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Hyperparathyroidism caused osteoporosis--now what treatment?

Posted by sebutler @sebutler, Dec 24, 2024

I had hyperparathyroidism for 10 years before my doctor noticed (!!), and as a result developed severe osteoporosis. The parathyroid problem has been fixed (with surgery), and I've been on Tymlos for a year, with no side effects, thankfully. My rheumatologist usually keeps patients on Tymlos for 2 years, then moves to Reclast for 3 years. I am terrified of taking any bisphosphanates, since my teeth are really bad and I could possibly need an extraction in the next year or so. Has anyone had osteoporosis due to hyperparathyroidism? I'm wondering if, now that my PTH levels are normal, maybe my body will start developing new bone on its own and stop resorbing bone. So maybe I don't have to go on Reclast???

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sebutler | @sebutler | Jul 29 8:15pm

Great info, gently!! Question: Wouldn't it be better than -- that is, one could get a more consistent value, and one that would say a lot about bone breakdown -- to have an NTX test rather than a CTX??

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sebutler | @sebutler | Jul 29 8:35pm
In reply to @sebutler "Great info, gently!! Question: Wouldn't it be better than -- that is, one could get a..." + (show)
Profile picture for sebutler @sebutler

Great info, gently!! Question: Wouldn't it be better than -- that is, one could get a more consistent value, and one that would say a lot about bone breakdown -- to have an NTX test rather than a CTX??

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Ooops -- correction: Wouldn't it be better then ....

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gently | @gently | Jul 29 11:23pm
In reply to @sebutler "Great info, gently!! Question: Wouldn't it be better than -- that is, one could get a..." + (show)
Profile picture for sebutler @sebutler

Great info, gently!! Question: Wouldn't it be better than -- that is, one could get a more consistent value, and one that would say a lot about bone breakdown -- to have an NTX test rather than a CTX??

Jump to this post

sebutler, CTX is thought to have less in-person variability and is preferred over NTX. https://news.mayocliniclabs.com/2023/08/07/laboratory-testing-of-bone-turnover-markers/
I think because of flow and dilution. Blood being of more consistent volume.
I have read that NTX is less susceptible than CTX to variations caused by circadian rhythm and food intake.
I'm curious about how you arrived at the thoughts about which would be better.

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sebutler | @sebutler | Jul 30 5:52am
In reply to @gently "sebutler, CTX is thought to have less in-person variability and is preferred over NTX. https://news.mayocliniclabs.com/2023/08/07/laboratory-testing-of-bone-turnover-markers/ I..." + (show)
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sebutler, CTX is thought to have less in-person variability and is preferred over NTX. https://news.mayocliniclabs.com/2023/08/07/laboratory-testing-of-bone-turnover-markers/
I think because of flow and dilution. Blood being of more consistent volume.
I have read that NTX is less susceptible than CTX to variations caused by circadian rhythm and food intake.
I'm curious about how you arrived at the thoughts about which would be better.

Jump to this post

I was just thinking that since CTX is so variable by time of day, that NTX might be more consistent.

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mayblin | @mayblin | Jul 30 8:15am
In reply to @meri8181 "I Didn’t know which thread to put this on so sorry if I’m incorrect. Here’s what..." + (show)
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I Didn’t know which thread to put this on so sorry if I’m incorrect.
Here’s what I sent to my Endocrinologist and her reply.
I don’t understand it.

“Hello Meridith,

We have checked one of the bone turnover marker COLLAGEN XLINK N TELOPEPTIDE,UR,RANDOM.

Component
Ref Range & Units (hover)
2/9/24 1439
N-Telopeptide
39
Comment: Note

Adult Female Reference Range for Collagen Cross-
Linked N-Telopeptide (NTx), Random Urine

Premenopausal: 4-64 nM BCE/mM creat

Component
Ref Range & Units (hover)
7/2/25 0907
N-Telopeptide
60
Comment: Note

Adult Female Reference Range for Collagen Cross-
Linked N-Telopeptide (NTx), Random Urine

Premenopausal: 4-64 nM BCE/mM creat

Again those bone marker are not for making decision on treatment options. Those are somewhat useful to monitor once you have started on osteoporosis medications.

Best regards, “

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Hi @meri8181, your uNTX, which is a bone resorption marker, seemed to trend upward from 2/2024 to 7/2025. I noticed numbers like 1439 and 0907 next to the dates - maybe those are time stamps? Like CTX, uNTX levels can vary depending on the time of day - they tend to be higher in the early morning and lower later in the day. If the urine collection times were different, that might explain the change and there may not be a big shift after all.

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