@mayblin This is helpful to see your numbers. They certainly point to the benefits of HRT. I wasn't aware that an anabolic could raise the CTX level if I understood you correctly. My Echolight scans 10 months apart showed a spine increase from -3 to -2.6 and total hip increase from -2.6 to -2.3. I began HRT 6 months before the second Echolight. When I see your increase in BMD after 6 months on HRT, I feel hopeful that my increases are legitimate. I'm not sure how significant my changes are, but at least I am moving in the right direction and hopefully have stopped the progression.

I mistakenly wrote total hip instead of right femur neck on the REMS Echolight increase from T score -2.6 to -2.3 on second Echolight after 10 months. The total hip went from -2.1 to -1.6 on the Echolights. As mentioned I started HRT 6 months before the second Echolight.

@mayblin , I am so excited to share my CTX results from five days ago. My CTX result in May, 2024 was 688. The result today, April, 2025, was 138! That's about an 80% decrease! I began HRT (.25 Estrodiol patch and micronized Progesterone 100mg) in July of 2024 and have been taking Keith McCormick's recommended supplements since December of 2023. I mentioned previously that my REMS Echolight spine T score went from -3 in April 2024 to -2.6 in February 2025. I was hoping to at least stop the progression of loss, so this improvement was a bonus. My total hip Echolight T score went from -2.6 to -2.3. The Echolight shows my fracture risk to be on the border of low/moderate so reasonably good bone quality still. The next test will be another DEXA with TBS I am waiting for. My worst DEXA T score was spine -3.5 in November, 2023. I am hoping there will be some improvement on the DEXA as well and that the TBS shows reasonably good bone quality. It is so encouraging and empowering to get this CTX result without heavy medication.

I forgot to mention my ALP liver enzyme lab result just received. The ALP level is determined by liver or bone activity as I understand. I first read about this in Keith McCormick's "Great Bones" If the ALP result is high, the cause could be from liver or bones. My ALP has been high for a few years at around 120 U/L -- the range 35-105. I suspected my high ALP might be due to my OP and high bone turnover rate. A follow-up Bone Alkaline Phosphatase test must be done to confirm either bone or liver cause. Along with my 80% decrease in CTX level, my ALP dropped from 120 U/L to 45 U/L for the first time in years! I strongly suspect the cause of elevated ALP levels was from my bones though would require a BALP to be 100% certain.