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Bone turnover markers (CTX and P1NP): do you have a baseline?

Posted by mayblin @mayblin, Mar 27 11:05am

Currently i am on forteo therapy with a couple bone markers tests done. However, I didnt have ctx or p1np tested before the start of forteo as a baseline, regrettably.

It is known that the CTX value varies greatly among different individuals, with a very wide range. For post menopausal women, the range could be 34 - 1037 pg/ml; while for perimenopausal women 34-635 pg/ml. Different labs also have a slight different range values.

CTX, a bone resorption (breakdown) marker, is heavily influenced by a number of factors, such as food intake, circadian variation and exercise/life style, etc.

Bone remodeling is a dynamic and complex process. CTX itself may not fully reveal the whole picture. The bone building marker P1NP, is a lot less influenced by external factors. Taking both into consideration at the same time may shed more lights than looking at CTX or P1NP alone.

For those who had their CTX and P1NP tested before treatment with a bone drug, could you share the results if you don't mind? Thanks a lot!

Interested in more discussions like this? Go to the Osteoporosis & Bone Health Support Group.

mayblin | @mayblin | Oct 5 9:09am
In reply to @balake "Question: 60 year old Male. Pretty Athletic. Delayed back surgery due to Osteoperosis. My CBeta-CrossLaps (B-CTx),..." + (show)
@balake

Question:

60 year old Male. Pretty Athletic. Delayed back surgery due to Osteoperosis.
My CBeta-CrossLaps (B-CTx), S is: 1105
My Procollagen I Intact N-Terminal, S is: 106
Makes my ratio around 10:1
Do these numbers seem oddly high, or is this relatively common?
Responses from two doctors" one shrugged and said it didn't mean much, the other seemed shocked and suggested drugs.

Also, should I be fasting and taking test in the mornings?

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Hi @balake I agree with @gently, if this is your baseline bone marker readings, the CTX looks high. For males around 60yo, the upper boundary of reference range for CTX seems to be in the 700s (although an Europian assay renders 1000-1100 CTX reading for upper reference range) - it could vary somewhat with different assays and maybe among different ethnicity. Your P1Np reading is good, most likely due to the coupling effect. Unless you had a recent fracture and/or immobilization which could increase CTX and P1NP, it's worth looking into the cause(s).

Have you taken any osteodrug(s)?

REPLY
kar50 | @kar50 | Oct 5 10:44am

I had no knowledge of bone resorption biomarkers until I found this group. Through you all, I learned to seek out an endocrinologist who has been wonderful. After months of tests, including my recent 24 hour urine calcium, and her consulting with a blood oncologist for other detailed blood findings, we finally agreed on starting Forteo. Through this support group I found Keith McCormick and the biomarker info. Last week I asked my endocrinologist about that before starting Forteo, and she said she would be happy to prescribe the lab (fasting) but that currently this info will not affect or guide my treatment, that (Kaiser) current medical science can't utilize the data effectively. So, I'll have the data and look for further guidance from this incredible Mayo Clinic Support Group.

REPLY
gently | @gently | Oct 5 5:35pm

@kar50,
excellent choice: Forteo.
The provider I see has the same idea about bone markers. He always orders both CTX and P1NP for all of his patients, but says he doesn't use them for treatment patterns. I'm a little fascinated with the markers and will enjoy seeing yours particularly with Forteo.
Some people experience adverse events. Tell us everything.

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