Before you reached -4 in your tscore and started on meds, did you do any of the recommended strategies, like the LiftMoor/Onero which have been shown to increase BMD? Or do Dr Loren Fishman’s 12 yoga poses, also shown to increase BMD? I have started the yoga poses, and will start weight training next week.
Yes, the CTX score is concerning. I will do some research and see if there are ways to bring those down other than meds.
Addendum; after I posted the above, i went on YouTube and found this podcast from Dr Doug Lucas on how to reduce CTX level. I am incorporating some of them already (higher animal proteins, 5-6 prunes a day and working out). I guess I will find out in a year if any of these help OP.