The last time i had a Reclast infusion, the clinic gave me a high dose of something like ibuprofen just before the infusion. I had No flu related symptoms.
The last time i had a Reclast infusion, the clinic gave me a high dose of something like ibuprofen just before the infusion. I had No flu related symptoms.
Thanks. .i have been advised to continue having Dexa Scans on the same machine for accurate comparison purposes. i’m an accountant—-i like comparing apples to apples
I wonder if they do represent "healthy" people and how would that be defined. There is a person recognized as an expert who claimed she had identified the optimum thyroid levels for dogs by breed. However, this was based on analysis of samples submitted to her lab for analysis. Sounds good until you realized that most dog owners only pay to have the thyroid tested if they, or their Vet, suspects there is something wrong. Some breed clubs may undertake a study where a cross section of dogs are tested but that may be the exception,
I believe it was WindyShores whose endo stated that bone markers are complex and that there could be a whole conference dedicated to this subject. If that is true, I think only a fool would think one of us has all the answers regarding interpretation of results.
I wonder if they do represent "healthy" people and how would that be defined. There is a person recognized as an expert who claimed she had identified the optimum thyroid levels for dogs by breed. However, this was based on analysis of samples submitted to her lab for analysis. Sounds good until you realized that most dog owners only pay to have the thyroid tested if they, or their Vet, suspects there is something wrong. Some breed clubs may undertake a study where a cross section of dogs are tested but that may be the exception,
I believe it was WindyShores whose endo stated that bone markers are complex and that there could be a whole conference dedicated to this subject. If that is true, I think only a fool would think one of us has all the answers regarding interpretation of results.
This is from the Clinical and Laboratory Standards Institute (CLSI). They provide guidelines and standards for clinical laboratories worldwide.
Defining, Establishing, and Verifying Reference Intervals in the Clinical Laboratory: "A reference interval (RI) is a calculated or observed range of values that is determined from testing a reference population and between which the values of a particular analyte (e.g., a constituent of blood or urine) for a specific subpopulation of healthy individuals (e.g., adults, children, pregnant women) can be expected to fall with a given probability (usually 95%). This interval usually includes the mean ± 1.96 standard deviations (SDs) of the distribution of values in the reference population."
I found a more vague definition on the Mayo Clinic site: "Results from your hematocrit test are reported as the percentage of blood cells that are red blood cells. Typical ranges vary substantially with race, age and sex. The definition of typical red-blood cell percentage also may vary somewhat from one medical practice to another. This is because laboratories decide what is a healthy range based on the population in their area."
As for CTX and P1NP, all of the drug studies I have read use a percentage change from baseline. This is because the baseline values vary a lot from person to person. But in general, higher CTX numbers mean higher bone teardown activity from the osteoclasts and higher P1NP numbers mean higher bone building activity from the osteoblasts. Looking at them as a pair is more useful than looking at them individually.
This is from the Clinical and Laboratory Standards Institute (CLSI). They provide guidelines and standards for clinical laboratories worldwide.
Defining, Establishing, and Verifying Reference Intervals in the Clinical Laboratory: "A reference interval (RI) is a calculated or observed range of values that is determined from testing a reference population and between which the values of a particular analyte (e.g., a constituent of blood or urine) for a specific subpopulation of healthy individuals (e.g., adults, children, pregnant women) can be expected to fall with a given probability (usually 95%). This interval usually includes the mean ± 1.96 standard deviations (SDs) of the distribution of values in the reference population."
I found a more vague definition on the Mayo Clinic site: "Results from your hematocrit test are reported as the percentage of blood cells that are red blood cells. Typical ranges vary substantially with race, age and sex. The definition of typical red-blood cell percentage also may vary somewhat from one medical practice to another. This is because laboratories decide what is a healthy range based on the population in their area."
As for CTX and P1NP, all of the drug studies I have read use a percentage change from baseline. This is because the baseline values vary a lot from person to person. But in general, higher CTX numbers mean higher bone teardown activity from the osteoclasts and higher P1NP numbers mean higher bone building activity from the osteoblasts. Looking at them as a pair is more useful than looking at them individually.
I am a 79 year old women and will finish 2-yr Tymlos regime in August. DEXA scan midway through treatment showed significant improvement. My endo wants me to start Fosamax after Tymlos. I am considering to be tested for CTX and P1NP (covered by insurance) before starting Fosamax.
I take daily statin (10 mg) beta blocker (25 mg) and blood pressure (2.5 mg) med.
Is it a good idea?
If you think this Q&A will help others feel free to post.
I am a 79 year old women and will finish 2-yr Tymlos regime in August. DEXA scan midway through treatment showed significant improvement. My endo wants me to start Fosamax after Tymlos. I am considering to be tested for CTX and P1NP (covered by insurance) before starting Fosamax.
I take daily statin (10 mg) beta blocker (25 mg) and blood pressure (2.5 mg) med.
Is it a good idea?
If you think this Q&A will help others feel free to post.
Hi @rajmayo22 - Great to hear things are going well on Tymlos. Tymlos seems to be a very effective drug for most people.
The drug you use next should be based upon your T-scores just as you finish your current treatment. Perhaps a month or two before your Tymlos treatment ends, get a DXA scan. Depending on your results, the best path might be Fosamax, Prolia, or perhaps Evenity. It all depends on where you are at at the end of your current treatment.
CTX and P1NP would be nice to have but I would not lose sleep if you can't get it. Since you are on drug now, it's not going to represent your baseline. It will not be super helpful IMO.
The other drugs you are on don't stand out to me as a problem, but this is not my area of study.
Let us know how your DXA turns out. I'm sure you will get a lot of advice on a follow-on solution. 🙂
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The last time i had a Reclast infusion, the clinic gave me a high dose of something like ibuprofen just before the infusion. I had No flu related symptoms.
No, there's one in Bew Jersey where I went and North Carolina and Massachusetts, I believe, so far.
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1 ReactionGood to hear. Thank you!!!
Hi @elisabeth007 - A description of the CTX test is here https://www.mayocliniclabs.com/test-catalog/overview/83175#Clinical-and-Interpretive. The ranges that are listed are based on the measurements of healthy people, about the middle 90%. It's not an optimal range, just a range where most health people reside.
Like @normahorn said, you really need to have both CTX and P1NP to get a good picture of what's going on. They are linked.
Thanks. .i have been advised to continue having Dexa Scans on the same machine for accurate comparison purposes. i’m an accountant—-i like comparing apples to apples
I wonder if they do represent "healthy" people and how would that be defined. There is a person recognized as an expert who claimed she had identified the optimum thyroid levels for dogs by breed. However, this was based on analysis of samples submitted to her lab for analysis. Sounds good until you realized that most dog owners only pay to have the thyroid tested if they, or their Vet, suspects there is something wrong. Some breed clubs may undertake a study where a cross section of dogs are tested but that may be the exception,
I believe it was WindyShores whose endo stated that bone markers are complex and that there could be a whole conference dedicated to this subject. If that is true, I think only a fool would think one of us has all the answers regarding interpretation of results.
-
Like -
Helpful -
Hug
2 ReactionsThis is from the Clinical and Laboratory Standards Institute (CLSI). They provide guidelines and standards for clinical laboratories worldwide.
Defining, Establishing, and Verifying Reference Intervals in the Clinical Laboratory: "A reference interval (RI) is a calculated or observed range of values that is determined from testing a reference population and between which the values of a particular analyte (e.g., a constituent of blood or urine) for a specific subpopulation of healthy individuals (e.g., adults, children, pregnant women) can be expected to fall with a given probability (usually 95%). This interval usually includes the mean ± 1.96 standard deviations (SDs) of the distribution of values in the reference population."
I found a more vague definition on the Mayo Clinic site: "Results from your hematocrit test are reported as the percentage of blood cells that are red blood cells. Typical ranges vary substantially with race, age and sex. The definition of typical red-blood cell percentage also may vary somewhat from one medical practice to another. This is because laboratories decide what is a healthy range based on the population in their area."
As for CTX and P1NP, all of the drug studies I have read use a percentage change from baseline. This is because the baseline values vary a lot from person to person. But in general, higher CTX numbers mean higher bone teardown activity from the osteoclasts and higher P1NP numbers mean higher bone building activity from the osteoblasts. Looking at them as a pair is more useful than looking at them individually.
I am a 79 year old women and will finish 2-yr Tymlos regime in August. DEXA scan midway through treatment showed significant improvement. My endo wants me to start Fosamax after Tymlos. I am considering to be tested for CTX and P1NP (covered by insurance) before starting Fosamax.
I take daily statin (10 mg) beta blocker (25 mg) and blood pressure (2.5 mg) med.
Is it a good idea?
If you think this Q&A will help others feel free to post.
Thanks
-
Like -
Helpful -
Hug
1 ReactionHi @rajmayo22 - Great to hear things are going well on Tymlos. Tymlos seems to be a very effective drug for most people.
The drug you use next should be based upon your T-scores just as you finish your current treatment. Perhaps a month or two before your Tymlos treatment ends, get a DXA scan. Depending on your results, the best path might be Fosamax, Prolia, or perhaps Evenity. It all depends on where you are at at the end of your current treatment.
CTX and P1NP would be nice to have but I would not lose sleep if you can't get it. Since you are on drug now, it's not going to represent your baseline. It will not be super helpful IMO.
The other drugs you are on don't stand out to me as a problem, but this is not my area of study.
Let us know how your DXA turns out. I'm sure you will get a lot of advice on a follow-on solution. 🙂
Wanting to know if Medicare in MN covers BTM testing?