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Bone turnover markers (CTX and P1NP): do you have a baseline?
Currently i am on forteo therapy with a couple bone markers tests done. However, I didnt have ctx or p1np tested before the start of forteo as a baseline, regrettably.
It is known that the CTX value varies greatly among different individuals, with a very wide range. For post menopausal women, the range could be 34 - 1037 pg/ml; while for perimenopausal women 34-635 pg/ml. Different labs also have a slight different range values.
CTX, a bone resorption (breakdown) marker, is heavily influenced by a number of factors, such as food intake, circadian variation and exercise/life style, etc.
Bone remodeling is a dynamic and complex process. CTX itself may not fully reveal the whole picture. The bone building marker P1NP, is a lot less influenced by external factors. Taking both into consideration at the same time may shed more lights than looking at CTX or P1NP alone.
For those who had their CTX and P1NP tested before treatment with a bone drug, could you share the results if you don't mind? Thanks a lot!
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@mayblin do you recommend still getting the btm markers after a fracture. I fractured hip and wrist 5 months ago and going for labwork next week.
Thank you!
Honestly I don’t know what I would do. If I know ahead of time that my insurance will cover the tests, yes I will.
This ‘baseline’ will likely be affected by the fractures. It might take a few more months to have a trending btms. With that said, P1NP may still have a meaningful increased reading after first couple of months to show tymlos’ anabolic effect. The readings of CTX and P1NP may just be off for a while.
I just got back my blood markers .
My CTX prior to treatment with Evenity was 933 then 4 months in was 316 and now prior to my 10th injection is 138 .
My P1NP was 77 , 67 and now 59 .
Same timeframe as CTX .
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1 ReactionThese are my baseline bone turnover markers:
CTX - 451
P1NP - 75
I did them at 8 am fasting. I am also 5 1/2 months post femoral neck fracture and wrist fracture so not sure how the scores are affected.
Any comments would be appreciated!
@kristie2 i think your bone markers are trending just wonderfully! The 10 month reading had CTX down much further, while P1NP not so much! This trend is hinting a great bmd improvement - let your Dexa at end of evenity prove it!
If I remember correctly, you are planning transdermal HRT after evenity? If so, do you have a dose in mind? Thank you.
Hi @bluebonnet242 your baseline bone markers (5.5 month after fracture) looked okay, my opinion. Some practitioners would like to see a lower CTX level, but your P1NP level compensated for it, although it’s hard to tell how much this set btms were influenced by the fracture healing process.
Were your fractures due to low or high impact accidents? Have you and your endo ruled out major causes of your osteoporosis, including sifting through your rx uses such as oral corticosteroids, ppi etc.?
Wish the drug of your choice - Tymlos help you greatly!
Thanks. My endo hasn’t asked me much. I asked her for some preliminary tests. My fracture was from a hard fall on cement. I have been a good walker and have worked out for many years. I have celiac and hypothyroidism and may have been over medicated. I took Armour thyroid which suppressed my tsh for years. The doctor was trying to keep my free t3 and free t4 in normal range. I don’t know if that has anything to do with it. Only steroid use was for a sinus infection and was not long term. I’ve had many fractures as a child. I did not like milk so lack of calcium as a child. I feel like it may have been from my celiac which took a long time to diagnose.
I have an appointment with another endo at Mayo in July and hoping she will know more.
I have been on BHRT using the pellets. I have had them inserted twice so far .
After Evenity which my last one is in July my endocrinologist wants me to go on Reclast . Unfortunately DEXA is only once a year but I will have my endocrinologist put in for it and see if they approve.
I see. You have two conditions that need to be well under control to ensure bone health and maximum effect of anabolic treatment. Your new consultation with endo at Mayo Clinic will for sure guide you through it. Wish you all the best!