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Support For Those Quitting Prolia

Osteoporosis & Bone Health | Last Active: 1 day ago | Replies (152)
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@formisc

I have received the results of my third BTM blood test done in early Sep 2024 after 36 weeks of Alendronate following cessation of Prolia.

To recap - I did 3 half-yearly Prolia injections in Jul 2022, Jan 2023 and July 2023 and started on Alendronate at end-Dec 2023. My first BTM was in early Mar 2024 after 10 weeks of Alendronate and my second BTM was in end-May after 22 weeks of Alendronate. I do not have any baseline BTM numbers. As per my opening post, I am sharing my BTM results in case it proves useful to anyone else monitoring their own exit from Prolia

CTX 54 pg/mL (May: < 50; Mar: 51)[range 171-970]
iPTH 4.4 pmol/L (May: 3.2; Mar: 3.5)[range 1.6-6.9]
Calcium (corrected) 9.1 mg/dL (May: 8.7; Mar: 8.3)[range 8.8-10.2]
Albumin 3.9 g/dL (May: 4.1; Mar: 4.1)[range 3.5-5.0]
Vit D 46.7 ng/mL (May: 43.3; Mar: 42)[range 30.0-99.9]

My CTX remains low. Am in fact, a bit relieved that it now again has a reading and is no longer the mysterious, numberless '< 50' ! Both calcium and Vit D have continued to increase since i upped my daily supplemental intake to around 900mg of calcium and 2000 IU of D3. iPTH has gone up too while albumin has decreased

Any insight or comments on the above numbers is very welcome

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Replies to "I have received the results of my third BTM blood test done in early Sep 2024..."
cmdw2600 | @cmdw2600 | Sep 16 6:54am

My integrative medicine doctor informed me that K2 should be taken with D3. I believe it’s for better absorption, but you should look it up.

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rjd | @rjd | Sep 18 11:24am

I share your relief to learn that your most recent CTX test number has presumably increased and is now measurable.

And I am heartened to also learn you have a well-designed plan to reduce the alendronate dosage perhaps with the aim, in part, of increasing your low CTX number whilst avoiding Prolia related 'rebound.'

I hated thinking with such a low CTX number, new bone might be forming on top of a less than ideal foundation of old bone because it is not undergoing osteoclastic grooming/preparation.

Are you monitoring your iPTH level for a particular reason? And could that reason be connected to the low CTX number?

Also you implied in an earlier post that you stopped Prolia because you had problems with it. What sort of problems did you experience?

I need to start thinking about weaning myself from post-Prolia alendronate but should perhaps wait until I have another CTX test in December (had no baseline.)By then, it will have been 2 years since my last Prolia injection, well past any 18 month rebound window.

My one and only CTX score was 313, taken last May after one year on alendronate which was started when my 3rd Prolia injection was due.

Would prefer for the CTX number to go down a bit more but it does not appear worrisomely high standing alone. Just wish I understood better what it means in relation to my P1NP result and to somehow knowing that the resulting bone formation is producing something strong, not just dense. I am very keen about not confusing bone density and bone strength.

Perhaps I will copy your alendronate reduction strategy .....if so, do I have your permission to call it the 'formisc step-down approach?'

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