I agree with your instinct to want those bone turnover markers as a baseline before starting a new drug. It's odd that your rheumatologist is reluctant to order the tests now when she'd done so before. You might ask her for her reasoning about that. One hopes that doctors can hear a question and not get too defensive about it.

Prior to starting Zometa, which is similar to Reclast, I requested a baseline as well. The Zometa was recommended by my oncologist because of being on an aromatase inhibitor which is linked to serious bone loss. Although my recent Dexa scan indicated osteopenia, my FRAX score was considered high. I did not want to fracture so accepted my oncologist's advice. The breast cancer diagnosis ruled out anabolic osteoporosis drugs which would have been my first choice. They weren't even suggested by any of my doctors (oncologist, endocrinologists)

My oncologist would not order those bone markers, however, saying she didn't know enough about them. She referred me to my primary care doctor who also would not write an order saying she, too, didn't know enough about them. I searched around and found an endocrinologist whom I could see without waiting 6 months. I told her my interest in having the bone turnover markers tested. She said this is usually done after a drug has been used to see if it is working. I asked didn't it make sense to have a baseline PRIOR to starting to be sure the drug was working.

She somewhat reluctantly agreed and wrote an order but she also made it clear that she would not really work with me to interpret the test results. Odd but whatever. At least I had my baseline results. She ultimately did send me a note saying my bone turnover was high so the Zometa/Reclast infusion made sense.

Meanwhile, I finally got an appointment with a different endocrinologist who works in the same health system as my oncologist. She is relatively young and I'm glad I found her. She seemed more open in her discussion with me. She agreed to test me again 6 months after my Zometa infusion. I've seen some people checking results more frequently than that, but with an infusion, I don't see the need to do that.

I like Laura1970's suggestion. If they are non-responsive, you might seek out another opinion from a different endocrinologist if that's an option for you.