Thanks so much @mayblin for your response. Unfortunately, my doctors don't seem to know as much as I do about this. I see my PCP next week and will get her opinion. Maybe I could get an appointment with the PA who suggested estrogen in the first place, but wouldn't prescribe it. The estrogen is prescribed by a functional physician, so I could ask her. My endocrinologists will just tell me to take Evenity, Prolia or Reclast, but I will ask the one who has mychart. From what you wrote, it is good that my CTX went down not up.

I am considering taking more calcium, since my blood level went down to 91 from 94. Also, I am considering taking Strontium again. My first bone marker results on 12/23 were P1NP 78 and CTX 519. At that time, I had been on 20 mcg, 2 clicks, for a month and 300 mg of Strontium citrate for a year. That was a better ratio than what I have now, 38 and 371.

I also wonder if the progesterone cream is lowering the influence of estrogen. If I stopped using the cream, would that lower the CTX? It does help me sleep.