I’ve been on 5 different osteoporosis meds, and I had terrible side effects from all of them. I just started hormone replacement therapy, it’s the last tool in the toolbox for me.
Have you tried Evista(raloxifene) it’s a SERM. It’s works like estrogen on bone receptors, but does not act like estrogen in places you don’t want it, like breast tissue. This was the last osteoporosis drug I took. The side effects were the least intolerable of all the others, but I wasn’t comfortable taking it. It’s the least effective of all the treatments though.
There are 2 bone markers - these are blood tests -
CTX or sometimes referred to as NTX - this marker looks at bone resorption, the bone breakdown or osteoclast activity. P1NP looks at bone building or osteoblast activity.
Depending on which drug you are taking, your doctor would expect to see a reduction in one or an increase in the other.
If you are taking teriparatide, this is an anabolic or bone builder so you would expect to see a higher P1NP.
If you were taking Prolia, an antiresorptive, which diminishes bone breakdown, you would expect to see a lower CTX.
It’s always best to get the bone markers at baseline before you start treatment so that you can determine the success of the treatment after taking the drug for a bit and then being retested.
Make sense?

cs53,
bone turnover markers measure particles in the serum that tell you if you are adding or resorbing bone. It tells you if a medication is working for you. Some suffer the side effects of a drug one or two years (until their next dexa only to find out that the medication wasn't effective.
CTX and P1NP each measure a specific fragment left in the blood during each process. It is best measured before the drug and two or three months after beginning to take the drug.
With drugs that work by preventing resorption of the bone CTX is the fragment that should be lowered. With drugs that work by building bone P1NP is the fragment that should rise while taking the anabolic.