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hi babs,
You can see the extent of remodeling because bone markers measure specific fragments released in the process. CTX is a fragment of type 1 collagen released in the bloodstream during resorption when the osteoclasts release an acid on bone. P1NP measures fragments cleaved from type 1 collagen when the osteoblasts fits the collagen into the pit letf by the osteoclasts.
I should have written your serum levels of markers reflect less rebuilding than higher number of balanced CTX/P1NP would.
The way we commonly look at the numbers, your's look perfect. The osteoclast/osteoblast couplet looks balanced. And the numbers are at the lower end of normal rather than the higher number.
In perfect balance you aren't removing more bone than you are replacing. And your BMD ( though not your bones) would be stable or (wouldn't change). We need higher balanced numbers to increase BMD.
(Unless,
we are taking bisphosphonates or Prolia. The antiresporptives completely alter the balance. Eliminating the remodeling process, increasing BMD by collecting older bone preventing renewal.) CTX/P1NP numbers are low when there isn't as much bone turnover.
Research hasn't revealed a perfect balance. The numbers aren't used for diagnosing osteoporosis. The are used separately to determine response to medications.
I'm leave this link because I like the video
https://www.youtube.com/watch?v=Cd0YT-OV97c
Replies to "hi babs, You can see the extent of remodeling because bone markers measure specific fragments released..."
Thanks so much for posting this video. It really provides a visual of Keith McCormick's explanations of osteoblasts, osteoclasts, osteocytes, coupling... It was uplifting to see something positive and encouraging to see the research on future treatment.
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@gently, I am starting to think I have a learning (processing) disability or maybe it's my anxiety kicking in. You said, "The way we commonly look at the numbers, mine look perfect, and then, "I should have written your serum levels of markers reflect less rebuilding than higher number of balanced CTX/P1NP would." Can you help me understand that? Message me privately if you prefer.
I liked the video, too. Thanks for attaching it. I haven't tried natto and it doesn't look too appealing. haha. Would these food suggestons make a difference once you have the diagnosis or are they preventative? I thought it was interesting that they called heel drops preventative and not for people with osteoporosis b/c they can cause fractures. Onero (Belinda Beck) includes them as part of her program.
There is so much to learn. Thank you very much for sharing your vast understanding. I have a lot of catching up to do!