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Bone turnover markers (CTX and P1NP): do you have a baseline?
Osteoporosis & Bone Health | Last Active: 23 hours ago | Replies (286)Comment receiving replies
This is my first time writing here but I have been reading many conversations from so many helpful, caring people, as I try to figure out what I go from here with a diagnosis of steroid-induced osteoporosis (REM scan -2.8 and -2.9 on all the points tested, but my strength is not bad apparently).
I was recommended Prolia but have heard so many problems with it that I am choosing to research more before I decide. I have done my CTX (658) and P1NP (82) tests as Dr.McCormack suggests but I have no idea what they mean and surely my rheumatologist never mentioned to do this before treatment!
I did not take any supplements two days before bloodwork and I was tested at 8:30am, if that helps.
I am 75 yo, 125 lbs, 5'5" and have now been put in total fear of breaking a bone that I hardly do anything. I am thinking about asking for info for me with MHT, SERMs, or maybe simply taking DHEA for a while, along with the tons of supplements and high protein diet and exercise and see any results.
When I know more, I will share. Best- Gracie
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@gracie7 you are on the right path... being proactive about your diet, supplements if necessary, exercise and fall prevention is the foundation of management; more importantly, questioning the right drug of choice to start the treatment journey.
Have you had a DXA scan and a FRAX/FRAXPlus risk assessment?
@gently had a great post re bone turnover markers.
Regarding the Prolia recommendation: it's an antiresorptive (slow down bone breakdown) that carries a unique "rebound" risk if stopped. It essentially requires a lifetime commitment or a carefully planned transition to another antiresorptive (a strong bisphosphonate), which adds significant long term complexity. It also complicates future treatment sequencing in the event you need any bone builders. Because of this, it's often not the first line choice -especially when anabolics (bone builders such as Forteo or Tymlos) have shown in several studies to be very effective for glucocorticoid-induced osteoporosis. Discussing with your doctors about the right drug to start is absolutely crucial, as your instinct tells you.