@mayblin you have a great memory. My "baseline" BTMS, if you can call them that, were very low indeed (CTx 115 / P1NP 11). They were done eight months after my one and only Prolia injection. That was the first treatment I underwent, and didn't do anything else before starting Evenity.
@mayblin you have a great memory. My "baseline" BTMS, if you can call them that, were very low indeed (CTx 115 / P1NP 11). They were done eight months after my one and only Prolia injection. That was the first treatment I underwent, and didn't do anything else before starting Evenity.
Prolia 8mo prior explained the low "baseline", thank you! Out of the three anabolics that are available, you and your endo picked the best one for your situation, in my opinion. What was your reasoning behind this choice?
Evenity's effects on bmds and btms are published in different trials, they more or less have similar results or trends. Your btms results especially ctx might be complicated by prior usage of prolia. Could now be the rebounding period when the antiresorptive effect of evenity is not enough to compensate it? You don't have a true baseline of ctx to compare to. The good part though, is that your p1np showed a great response to evenity early on at 2.5 mo, and is still trending higher (maybe start to plateau) at 5.5mo (this is a point when many trial data showing p1np dropping back towards baseline). Unlike forteo or tymlos, evenity building bones mainly via modeling process from what ive read (someone please correct me if this statement is incorrect). Because of this you may well see a good dxa improvement despite a "jump" (increase ~50%) ctx this time with "only" ~17% increase in p1np since coupling is not too relevant here. Time will tell. It will be nice to keep monitoring btms to see how the two will be trending. Wish you the very best going forward!
Prolia 8mo prior explained the low "baseline", thank you! Out of the three anabolics that are available, you and your endo picked the best one for your situation, in my opinion. What was your reasoning behind this choice?
Evenity's effects on bmds and btms are published in different trials, they more or less have similar results or trends. Your btms results especially ctx might be complicated by prior usage of prolia. Could now be the rebounding period when the antiresorptive effect of evenity is not enough to compensate it? You don't have a true baseline of ctx to compare to. The good part though, is that your p1np showed a great response to evenity early on at 2.5 mo, and is still trending higher (maybe start to plateau) at 5.5mo (this is a point when many trial data showing p1np dropping back towards baseline). Unlike forteo or tymlos, evenity building bones mainly via modeling process from what ive read (someone please correct me if this statement is incorrect). Because of this you may well see a good dxa improvement despite a "jump" (increase ~50%) ctx this time with "only" ~17% increase in p1np since coupling is not too relevant here. Time will tell. It will be nice to keep monitoring btms to see how the two will be trending. Wish you the very best going forward!
Mayblin, Thank you! I chose Evenity because it acts fast, provides the best results, and was recommended to me by three specialists. My first DEXA T-scores in 2023 at 53 yrs were lumbar spine -3.7, and left femoral neck -3.2, and I had had a compression fracture in 2020, so it made sense.
Mayblin, Thank you! I chose Evenity because it acts fast, provides the best results, and was recommended to me by three specialists. My first DEXA T-scores in 2023 at 53 yrs were lumbar spine -3.7, and left femoral neck -3.2, and I had had a compression fracture in 2020, so it made sense.
Hi mayblin, Has anyone on here has ever started a discussion for sharing the causes of our OP? That would be really interesting. If there isn't one already, I think it would be cool if you started one.
In my case, I may not have reached my full bone density potential. That's probably true, but I did gymnastics and cheerleading--lots of impact exercise--so that can't be the whole story.
Here's the list of potential contributors that my endocrinologist and I discussed:
I was malnourished as a child and young adult.
My hormones have been a mess since puberty. There was a whole year when my menstrual cycle stopped, and perimenopause started in my early 40s.
I have anxiety, and stress out easily, so I suspect my cortisol levels are high--not yet tested.
I got Giardiasis (a parasitic disease) when living in rural Thailand. I had it for several years before it was diagnosed. That may have had lasting effects on my digestive system causing further malnutrition as an adult.
Finally there's a genetic component--my 80 year old mother has had osteoporosis since her mid-50s.
I just got my BTMs from earlier this month two weeks after my 6th Evenity injections. I'm comparing them to my BTMs done in April two weeks after my 3rd injections, and curious if there's anyone having their BTMs done every three months. My P1NP went up a bit, but my CTx went up a lot. I know that it's to be expected with Evenity that it's efficacy will wain over time, but, to be honest, my CTx score concerns me. If it's this high now, how much higher will it be in another 6 months?
@hopefullibrarian
Hi, I was just thinking, possibly the test was off? These tests seem to be very sensitive and don't always give you the true picture. Will your Dr reorder the test for you?
Hi mayblin, Has anyone on here has ever started a discussion for sharing the causes of our OP? That would be really interesting. If there isn't one already, I think it would be cool if you started one.
In my case, I may not have reached my full bone density potential. That's probably true, but I did gymnastics and cheerleading--lots of impact exercise--so that can't be the whole story.
Here's the list of potential contributors that my endocrinologist and I discussed:
I was malnourished as a child and young adult.
My hormones have been a mess since puberty. There was a whole year when my menstrual cycle stopped, and perimenopause started in my early 40s.
I have anxiety, and stress out easily, so I suspect my cortisol levels are high--not yet tested.
I got Giardiasis (a parasitic disease) when living in rural Thailand. I had it for several years before it was diagnosed. That may have had lasting effects on my digestive system causing further malnutrition as an adult.
Finally there's a genetic component--my 80 year old mother has had osteoporosis since her mid-50s.
I also did not eat well as a child…I took nexium for 10 years….synthroid for 30…all contribute to osteo. I am doing the testosterone pellets etc. my dexa scores have improved since diagnosed ten years ago. I also take supplements exercise etc.
@hopefullibrarian
Hi, I was just thinking, possibly the test was off? These tests seem to be very sensitive and don't always give you the true picture. Will your Dr reorder the test for you?
Thank you. I hope you're right, though I did everything that Dr. McCormick suggests---fasting, no collegan or biotin for 48 hours, blood drawn first thing in the morning, then the same time each time. I'm going to redo the BTMs in October after the 9th injections, and cross my fingers. I've said to others in the past that the tests are a snapshot in time. If my CTx result is accurate, maybe my osteoclasts were just having an overly active that day (???). Trying to be optomistic.
I also did not eat well as a child…I took nexium for 10 years….synthroid for 30…all contribute to osteo. I am doing the testosterone pellets etc. my dexa scores have improved since diagnosed ten years ago. I also take supplements exercise etc.
Hi mayblin, Has anyone on here has ever started a discussion for sharing the causes of our OP? That would be really interesting. If there isn't one already, I think it would be cool if you started one.
In my case, I may not have reached my full bone density potential. That's probably true, but I did gymnastics and cheerleading--lots of impact exercise--so that can't be the whole story.
Here's the list of potential contributors that my endocrinologist and I discussed:
I was malnourished as a child and young adult.
My hormones have been a mess since puberty. There was a whole year when my menstrual cycle stopped, and perimenopause started in my early 40s.
I have anxiety, and stress out easily, so I suspect my cortisol levels are high--not yet tested.
I got Giardiasis (a parasitic disease) when living in rural Thailand. I had it for several years before it was diagnosed. That may have had lasting effects on my digestive system causing further malnutrition as an adult.
Finally there's a genetic component--my 80 year old mother has had osteoporosis since her mid-50s.
@hopefullibrarian thank you very much for sharing your personal story and experience. The sequencing you are doing isn't that common. There was a paper published on 2021 with results of this sequencing examing 2 doses of prolia followed by 12mo evenity, bmd results in table 2: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8260819/
Very likely 1 dose of prolia followed by 12mo evenity will have similar results and you are in the clear. Note that evenity's effect was attenuated after 2 doses prolia, however, overall bmd% increase with prolia to evenity holds well when compared to evenity alone during same time frame.
Between the two bone markers, ctx is more variable in nature but you had controlled all the premetrologic cause of variability in your power. That said, the overall variability of the markers is 10-15% measured in serum according to publications. If ordering and payment of btm testing are not a problem, getting them monitored frequently will offer lots of information. Please keep us posted and best of luck!
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@mayblin you have a great memory. My "baseline" BTMS, if you can call them that, were very low indeed (CTx 115 / P1NP 11). They were done eight months after my one and only Prolia injection. That was the first treatment I underwent, and didn't do anything else before starting Evenity.
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Helpful -
Hug
1 ReactionProlia 8mo prior explained the low "baseline", thank you! Out of the three anabolics that are available, you and your endo picked the best one for your situation, in my opinion. What was your reasoning behind this choice?
Evenity's effects on bmds and btms are published in different trials, they more or less have similar results or trends. Your btms results especially ctx might be complicated by prior usage of prolia. Could now be the rebounding period when the antiresorptive effect of evenity is not enough to compensate it? You don't have a true baseline of ctx to compare to. The good part though, is that your p1np showed a great response to evenity early on at 2.5 mo, and is still trending higher (maybe start to plateau) at 5.5mo (this is a point when many trial data showing p1np dropping back towards baseline). Unlike forteo or tymlos, evenity building bones mainly via modeling process from what ive read (someone please correct me if this statement is incorrect). Because of this you may well see a good dxa improvement despite a "jump" (increase ~50%) ctx this time with "only" ~17% increase in p1np since coupling is not too relevant here. Time will tell. It will be nice to keep monitoring btms to see how the two will be trending. Wish you the very best going forward!
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Hug
5 ReactionsMayblin, Thank you! I chose Evenity because it acts fast, provides the best results, and was recommended to me by three specialists. My first DEXA T-scores in 2023 at 53 yrs were lumbar spine -3.7, and left femoral neck -3.2, and I had had a compression fracture in 2020, so it made sense.
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1 Reaction@hopefullibrarian after reading your bio, I got curious. Did your doctors figure out what’s causing your op at such a young age?
Hi mayblin, Has anyone on here has ever started a discussion for sharing the causes of our OP? That would be really interesting. If there isn't one already, I think it would be cool if you started one.
In my case, I may not have reached my full bone density potential. That's probably true, but I did gymnastics and cheerleading--lots of impact exercise--so that can't be the whole story.
Here's the list of potential contributors that my endocrinologist and I discussed:
I was malnourished as a child and young adult.
My hormones have been a mess since puberty. There was a whole year when my menstrual cycle stopped, and perimenopause started in my early 40s.
I have anxiety, and stress out easily, so I suspect my cortisol levels are high--not yet tested.
I got Giardiasis (a parasitic disease) when living in rural Thailand. I had it for several years before it was diagnosed. That may have had lasting effects on my digestive system causing further malnutrition as an adult.
Finally there's a genetic component--my 80 year old mother has had osteoporosis since her mid-50s.
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Hug
2 Reactions@hopefullibrarian
Hi, I was just thinking, possibly the test was off? These tests seem to be very sensitive and don't always give you the true picture. Will your Dr reorder the test for you?
I also did not eat well as a child…I took nexium for 10 years….synthroid for 30…all contribute to osteo. I am doing the testosterone pellets etc. my dexa scores have improved since diagnosed ten years ago. I also take supplements exercise etc.
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Hug
4 ReactionsHi rola,
Thank you. I hope you're right, though I did everything that Dr. McCormick suggests---fasting, no collegan or biotin for 48 hours, blood drawn first thing in the morning, then the same time each time. I'm going to redo the BTMs in October after the 9th injections, and cross my fingers. I've said to others in the past that the tests are a snapshot in time. If my CTx result is accurate, maybe my osteoclasts were just having an overly active that day (???). Trying to be optomistic.
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Hug
2 Reactionsnme1985, Thank you for sharing. I'm so glad your BMD is moving in the right direction. It's an inspiration.
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1 Reaction@hopefullibrarian thank you very much for sharing your personal story and experience. The sequencing you are doing isn't that common. There was a paper published on 2021 with results of this sequencing examing 2 doses of prolia followed by 12mo evenity, bmd results in table 2:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8260819/
Very likely 1 dose of prolia followed by 12mo evenity will have similar results and you are in the clear. Note that evenity's effect was attenuated after 2 doses prolia, however, overall bmd% increase with prolia to evenity holds well when compared to evenity alone during same time frame.
Between the two bone markers, ctx is more variable in nature but you had controlled all the premetrologic cause of variability in your power. That said, the overall variability of the markers is 10-15% measured in serum according to publications. If ordering and payment of btm testing are not a problem, getting them monitored frequently will offer lots of information. Please keep us posted and best of luck!
-
Like -
Helpful -
Hug
3 Reactions