Connect
← Return to Support For Those Quitting Prolia
Discussion
Support For Those Quitting Prolia
Osteoporosis & Bone Health | Last Active: 5 days ago | Replies (153)Comment receiving replies
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!
Replies to "My CTX is 35. I was interested in your comment about dental work with a CTX..."
Connect
My statement about low CTX and risk of ONJ from invasive dental work comes from these sources:
https://australianprescriber.tg.org.au/articles/osteoporosis-treatment-and-medication-related-osteonecrosis-of-the-jaws.html
and
https://www.carrollperio.com/dental-implants/ctx-test/
It was suggested to observe a "drug holiday" until CTX rises to at least 150 before embarking on any invasive dental work.
Nevertheless, i should point out that i just came across another study which questions the exact cut-off value if not the link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6459452/
I am quite surprised at your low CTX since i recall you have been on mostly anabolics rather than anti-resorptives. Did the low CTX just come about recently or has it always been this low?
Sorry i left out the reference ranges. Here are my numbers again, with reference ranges from the lab in brackets:
- CTX 51 pg/mL (177-1015)
- iPTH 3.5 pmol/L (1.6-6.9)
- Calcium 8.3 mg/dL (8.8-10.2)
- Albumin 4.1 g/dL (3.5-5.0)
- Vit D 42.0 ng/mL (30.0-99.9)
If your calcium level is a little over the range, you could just reduce your supplement intake to a lower dose, say 500-600mg?
On trying to time the Zol infusion, i think the other endos have a point. It may be ideal to get the perfect timing but even if this does not happen, Zol is a 12m dosage with long-term effect so it should still be able to do its work even with imperfect timing.
Based on the above results, i will continue with the Alendronate and redo blood test in around 2-3 month's time. Apparently, from charts i have seen, the peak for CTX after stopping Prolia happens at around 12 months from the last Prolia shot (or 6 months after stopping) so there is still a need to monitor CTX closely over the next several months. Guess not completely out of the woods yet 🙁