@debhatchell So very much in agreement with you! I did not get CTX until I requested it after a year on Fosamax. P1NP has never been considered (but I am on bisphosphonates). I feel there are few doctors who are doing a deep dive on osteoporosis (no osteoporosis specialty; it is tacked on to endos, rheumatologists, sometimes gynecologists or PCPs)! Treatment/medical procedures, blood tests and imaging/drugs to take or not/exercise/high impact/low impact/weighted vests/Pilates/personal trainers/physical therapists/supplements/protein powders/collagen the list goes on and on and on. Some docs seem to do some things that others don't. Makes your head spin!