Bone turnover markers (CTX and P1NP): do you have a baseline?

You are using BHRT and evenity concurrently! I’m not familiar with pallets. What dose of estradiol do you use? Is there a blood level of estrogen you and your doctor are targeting at? Thank you!

The blood level for Estradial to help with BMD is 70 pg/ mine is at 69.6. The biote pellets have a mixture of testosterone & Estradial . Then I take progesterone by mouth nightly .

My spine T score of -4.6 made me think long and hard about starting hormone therapy. My endocrinologist is not a fan .

Thanks! My celiac is under control and has been for about 14 years but probably caused some issues prior to diagnosis. I’m super strict being gluten free. We’ve already reduced my thyroid meds in half so hopefully that will be enough. Hoping the Mayo endo will have some thoughts. Thank you for all of your thoughts and support!

Thank you very much @kristie2 for the information. It’s interesting to use BHRT pallets and evenity at the same time. You might get to know if the two will have synergistic effects. I’d assume you will use BHRT with Reclast that you and your endo planned after evenity, right?

If i finalize my follow-up med after FORTEO being transdermal HRT, I will need the dosing and timing schedule so thank you so much for sharing your experience!

My endo was against using the pellets she never gave me a good reason not to. Yes, I will continue to use them .

Just received my bone marker test result. They are fasting for 12 hours and blood drawn before nine am, as instructed by ordering physician:
CTX 231
P1NP 41
Also, (not listing very long results, but what seems most applicable here):
PTH Intact 23
Serum calcium 10.0 (was 10.1 12/23 before supplementing).
I am not yet on meds, but make sure to get 1200 mg calcium supplements /food daily and d3. No other supplements yet (have on list for doc magnesium and K).

My dexa was -3.6 spine and osteopenia everywhere else.

@babbsjoy, I'm sorry babbs, what was your history ? Have you just begun to decide on an osteodrug? What was your reason for this test?

@rola, My PCP ordered DEXA (a little early, I’m not 65 yet), and I was surprised with results. I have had initial visit with doc specializing in osteo. They test pretty extensively to try to determine cause, and at next visit with all info in hand, we are to discuss meds (which she did indicate would be necessary due to my dexa score in spine). I have no other known health issues. No fractures. My mom did have osteo…..

Hi @babbsjoy am glad that you had your baseline bone markers done. Your ctx looks great, while p1np could be better (higher). It's great that your endo is ruling out secondary causes. keep in mind also that certain meds such as corticosteroids, PPIs, SSRIs and AI etc. as well as certain conditions like kidney diseases, IBS or thyroid problems to name a few could have negative impacts on bone health. Osteoporosis has a heterogeneous etiology, but many postmenopausal women have it as a result of estrogen difficiency.

I had almost the same dexa results as you do at the time of diagnosis, although I'm a few years younger than you are. What's your frax number, if you don't mind me asking? With typical postmenopausal osteoporosis due to estrogen difficiency where L spine (trabacular in nature hence more bfu gets affected) were more deteriorated than hip or femur neck, Forteo or Tymlos are wonderful choices. Monitoring bone markers during therapy is a tool to check if the drug is working. What's more, btms could be used to guide therapy duration as well as for future plans should you elect a second course of anabolic therapy.

Please keep us posted.

Best wishes!

Very impressed with the medical care you are receiving! Sounds like you are in very good hands. Very thorough!