Help needed comparing CTX & P1NP results

jozer, the bone markers aren't prescribed by many physicians. Some consider the assays unreliable, and consequently without signification.
Fosamax represses bone turnover which increases the risk of osteonecrosis of the jaw and atypical femur fracture. Given your previous hip fracture and the lack of gain in the left hip, you might consider your density numbers in that left femur while considering your options.
Stomach issues on the injectable bisphosphonates are less problematic because they avoid the alimentary canal. If your IBS is not autoimmune it might not have to be a consideration.
I'm partial to the bone building drug Forteo.

@gently the YouTube video you recommended is perfect! I’ve been watching it the last two mornings on the exercise bike and getting a lot out of it! It’s also over my head and I’m so impressed by your knowledge and experience and your ability to understand and digest it all! Since I am involved in my high school reunion leading the committee and getting a 19 piece show of my art up next week, my brain can only hold so much so I am taking away generalizations and Hope to watch the video over again so I can retain more of it in preparation for my meeting with the NP on May 29. What I am getting out of the information is that as horrible as the RECLAST was on the first go around and the TYMLOS with the malaise, I experienced the first two months because of my drug sensitivity and not being told to titrate up — in the end. They were the perfect prescription for me and the test results are proving that. I have questions but I’m going to wait till I really get a better handle on this. I’ll have my annual DEXA in a couple months and I think that will be the kicker on top of the blood tests! Thank you for your generosity and support in this process. This group at the Mayo Clinic forum online, I find, is so vital and helpful!

I was merely trying to make sense of these lab results based on the information from readings @gently

If loriesco had more frequent labs, then perhaps the trend could reveal more information than the info from 2 data points? My understanding of bone markers is very limited. Hope other chime in to offer their perspectives.

My baseline: P1NP 67, CTX 225

I have had 3 quarterly blood tests with the following results following Evenity treatments (9 as of now):
P1NP: 157-100-71
CTX: 235-198-224

I am not sure how to understand these results, especially the last one: if I’m back to the baseline, does it mean my Evenity treatments yield good or bad results?

I have not done DEXA yet since June 2024.

Any help would be appreciated.

@yingjichi, the figure below shows the changes of P1NP and CTX during 12 month romososumab (evenity) treatment from phase 3 trial. I think your results fit as expected, considering variations exist among individuals. Fingers crossed for a great DXA results!

Were you on any bone meds before evenity therapy?

What follow-up med you and your physician are planning after the completion of evenity?

Thanks for sharing!

Thank you for the curves! Along with Evenity, I also changed my lifestyle mainly protein rich diet and added exercises. I am feeling stronger and have resumed hiking with some elevations.

My Endocrinologist suggested Prolia, saying it’s safe and effective and can be taken for many years. I hesitate due to reported potential rebound fractures (I had several spine compression fractures in 2024). I’m leaning towards Reclast despite reported side effects. I’d rather suffer side effects than having more fractures.

I took Fosomax for 2 years long time ago when I was first diagnosed osteoporosis but stopped without any other medication.

Thanks.

Hi, I didn’t see this and just posted a new related question, I hope some on this thread will see. I was on alendronate for 4 years, the first Dexa was good, but the at 4 years showed bone loss. The endo said my labs showed I was absorbing alendronate well, and calcium was good , but even so, it wasn’t working for me, so prescribed Evenity. But I am puzzled about why the labs would show good absorption and the DEXA outcome would still show bone loss. I do have RA, am very slight, and have other risk factors. Any insights on good lab, poor outcome welcome. Thank you.

Don't let one DEXA rule your life. My DEXAs were the opposite! Turns out my cervical bones were paper thin and C5 fell apart and I had to be rescheduled for a big massive surgery via my backside. WHY?! Because the Dexa's are general. They are only done on certain bones. Make sure you have a DEXA with a TBS score done. (look what TBS is) it standardizes your test. Maybe @gently can help with explaining the TBS (I have to get an art show hung today). There are bone xrays that also help. My orthopedic surgeon always looks and compares year over year.
Yes, my labs over the year showed good but the reality is my bones demineralized - even with great calcium scores! You can have good or bad scores and be the opposite. Good for you for trying something else. Don't forget to exercise. I am slight too. At 68 my genetics are in control and I am degenerating as did my ancestors! I am also on bioidentical HRT because I was for 10 years, 10 years ago and my bones were in better shape. It takes a lot of stuff to stay strong and slow down the effects of aging.