@hollygs not to intrude but I was wondering a few things after reading your post and it would help me since NTX is another way to test for anti-resorption.

Was that a urine NTX? Maybe it's something else because yours look like it is in the normal reference range.? What test did you have? What was the reference range?
https://emedicine.medscape.com/article/2093977-overview
Apparently it fluctuates and is not as reliable as the serum CTX https://en.wikipedia.org/wiki/N-terminal_telopeptide

I have read and experienced that Tymlos raises both P1NP and CTX so it would probably raise NTX, if that is what you had.

Hello Holly,
The bone health specialist I was seeing gave up on my case. The last NTX he did was back up to 31.2. on 1/14/2022. I have a new bone health doctor who is a woman and hopefully she will be more on the ball. I'm still dealing with osteopenia and had a DEXA scan in May so at least I'm holding onto osteopenia and not back to osteoporosis. My stomach is beyond tolerating any of the oral meds and I didn't want to start the Tymlos after what I went through with it again so trying to walk more with an another failed thoracic and cervical spine surgery in January, 2023 and taking calcium and vitamin D supplements. Thank you for your message since the N-telopeptide concern is something that I had not brought up with the new doc. I have seen more journal articles pertaining to the NTX but didn't follow them since it had been dismissed.
I wish you the best of luck in finding answers with your new endo. I have found Medscape to be a good source of information. Keep up your spirits and we'll hope you find the solution.