Evenity and side effects: What helps joint and muscle pain?

I have completed my seventh month of Evenity. I usually have a light headache along with some joint pain. I would like to ask if anyone has experienced bloating as well as constipation?
This is happening to me and I try to be very conscientious since I had colon surgery a few months ago and I’m also a liver transplant recipient. After colon resection I was doing fine. After I restarted evenity in January (had to pause due to dental extraction) it seems I have more issue with bloating and constipation.
I am determined to finish my treatment!
Wishing all of you the best !

Hi @hopefullibrarian do you happen to have baseline bone turnover markers tested? If you do, do you mind sharing your baseline results? Thanks a lot!

Hi mayblin,
When I was first diagnosed in January 2023, I didn't even know there was such a thing as BTMs. That May I had my one and only injection of Prolia. It wasn't until early January of this year, just before I started Evenity injections, that I had my first BTMs done. I don't know if those tests can be considered a true baseline. They're at least something to use for comparison.
Here are those results along with the those from this month for 'side-by-side' comparison:

January 10, 2024
CTx = 115
P1NP = 11

April 11, 2024
CTx = 355
P1NP = 102

Note: I was fasting, did not take collagen for 48 hours, and was not taking biotin supplements. However, the blood was drawn at 11:30 am which is much later than my tests this month. The way I understand it, the CTx is highest at around 3 am, and goes down from there throughout the day. If that's true, then the two CTx scores are not good for comparative purposes. The dramatic change in P1NP for the better is what I'm focusing on.

Thank you @hopefullibrarian for sharing your treatment details! You and your doc made a great call to stop prolia after just one shot and transition to evenity is a great one. You are absolutely right about your bone markers that P1NP is the one to focus here, which showed such a tremendous anabolic response! Although the CTX reading prior to evenity may not be accurate, the reading on 4/11/24 is just wonderful because the number indicated there wasn’t any dramatic effect from prolia withdrawal. Looking at bone markers, things are working out perfectly 😀. Thank you so much for this rare set of bone marker readings, which showed how they change during a transition from prolia to evenity. You and your doc must be thrilled!

Mayblin, do you have (m)any doubts about the use of bone markers? or their use in some.

It’s funny you ask, @gently. When I got my very first result of bone turnover marker back, which showed P1NP 400 at 13 mo of forteo, I had my doubts already. Looking at the reference range of 20-108mcg/L for 46-60yo female, my raw reaction at that moment is what the _!? Dr. Internet doesn’t help either: severe liver disease, even malignancy could be the culprit. When the rational mind took over, I realized that I had a huge anabolic response to forteo! Bone turnover markers offer more than a glimpse to bone formation vs resorption than we thought. The dynamics of two markers are in tandem. Although the markers are still not prefect in predicting or directing clinical decisions in all patients’ cases, I personally have more confidence in them and my serial tests since then showed. Instead blindly ‘walking’ towards the target, i.e., end of therapy or the annual/biannual Dexa scan, I definitely would like to see how those markers changes during therapy, especially during anabolic therapy, for future reference should repeated anabolic treatment occur.

Many factors affect bone markers results, as discussed in this thread:
https://connect.mayoclinic.org/comment/1052882/
Besides the factors mentioned above, doubts for bone turnover markers could also stem from many other reasons. The assays themselves have storage requirements. Sensitivities among different assays differ also so we’d want to stick with one lab. People who have severe liver diseases, end stage kidney diseases and some particular malignancies, etc. could throw results off, either up or down. I’m sure researchers on the front line are working on those issues. We as patients shouldn’t be easily backed off just by the non-believers. Science advances faster if we all be part of the process.

Are you a doubter or a believer, @ gently?

Both

Did Medicare pay for the P1NP test? My doctor wouldn’t order it because she said Medicare won’t pay for it

I’ve gained several pounds since going on Evenity. I guess the increased appetite that you mentioned is the reason. Wondering if anyone has experienced brain fog and or depression with Evenity?

ritabtripp, Medicare pays for mine. Are you on original Medicare?