@drsuefowler you could try and see if it will make a difference by skipping a dose in the night. The trick is you dont know if changes in new lab results are due to the maneuver in injection timing or passage of time in treatment, unless you do two labs closer together (within a week or two)- one with old dosing time and one with skipping a dose then compare the results. Like @njx58 pointed out, missing a dose won't hurt in the overall treatment. From what i read, dosing adherence were never 100% as some clinical studies tabulated, I can't recall the #% though. I definitely missed a dose here and there but I don't think my end results were affected.

Here is a link for the study of a single dose teriparatide on serum p1np and urine ntx (a similar measure of resorption), scroll down to Fig b and c:
https://pmc.ncbi.nlm.nih.gov/articles/PMC3923119/
Ir seems urine ntx reached a peak between 4-8 hours post one single injection. My thinking is both ctx and p1np are elevated after many months' daily injections of pth analog especially teriparatide, neither bone markers will fluctuate dramatically due to timing of the injection - don't know for sure unless we can get the info from publications. Hope other members chime in with what they know.

High ctx during Forteo (I recall you had high ctx during tymlos as well ?) might be of concern. I have some notes from an endo. Will send them to you when I locate them. They might be useful.