My statement about low CTX and risk of ONJ from invasive dental work comes from these sources:
https://australianprescriber.tg.org.au/articles/osteoporosis-treatment-and-medication-related-osteonecrosis-of-the-jaws.html
and
https://www.carrollperio.com/dental-implants/ctx-test/
It was suggested to observe a "drug holiday" until CTX rises to at least 150 before embarking on any invasive dental work.

Nevertheless, i should point out that i just came across another study which questions the exact cut-off value if not the link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6459452/
I am quite surprised at your low CTX since i recall you have been on mostly anabolics rather than anti-resorptives. Did the low CTX just come about recently or has it always been this low?

Sorry i left out the reference ranges. Here are my numbers again, with reference ranges from the lab in brackets:

- CTX 51 pg/mL (177-1015)
- iPTH 3.5 pmol/L (1.6-6.9)
- Calcium 8.3 mg/dL (8.8-10.2)
- Albumin 4.1 g/dL (3.5-5.0)
- Vit D 42.0 ng/mL (30.0-99.9)

If your calcium level is a little over the range, you could just reduce your supplement intake to a lower dose, say 500-600mg?

On trying to time the Zol infusion, i think the other endos have a point. It may be ideal to get the perfect timing but even if this does not happen, Zol is a 12m dosage with long-term effect so it should still be able to do its work even with imperfect timing.

Based on the above results, i will continue with the Alendronate and redo blood test in around 2-3 month's time. Apparently, from charts i have seen, the peak for CTX after stopping Prolia happens at around 12 months from the last Prolia shot (or 6 months after stopping) so there is still a need to monitor CTX closely over the next several months. Guess not completely out of the woods yet 🙁