making food more appealing. The presence of UVA light promotes proper foraging, feeding, digestion, activity levels, social behavior, reproduction, and basking.
He gets outside . Id say 2-8 hours a week. I also have 2 UVB 18" fluorescents, a compact bulb, and a MVB that just burnt out , for basking.
I just hope I can continue to take better care of him. He needs an out door enclosure. However i am in progress of moving cities.
Sounds like your doing most things right. I would say if he continues to pyramid worse, take him to a vet soon. In the bigger cities you might find a few exotic animal vets in your area, you could call ahead to inquire about prices. Here in the Chicago suburbs there are several exotic animal vets and I discovered that their fees were not the same. I found a vet clinic called All Creatures Great and Small (630)852-0910 (Dr. Ken Eisenberg) in Downers Grove Illinois to be very reasonable and good service. They did a fecal exam on my tortoises for $23.00 I didn't request a vet exam but a vet exam there is $59.00 This vet clinic is also in a nice neighborhood.
Other places almost charge triple these prices or more.