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Support For Those Quitting Prolia
Osteoporosis & Bone Health | Last Active: Oct 2 7:15am | Replies (136)Comment receiving replies
Just to update on my BTM blood test results. The test was done on 2 Mar 2024, 8 months after my 3rd (and last) Prolia injection on 1 July 2023 and 2 months after i started on my weekly Alendronate on 30 Dec 2023:
- CTX 51 pg/mL
- iPTH 3.5 pmol/L
- Calcium 8.3 mg/dL
- Albumin 4.1 g/dL
- Vit D 42.0 ng/mL
As mentioned earlier, i unfortunately, do not have any base numbers to compare with and will have to work with absolute numbers.
On the CTX number, i guess i am relieved that it indicates that Alendronate is effective in preventing any rebound effect but it could also just mean that Prolia is still active. But i don't know if i should be concerned about it being so low i.e. in the high-risk zone for any invasive dental work?
My Calcium is below the recommended range of 8.8 - 10.2 so i will need to increase my calcium supplement from the current 500mg to 700-900 mg.
Vit D is within the acceptable range.
I would welcome and appreciate any insight or comments on the above numbers esp on the low CTX
Replies to "Just to update on my BTM blood test results. The test was done on 2 Mar..."
What I have read I would be concerned about having any invasive dental work done with that low of CTX. Needs to be >150 .
Hey Formisc,
I believe your transition from Prolia to alendronate had perfect timing and will hopefully allow you to avoid any type of rebound. Might be a good idea to check your calcium in the next 30-60 days just to be sure CTX stay low but you're probably good. Many people that transition like you did after just 18 months will continue to gain bone mass on alendronate after Prolia. You might also have a low CTX baseline, which again, helps with the transition. I would not worry about the low CTX markers. Low is good and it will continue to be suppressed on alendronate. For reference, my CTX after one month on Prolia was 37pg/mL. It will be higher by month 6 before my next shot.
Not sure what to tell you on dental surgery other than tell your surgeon that you are on alendronate so they can get the job done quickly to minimize risk. Exposed bone seems to be what you want to avoid.
So the low calcium needs to be addressed. I to saw my calcium drop when I started Prolia and have bumped up my intake. I have hypercalciuria as well which means I have to take even more than the average just to have a chance at building bone. Low calcium can cause all kinds of side effects so you need to make sure you're getting enough in your diet + supplements. Prolia and alendronate will make it more difficult for your body to borrow calcium from your bone bank (so to speak). You REALLY want to get close to the 1200mg/day range to ensure you have enough calcium to support your bodies set point as well as to have enough for your bones to build. You can't build bone without calcium.
25(OH)D looks perfect. To low or too high is not good for bones. I'm a bit surprised your PTH is only at 3.5 pmol/L (33pg/mL). PTH will typically go high when serum calcium is low. I would have expected numbers closer to 60-70pg/mL. I can't explain that one. Maybe my conversion is off.
Albumin looks great too. No calcium correction required.
My two cents.
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My CTX is 35. I was interested in your comment about dental work with a CTX that is low. Does that dental vulnerability only happen over time?
I take 800mg calcium and don't eat dairy, and calcium is 10.3. In fact, it has been a little over range for years even when I just have one Tums, which has made me wonder.
What is the reference range for your PTH?
Hope these numbers mean you have avoided rebound! It's been 8 months and you started at the standard 6 months. Keith McCormick tells us to customize this transition but one of my endos told me there are studies saying it makes no difference to do CTX to time the transition.
Hope your doc affirms that you are fine! Sure seems like it!