My integrative medicine doctor informed me that K2 should be taken with D3. I believe it’s for better absorption, but you should look it up.

I share your relief to learn that your most recent CTX test number has presumably increased and is now measurable.

And I am heartened to also learn you have a well-designed plan to reduce the alendronate dosage perhaps with the aim, in part, of increasing your low CTX number whilst avoiding Prolia related 'rebound.'

I hated thinking with such a low CTX number, new bone might be forming on top of a less than ideal foundation of old bone because it is not undergoing osteoclastic grooming/preparation.

Are you monitoring your iPTH level for a particular reason? And could that reason be connected to the low CTX number?

Also you implied in an earlier post that you stopped Prolia because you had problems with it. What sort of problems did you experience?

I need to start thinking about weaning myself from post-Prolia alendronate but should perhaps wait until I have another CTX test in December (had no baseline.)By then, it will have been 2 years since my last Prolia injection, well past any 18 month rebound window.

My one and only CTX score was 313, taken last May after one year on alendronate which was started when my 3rd Prolia injection was due.

Would prefer for the CTX number to go down a bit more but it does not appear worrisomely high standing alone. Just wish I understood better what it means in relation to my P1NP result and to somehow knowing that the resulting bone formation is producing something strong, not just dense. I am very keen about not confusing bone density and bone strength.

Perhaps I will copy your alendronate reduction strategy .....if so, do I have your permission to call it the 'formisc step-down approach?'