Bone turnover markers (CTX and P1NP): do you have a baseline?

this link works the above doesn't
https://www.ncbi.nlm.nih.gov/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html

Biote is the method of hormone optimization uses bioidentical hormone pellets, which contain testosterone and estrogen. The pellets are placed subcutaneously in the body in the upper buttocks and release a continuous stream of hormones. These pellets dissolve and are absorbed into the body.

@kristie2

Thanks Kristie. Ive had estradiol and testosterone pellets for over a year. Not called Biote though. I also take progesterone and estradiol vaginal cream.

@gravity3 I also take progesterone and use estradiol vaginal tablets

can someone please explain to me what are bone markers? It has not been mentioned at all by my endocrinologist. I have osteoporosis and will be taking Risedronate weekly. Also it seems no one takes Risedronate as I never have seen it mentioned here. Any information on it will be super appreciated. It seems everyone is getting shots and nothing oral.
Looking forward to your replies.

hi, dale. Bone markers measure residue in your blood or urine that is left by cells called osteoblasts building bone and the residue left by cells called osteoclasts that disintegrate the bone.
The most common and (I think) most reliable are P1NP for the building cells and CTX for the disintegrating cells.
These tests can be used to determine whether a medication is effective for you, so that you don't have to wait for dexa results.
Oral bisphosphonates have been the mainstay against osteoporosis, and are commonly given to patients whose T scores are under -2,5. There are injectable bisphosphonates zoledronate in the form of Reclast and Zoloft. They can deliver a higher dose because much of the oral dose is lost in the stomach. Then there are the anabolic injectables Tymlos, Forteo, Evenity--thought to be half anabolic and half antiresorptive. And finally Prolia which is antiresorptive through a different mechanism than the bisphosphonates.

@gently
Thank you for the explanation about bone markers; very appreciated.
My second question was about Risedronate. Do you or anyone you may know have had this bisphosphonate.? This will be my first medication for osteoporosis and honestly I am very concerned about all the bad things I read about the meds. One last question, are the bone markers tests usually given without having to ask the doctors about them?
Thank You!!

dale, I don't know anyone who has taken risedronate. It is most similar to (the more widely used) alendronate having an equal fracture risk protection profile while a slightly lesser bmd increase. Risedronate is the bisphosphonate I would take if I were cornered precisely because of it's less density gain. Bisphosphonates can reduce the effect of anabolic osteoporosis medications taken sequentially after risedronate.
Some studies show that risedronate has less a tendency to cause reflux, though a slightly greater tendency to cause stomach distress. There may be other reasons you are prescribed this medication, but your prescription makes me wonder if you are being treated by primary care rather than an endocrinologist. Still, if you aren't actually osteoporotic it could be the best medication for you. It you tell us your numbers we'll try to outguess your physician.
gently

@gently
I am seeing an endocrinologist; he actually prescribed Prolia but I refused to take it because of the rebound problem and also because it lowers your immunity. I suggested Risedronate because I had read that it was milder on the stomach than Alendronate which has been around forever. I am actually quite scared of the very serious side effects osteoporosis drugs have. My numbers: femoral neck T=-2.9; Total hip T=-2.4; Lumbar Spine, T=-1.7. Do you think Risedronate could help increase my BMD? Thanks for your help.

dale, you'll gain bone density on risedronate. Risedronate and the other bisphosphonates clad to the bone for many (pathologists say 10+) years. Bisphosphonates don't cover the bone in a fine sheath, but rather attach to mineral contend called hydroxyapatite. They block the cells that break down bone from attaching to the bone and cause them to self-destruct (apoptosis).
To maintain strong bone these cells that break down the one are followed by cells that build bone. Bisphosphonates slow down the renewal of you bones. Consequently, you collect bone instead of replacing it.
This collected bone is less vascular, less flexible and may sustain unresolved fissures. Because of this all of the antiresorptive medications including risedronate carry a risk (smaller with risedronate than the others) of bone necrosis in the jaw, with dental work, but also a risk of atypical femur fracture. So we are advised to take the medication for 3-5 years.
Your greatest risk is in the femur at -2.9, so you add to the risk incurred by risidronate. I would guess that you are pretty safe, still--
At -2.9 in trabecular bone, the kind of bone dominant in the femur, some doctors would rather see you on an anabolic like Forteo or Tymlos before taking risedronate. A 2% gain in the femoral neck is commonly seen after one year of risedronate.
I think you are wise to pass on Prolia. You might be even wiser to take Forteo. But risedronate is a happy middle ground.
Do you know the cause of your osteoporosis.