I apologize if my previous explanations about CTx to P1NP (CTx:P1NP) were unclear. Let me attempt to clarify here. But before I do, I'd like to share a simpler way to track treatment progress that I learned from a YouTube video from Dr. Doug Lucas posted last December.
You can watch it here: https://youtu.be/NgZf1Vu8UyM?si=elj8Y6u_bWMLY9UT

Dr. Lucas uses this equation:
P1NP ÷ (CTx ÷ 1000) = X

When the result (X) increases, it indicates you're moving in the right direction. Here are my results from January and April using this calculation:

- Before Evenity treatment (January): X = 95.5
- 2 weeks after the 3rd Evenity treatment (April): X = 287

The number went up dramatically with Evenity treatment, so I know that it's working.

Now, let me provide a clearer explanation of the 10:1 ratio:

A good ratio in this context means that for every unit increase in CTx (a marker of bone breakdown), we ideally want to see a proportional increase in P1NP (a marker of bone formation).

For instance, if the ratio is 10:1 (10 to 1), it suggests that for every 10 units of CTx, there is 1 unit of P1NP. This indicates a balance where some bone formation is occurring relative to bone breakdown.

If our goal is to increase P1NP, we should ideally see the ratio adjust accordingly. A higher ratio, like 10:2 or 10:3, would mean that for every 10 units of CTx, there are 2 or 3 units of P1NP, respectively. This higher ratio indicates more bone formation relative to bone breakdown, which is beneficial for bone health.

Therefore, a good ratio when aiming for an increase in P1NP shows a proportional or higher increase in P1NP compared to CTx, suggesting improved bone formation relative to breakdown."

I hope that's helpful. It can be a real brain twister.
If your goal is just to track treatment progress, I recommend using Dr. Doug's equation. It's far more straight-forward.