What are bio markers for bones?

hi mdm30
The biomarkers are residues left in the blood or urine that when measured give us a number amount for bone building and bone resorption.
The two most commonly used for osteoporosis are CTX for bone breaking down and P1NP
for bone building.
The numbers are used to determine if a particular medication is working for a patient. Serum draws are taken before treatment and after several months of treatment.
With antiresorptives like bisphosphonates and Prolia. A lower number of CTX is expected. With anabolics Tymlos and Forteo a rise in P1NP is expected.

Using these numbers can make sure that a patient doesn’t continue to take a medication that isn’t working for their bones.
Some medical providers don’t think the markers are necessary. And don’t write script for them. But they are becoming more commonly prescribed as doctors become aware of their value and reliability.
There are other bone markers some taken from urine samples.

P1NP is a peptide left in the blood by cleavage of type I procollagen molecules during collagen deposition by osteoblasts.
During bone resorption, osteoclasts secrete a mixture of acid and neutral proteases that degrade the collagen fibrils into molecular fragments, including C-terminal telopeptide (CTx). As bone ages, the alpha form of aspartic acid present in CTx converts to the beta form. CTX is a protein fragment released (as bone is digested by enzymes) into the bloodstream during bone resorption and it is a specific marker for the degradation of mature type I collagen.

Thank you. This info was very helpful.