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Bone turnover markers (CTX and P1NP): do you have a baseline?
Currently i am on forteo therapy with a couple bone markers tests done. However, I didnt have ctx or p1np tested before the start of forteo as a baseline, regrettably.
It is known that the CTX value varies greatly among different individuals, with a very wide range. For post menopausal women, the range could be 34 - 1037 pg/ml; while for perimenopausal women 34-635 pg/ml. Different labs also have a slight different range values.
CTX, a bone resorption (breakdown) marker, is heavily influenced by a number of factors, such as food intake, circadian variation and exercise/life style, etc.
Bone remodeling is a dynamic and complex process. CTX itself may not fully reveal the whole picture. The bone building marker P1NP, is a lot less influenced by external factors. Taking both into consideration at the same time may shed more lights than looking at CTX or P1NP alone.
For those who had their CTX and P1NP tested before treatment with a bone drug, could you share the results if you don't mind? Thanks a lot!
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How much can lack of sleep affect CTX values? For some reason, I was only able to sleep in half hour to hour periods of time before my recent blood draw. My CTX value 2.5 years ago was 210; now it was 326. Patiently waiting for the P1NP result. Don't want to have my endo try to frighten me about the increase if not necessary. I have not started any treatment yet.
@normahorn
I’ve read some studies on this. My takeaway is that in postmenopausal women, CTX levels do not significantly increase after acute sleep restriction, unlike in healthy premenopausal women where increases of around 30% have been observed. The effect on P1NP (usually a decrease) is also less pronounced in postmenopausal women. However, chronic sleep disturbances could contribute to higher CTX levels over time.
Given that, the increase from 210 to 326 over 2.5 years is more likely due to natural long-term variation in bone turnover rather than a single night of poor sleep. The acute sleeplessness may have a small effect on CTX, but it may not be enough to explain this magnitude of change (a 55% increase). A CTX of 326 is still fairly “calm” in terms of bone resorption, so it will be very interesting to see what your DXA shows with these lower-level CTX values.
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4 Reactions@mayblin
I did NOT ask for any further discussion on the results; just whether a very restless night could affect the results.
@normahorn
Understood. The information you asked for is in the first paragraph of my earlier reply. You can skip anything beyond that.
Just got confirmation regarding a reason my CTX and P1NP values are higher than they were 2 years ago without any treatment. It can take 6 months for the values to return to normal after a fracture and I had a hairline fracture in my radius 3 months ago.
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1 Reaction@michaellavacot Make sure you do NOT consume more than 600 mg of calcium (diet or other) at any given time as your body can only absorb 600mg or less at a time and the rest get thrown out (via urine). Secondly, the standard now is a total of 5-600 mg of calcium for the entire day is sufficient (preferably from diet).
@tpinheiro29
Can you provide a source for the new guideline?
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