1. < Osteoporosis & Bone Health

On Forteo 18 months - high CTX?

Posted by cat30064 @cat30064, Aug 27 10:28am

I need some help. I’ve been on Forteo for about 18 months. No gains, but no loses in bone density. I just got my 18 mo. test results. I’d love to stay on Forteo, but not sure if I should. My CTX is high, (see below) but perhaps moving in the right direction. P1NP is still decent. Any advice is appreciated to understand my CTX, P1NP and Osteocalcin results. My doctor does not support the tests.

P1NP
Pre Forteo - 34
3 month - 146
6 month - 231
12 month -250
*18 months - 200

CTX
Pre Forteo - 376
3 month - 858
6 month - 1232.
1 yr. - 1228.
*18 month - 927

Osteocalcin
Pre Forteo - 13
3 month - 43
6 mo. - 47
1 year - 63
*18 month - 98

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rjd | @rjd | Sep 19 10:20am
In reply to @gently "@midwestgirl I've been waiting for someone wise to answer your question, so I could read it...." + (show)
@gently

@midwestgirl
I've been waiting for someone wise to answer your question, so I could read it.
Because higher numbers represent more bone remodeling, it might be best when both CTX and P1Np are high. The tricky part is the ratio.
Decades ago there weren't medications that increased P1NP. Osteoporosis medications could only moderate the bone breaking down. So lower CTX was considered better.
But you need the bone to be broken down where it is weak so it can be replaced by stronger, unfissured bone. As CTX represents that clearing of older bone and P1NP represents the laying down of strong bone, I want high numbers of both working on my poor bones.
While I recommend questioning all of my suppositions, I offer one of my favorite videos which doesn't prove any point. https://www.youtube.com/watch?v=Cd0YT-OV97c

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The video you reference is excellent. For me, it was my 'aha' moment about understanding bone remodeling and the complimentary/interdependent roles of osteoclasts and osteoblasts.
Highly recommended.

REPLY
lynn59 | @lynn59 | Sep 20 9:49am
In reply to @cat30064 "I had my DXA at 14 months. No TBS software. But 2 years ago I had..." + (show)
@cat30064

I had my DXA at 14 months. No TBS software. But 2 years ago I had a REMS (Echolight) scan that showed good bone strength. My cause of osteoporosis is most likely age, no parathyroid issues. I will be 70 soon. I’m conflicted whether to stay on Forteo or try Reclast.

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My endocrinologist told me it takes awhile for new collagen to mineralize. You may show gains at the 2 year mark?

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