Blood Marker Testing

@gently, here is the video. Nelson Watts is speaking and this particular part of the conversation starts at about 39:55.

@glojo, I share the analysis paralysis condition. It's hard b/c there is so much conflicting information. How do you (personally) go about deciding who and what to believe?

Thanks.

That’s a hard question! In the end, after listening to all the experts, reading so many research papers, and hearing individual stories, I trust myself to eventually synthesize the information and proceed down a path that makes most sense for me. But I always remain open to changing course when I am presented with more facts. It’s like checking your multiple choice test answers…..go with your first choice unless you know for sure there is a reason to change your answer. When you just don’t have a clue, select C. That video was fascinating….I would probably trust any of those doctors who spoke, yet they disagreed on many points, so there’s that…..

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.

I watched the whole video and was especially interested in the second half. Around the one hour mark they mention adjustable doses of Tymlos as being an advantage of that medication and that they have seen patients on 1/2 dose have robust increases in P1NP.

The discussion of hormones (testosterone) as interesting and I felt there was little bit of a put down of the one female participant (she reasonably thought Prolia may have caused the patient's atypical femur fracture after some years on a bisphosphonate as well). That option is not available to me due to past cancer. The idea that increases in muscle mass improve quality of life for someone with several vertebral fractures was relevant for me and wish I could take it!

The video contains the usual discordance of opinion on bone markers. My P1NP was pretty low after 18 months on Tymlos and some docs would continue and others wouldn't.

I have seen the small study mentioned that Evenity might be a good follow-up for Prolia. More needed because Prolia is effective, just too risky to stop.

For some of us this gets less and less complicated as we react to some drugs or develop health conditions or whatever that limit our options! I am down to Tymlos as tolerable and we'll see how I do with lower dose Reclast. My concern is whether I can do Tymlos again since on the video they say that extending Tymlos use past 2 years is unlikely because the company doesn't have the ability to do a study the way Lily did for Forteo.

Looks like I am done with choices and can only do Reclast. Not sure what happens after a year or two!

By the way I hurt my back badly last week but x-rays show no new fractures. Six or seven preexisting ones, curvature, scoliosis, arthritis, degenerative changes. Not pretty but stable thanks to Tymlos.

I self inject my Evenity and I have a Medicare advantage plan and I very quickly get in the donut hole and I am paying $599 . A month .

I just received my blood marker test results and don't know what to make of it. I had an appointment with my endocrinologist tomorrow, but I just learned that they switched my appointment to be with a brand new nurse practitioner. I'm afraid that she won't be helpful. I have been on 40 mcg of Tymlos for 6 months. Both blood draws were at the same time early morning at the same lab. I stopped calcium, Vitamin B and collagen 48 hours before.

December, 2023 May, 2024
P1NP 78 P1NP 190
CTX 519 CTX 1401

Do these results make any sense?

@drsuefowler, I wish I could answer. Hopefully the NP will be able to help you.

windyshores, Miller comments in the video that the porosity with Forteo was only seen in monkeys. The theory of cortical steal comes from monkey bone. They don't even walk like we do.
The response to Susan Nattrass and the use of testosterone was two snaps about no evidence. Alternately the purely hypothetical computer generated concept of decrease in hip strength with Forteo from Nelson Watts remained unchallenged.

They seem to make sense if you are on a bone builder? It shows more bone turnover activity. Your P1NP is up which shows an increase in osteoblast activity and the CTX is also up, indicating the osteoclasts are removing bone to make way for the new bone. Are the numbers balanced like they should be? Hopefully a medical professional can help you with that.