loriesco, in the olden days all that could be controlled were the osteoclasts (reflected by serum CTX). With the approval of anabolic drugs controlling the osteoblasts (reflected by P1NP) provided a better option.
If the medication lowers osteoclasts it will eventually lower osteoblasts. The literature, the protocols and guidelines are anchored in the past and slow to change. It remains true that bisphosphonates when they work lower both building and losing bone. They are intended to stop remodeling and to add density to the bone gradually by the accretion of old bone.
Remodeling, now that's the work of the osteoblasts they move into the areas that where osteoclasts have cleared out bone that has become weak or fissured. The fill in the bone then settle in becoming osteocytes which have the task of realigning in accordance with reverbrations of your activities. so that your bones have resilience with the direction of impact. I don't jump off roofs or out of airplanes anymore; my spicules are realigned for hard running. So I'm less likely to develope bone fissures from this new activity. Thanks to Forteo.
The bone markers are in a toss. Its still a little fringe to use them together, no matter how much sense it makes. How to use them together will be a slow process of discovery littered with multiple opinions.
I'm of the mind that there is a best ratio. It could be reflected in the morning draw, but maybe we miss important information if the osteoclasts are the night workers. I want a fairly close ratio and I want the numbers both on the higher end.
But everything I write should be viewed with suspicion.