@awfultruth , I appreciate it very much for your first hand information! It's interesting how your CTX presented and responded to dosing variation. Guess there are a few challenges: there might be a latency period for the full effectiveness of oral tablets to achieve your desired CTX. Also, terminal half life for once monthly dosing of risedronate (~23days) may affect your CTX readings, or at least at the beginning. As I recall, your baseline CTx prior to evenity was kinda high - if it returns to that level, you may need extra effort to suppress it.

The drug information which the manufacturer provided indicates that for men treated with 35mg actonel/wk, CTX has a mean decrease of 45% compared to placebo; for postmenopausal women with osteoporosis treated with actonel 150mg/month, urine NTx was decreased by 49%. And bone turnover markers reached a nadir below baseline within about 6 months of treatment.

The larger decrease in CTX I was talking about in my last post was from this paper:
https://pubmed.ncbi.nlm.nih.gov/17500121/
The pdf version can be downloaded via another site. In this study, they used 10mg/day risedronate x1yr and achieved suppression of CTX from 800 to -~mid 100s at end of one month and remained low thereafter. Total monthly dose is the same as that in your 2x monthly dosing, but with a different dosage and dosing regimen.

Based on above information, dosage, dosing regimen and baseline CTX level may make a difference in achieving desired CTX.

It will be a trial and error for anyone who tries to use a sensible "relay" drug without a lot of established protocol. My use of a low dose HRT after Forteo turned out to be a surprise too - CTX reached a low of 163 at 6mo. Now I have to watch it closely too to avoid the oversupprssion of bone remodeling.

Hope your CTX stabalizes soon, and, please keep us posted!