Can't speak to the CTX levels. Question for your doc.
I had a spontaneous thigh fracture 1 year prior to starting Evenity. My ortho doc said I really had no choice.
She was very encouraging. I met with endo doc later. Both on same page.
Risk of spine fracture not something I ever want to experience. The thigh recoup time was almost a year.
Enough was enough for me.

It is very understandable to be fearful of starting powerful drugs. I was.