bone markers

I finally received the pre authorization from insurance for Tymlos and had my labs done yesterday. I requested bone turn over markers specifically, CTX and P1NP, my lab results came in this evening and I’m worried that I did not get the P1NP
was ordered is:
CREATININE, SERUM
ALBUMIN
CALCIUM
VITAMIN D 25 HYDROXY
C-TELOPEPTIDE- which I think is the same as CTX?
BONE SPECIFIC ALKALINE PHOSPHATASE- does anyone know if this could be instead of the P1NP and if so is it ok to use for my markers prior to starting the Tymlos? I am asking here because it’s Friday so I can’t call the dr. office plus it’s almost impossible to get an answer from the dr. I waited 6 months to see him. This all started a year ago so I’m anxious to start the med as soon as possible even though I first said I’m would not take any drugs. LOL
The Tymlos has to come from a specialty pharmacy which may be another delay because there is not one in my area. I did located one 3 hours away but don’t want to start the process of filling the prescription until I know I have the correct labs done.
I appreciate clarification on the bone specific alkaline phosphate lab.
Thanks

@lurawilson, bone specific alkaline phosphatase bsap is also a biomarker used to assess bone formation, it reflects bone mineralization process. P1np, another marker for bone formation, reflects collagen synthesis. It looks like your endo will use BSAP to monitor your therapy progress.

C telopeptide is CTX.

I finally received the pre authorization from insurance for Tymlos and had my labs done yesterday. I requested bone turn over markers specifically, CTX and P1NP, my lab results came in this evening and I’m worried that I did not get the P1NP
was ordered is:
CREATININE, SERUM
ALBUMIN
CALCIUM
VITAMIN D 25 HYDROXY
C-TELOPEPTIDE- which I think is the same as CTX?
BONE SPECIFIC ALKALINE PHOSPHATASE- does anyone know if this could be instead of the P1NP and if so is it ok to use for my markers prior to starting the Tymlos? I am asking here because it’s Friday so I can’t call the dr. office plus it’s almost impossible to get an answer from the dr. I waited 6 months to see him. This all started a year ago so I’m anxious to start the med as soon as possible even though I first said I’m would not take any drugs. LOL
The Tymlos has to come from a specialty pharmacy which may be another delay because there is not one in my area. I did located one 3 hours away but don’t want to start the process of filling the prescription until I know I have the correct labs done.
I appreciate clarification on the bone specific alkaline phosphate lab.
Thanks

Thank you mayblin,
so after 3 months of Tymlos I should get the ctx and bsap labs again to see if the Tymlos is working? I want to,stay informed in order to communicate with my dr. Currently my ctx is 389 and bsap 8.2 Can you direct me to information where I can find information about bsap and what to look for? I only find info on p1np.

@lurawilson, bone specific alkaline phosphatase bsap is also a biomarker used to assess bone formation, it reflects bone mineralization process. P1np, another marker for bone formation, reflects collagen synthesis. It looks like your endo will use BSAP to monitor your therapy progress.

C telopeptide is CTX.

Is one better than the other? I would like to get started on the Tymlos if BSAP bone marker is ok to use along with the CTX rather than P1NP. It takes so long to get an appointment or answers from my endo that if BSAP is similar to P1NP I’d rather not push or wait to get labs for P1NP and use the BSAP the dr. ordered.

This is a good question. To be honest I don’t know enough to give a proper answer. What I know is IOF (International osteoporosis foundation) and a few others endorsed P1NP as a preferred bone formation marker for osteoporosis assessment and monitoring around 2011. However, BSAP continues to be used by some physicians - it must have its place clinically.