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@lynn59

Thanks so much for your comments. I have no known secondary causes, I’ve been tested including celiac. What bone markers did you get done, and your endo felt every 3 months was necessary? I’m trying to get a baseline DEXA at a facility that will measure my forearm as well as TBS, but it’s like pulling teeth to find a place that offers TBS in Toronto. No one who answers the phone seems to know the answer! I’m prepared to pay out of pocket. I’m only allowed one every year if I want it covered, so this one 8 months later will be on me, but another on a year later will be covered.

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Replies to "Thanks so much for your comments. I have no known secondary causes, I’ve been tested including..."

I only have p1np at 13 mo, which was 400, then was tested again at 17mo for both ctx (910) and p1np (200). The baseline wasn't tested and I won't have it ever (lost opportunity). Tentatively I will be tested for both markers every 3 mo going forward. This frequency maynot be necessary but i like it. It is said if one is to take forteo/teriparatide, it's best to get at least p1np tested at 3-6 mo after the start of forteo to ensure the drug is working. Some insurances may not pay for bone markers even if you have your doctor's order. You will know after your first test. If insurance covers btms, I don't understand why doctor won't write the order if a patient requests them, although interpretation of tests is another matter.

Get a dexa with a tbs is a good idea. You might have to call radio,ogy dept directly. My results 13mo post forteo isn't remarkable. But I was comforted by my tbs improvements to the bottom of the normal range, whatever it might mean. And it's important to stick with the same dexa machine or facility from this point on for future comparison. Not sure if many ppl get scanned for the forearm, I did read some ppl's forearm t scores reduced after the therapy. Not sure the significance for it. But I'd prefer to have a stronger spine and femur/hip than a stronger forearm personally. There was a MD, whose mom has op and fell, broke her arm. The MD was glad that she didn't break hip/femur. I felt the same, although we don't have a choice when we fall.

100% agree with @windyshores : bone markers are not magical solutions, neither can they offer a solid base for our decision yet (but who knows how it might evolve in the future)? The usage of them entirely is up to you and your doctor. In the end dexa is still the golden standard for now. Our ultimate goal is to try our best not to frature.

@windyshores it seemed like you might be a (btm) non-responder to anabolics. Dr. P Miller mentioned he came across a few ppl like you but turned out they had great improvemnts with their dexas. My btms is out of normal range yet bmd increases are not reflecting correspondingly.

"we are all looking for certainty and there isn't any!", hope someday we have one!