Hi, 255anny I agree with jennirdh about repeating the CTX. Your medications are working as expected.
The doctor who conducted the clinical trials almost never gives his patients the second year of Reclast, as the positive effects endure for two years. With that in mind, you might consider forgoing the second year. But CTX monitoring would be crucial. We don't have your bone density improvement numbers throughout the medications, which would affect your future decisions.
Your medications have been antiresorptives and your CTX looks appropriate.
You might contact the physician in July and ask for CTX and P1NP so you'd have that information for the August appointment. If your CTX has risen sufficiently, another Reclast infusion would be appropriate. I would be wanting to skip the Reclast and start a anabolic--tymlos or forteo at the two year mark August 2026.
CTX is the measurement of a fragment left in the blood when osteoclasts (the acid producing cells) break down bone, which is the initial process of remodeling-- the removal of older fissured bone.
When CTX is high, you can either stimulate the Osteoblasts (bone building cells) or supress the acid producing cells. The osteoblasts are a residue left in the blood when bones are building, measured by P1NP.