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Blood Marker Testing

Osteoporosis & Bone Health | Last Active: May 22 8:02pm | Replies (58)

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the normal range is so broad that I haven't seen any numbers in the literature where an osteoporosis patient was out of range. The scales are 20 years old and were developed by the assay labs and adopted by medical providers.

From what I've observed (from my own dxas and from reading) women lose the most estrogen and bone in the first 5 years of menopause. Bone markers would be of value then. There should be a separate range for women from 50 to 55. Speculating; when you first lose bone your bone markers rise. After bone loss your markers will settle back down because you are not building bone. Where bone is lost blood supply and nerve supply are also lost. Without intervention your body hasn't a way to rebuild the bone. Your serum levels of markers reflect reduced rebuilding.
Before Forteo, the only way to medically address osteoporosis was by reducing osteoclasts. Bisphosphonates were the medication we used. Osteoclasts were maligned, undeserveably. Lower really isn't better. More commonly. now, bone specialists are saying that it is best to raise osteoblasts than to supress osteoclasts, especially in osteoporotic women. Reduction in bone formation is the primary reason for age related bone loss. Turnover is said to increase by 50 to 100% within the first years of menopause because of the loss of estrogen. It's higher in a desperate attempt to save those bones.
So babs, your bone markers look perfect.
The bone markers will be of benefit to measure the effect of medications. With Forteo or Tymlos markers are best taken at 2 month not 3 as is common.
Best use for bone markers has not been sufficiently explored.

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Replies to "@babs10 the normal range is so broad that I haven't seen any numbers in the literature..."

Great post @gentlemanjoe

took a cancer med that reduced estrogen below detectable levels (it addressed estrogen from adrenals post-menopause). I had an abrupt drop of 10% in bone density the first year then it stabilized. I think the same thing happened at menopause.

From what my doctor has explained, bone markers kind of oversimplify things but a comparison with baseline seems very helpful and the suggestion of timing made by @gently is a good one. I have kidney disease and read that can also affect CTX and bone specific alkaline phosphatase may be useful.

@gently, You wrote, "Your serum levels of markers reflect reduced rebuilding."

Would you please say a little more about this? I'm not clear on how you can tell. Thanks.