Hi @dvargo, Your CTX change shows that HRT is definitely reducing bone breakdown, which is the goal. However, the current value looks quite low - below the lower end of the typical reference range for premenopausal women. It's good idea to double check the reference range and units on your lab report, and discuss with your doctor to make sure it's within a safe range, since long-term oversupprssion can affect normal bone remodeling.