New DX with a lot of Confusion and Stress

@2young4bones, P1NP is the fragment left in the bone after specific protein-cutting enzymes cleave off extension peptides from the procollagen molecule before it forms collagen fibers. The N-terminal propeptide (P1NP) is one of these removed fragments, released into the bloodstream. Measured they stand to represent the action of the cells that build bone, just as CTX represents the action of cells that break down bone.
They are both sourced through a simple blood draw that should be done fasting, early in the morning after an interlude from biotin and collagen.
The standard use is CTX before dosing with an antiresorptive and again after 2 months; P1NP before use and after a month of use. Primarily it is used to ascertain that the medication is effective.
If the original plan was to take Tymlos, P1NP would be (have been) useful.
I think that they should always be measured together. But, I haven't done the long arduous studies required to be a doctor.

@jozer

Is there a reason why you have it been prescribed an anabolic like forteo, tymlos or evenity yet?

@dvargo so are you saying no treatment based on the risks after treatment? I thought some of the anabolic options built bone in different way and biphosonates only added to the outer layer. Anyone know that to be true or false?

@dvargo that's why I'm interested in hrt during and after treatment. Frankly, in reading more posts, I'm getting scared to start Evenity as many ppl say they have bad side effects. My husband just battled head and neck cancer and I'm the majority bread winner so we can't afford me to be down and out for days each month. How is anyone supposed to make an informed decision when it seems like we aren't ever told the whole truth about treatments?

@2young4bones

If it were me I would ask your Endo if she/he is open to reviewing the latest research and the FDA s latest info. My endo is part of a very large medical group and I wonder if the docs are following the stance of the medical group they belong to.

@2young4bones I would never tell someone treatment or not. After the person does their due diligence, then they decide. I spoke with an orthopedic once and he said the drugs make the quality of your bones worse.

@dvargo That orthopedist is ignorant and he's wrong. I would never listen to an orthopedist about osteoporosis. That is not their area of expertise.

@njx58 Well maybe it is because he replaces the hips with metal plates all day long. I was surprised he was so candid with me.

@gravity3 It is maddening when they (endocrinologists and other physicians) do not follow the findings of medical societies they are part of and which provide their certifications to practice medicine. It is also maddening that I have to make an appointment and pay for an office visit to find out their "stance" on HRT/BHRT. I had an experience with an OB-GYN who would not prescribe HRT unless I got a D&C; he initially was going to require me to have endometrial ablation before he would prescribe the HRT. I challenged him on the endometrial ablation procedure as I had NONE of the symptoms indicating that procedure and my insurance would not pay for it. I did have to get a D&C and anesthesia--totally unecessarily, just to get the HRT prescription. Not surprising, this doctor owns the clinic locally that does endometrial ablation. You know, when you have the hammer, everything looks like a nail. He also did not give me the correct HRT medications for someone with a uterus; he prescribed the estrogen patch and micronised progesterone to be taken 2 days per month, i.e. he was setting me up to need an endometrial ablation.