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@zygote

Thank you for your response. It gave me pause and I spent some time really looking at my results. Your lab is measured in Liters, mine in milliliters. I tried converting my results to Liters and it's nutty .. a negative number. I had asked for a P1NP which, apparently, he had never ordered because he couldn’t find the code in Quest and ordered it in LabCorp. But I see now- that the lab he ordered was a propeptide type 1 collagen, not a procollagen type 1 intact N terminal peptide. Looking up the differences it says : Procollagen type I intact N-terminal propeptide (PINP) and propeptide type I collagen both relate to bone formation but differ in their detection and clinical uses. P1NP refers to the intact N-terminal propeptide of type I procollagen, while propeptide type I collagen can refer to either the N-terminal or C-terminal propeptides released during procollagen processing. P1NP is a sensitive marker for bone formation and is often used to monitor osteoporosis and bone health.
Feb 2025 the labs from LabCorp result of 715 was propeptide type 1 collagen. (7months of Tymols)
May 2025 labs were from Quest and the result of was P1NP 250mcg/ml and CTX. 1213pg/ml
Confusing, but it makes me feel better knowing that the high number of 715 really was not a P1NP but a differnt marker .

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Replies to "Thank you for your response. It gave me pause and I spent some time really looking..."

I just asked my son to do the math. I'm way off. P1NP 250mcg/ml= 250,000 mcg /L . if that is correct ..yikes.

I see. There are two similar bone formation markers:
P1CP - your endo might have ordered this one at first? and
P1NP which is more sensitive and more commonly used.
Their reference ranges are slightly different when expressed with same unit of concentration. So your response to Tymlos at 7mo was a huge one no matter which marker was tested.

P1CP: Procollagen type 1 C-terminal propeptide
P1NP: Procollagen type 1 N-terminal propeptide

The order code for P1NP is 16609. Quest CPT code is 83519 if this helps.