I wish I could help but I’m looking for help with my BTMs results also. I had my BTMs tested for the 1st time in November 2022. My endocrinologist failed to order BTM tests prior to starting me on bisphosphonates so I don’t have true BTMs baseline numbers. The BTM labs that I had done in November 2022, were done exactly 1 year after my 1st and, so far, only zoledronic acid infusion, which was rec’d in November 2021.

The results of my Fasting BTM tests are

C-Telopeptide, Serum, 179 pg/mL

Reference Range:
Premenopausal women: 34 - 635
Postmenopausal women: 34 - 1037

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Osteocalcin, Serum, 8.8 ng/mL

Reference Range:
Premenopausal women: 4.9 - 30.9
Postmenopausal women: 9.4 - 47.4

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N-Telopeptide, Serum, 15.7 nmol BCE/L

Reference Interval: 6.2 - 19.0

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Propeptide Type 1 Collagen, 20 ug/L

Reference Range:
Premenopausal women: 19 - 83
Postmenopausal women: 16 - 96

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The only comment my endocrinologist made, when I asked him to review my BTM lab results, was that my Osteocalcin was low and that you want it to be higher.

When I left his office I looked up osteocalcin to see how I could improve it. Note, my endocrinologist wrote an order for me to have another zoledronic acid infusion in November 2022–I chose not to have it. When I looked up osteocalcin, the info I found says that bisphosphonates lower osteocalcin. Why, if my endocrinologist thinks my osteocalcin is too low, is he prescribing another zoledronic acid infusion? Additionally, he has been treating my hypothyroidism since 2018. Hypothyroidism also reduces osteocalcin. Shouldn’t an endocrinologist know this?

So, as I said, I’m pretty much in the same position you are in, in other words, stuck with a doctor who’s not up to snuff.

I’m considering calling the manufacturer of zoledronic acid again. Yes, I have called them before with other questions.