awesomemomx2, good thinking about P1NP.
I think everything is in the ratio. My CTX hasn't ever been below the baseline of 294. I don't see a ratio imbalance until CTX is in the 600s. At 424 pg/ml CTX with 128 P1NP mcg/L , my body is building bone.
Usually when the med lit talks about high bone turnover, the reference is to high bone dissolution. I'm
after high bone turnover that results in dissolution of damaged bone followed by new bone placement.
I have noticed that following P1NP after antiresorptives is unusual.