What is a reasonable C-Telopeptide marker value

@drsuefowler I like to be on the safe side and do 72 hours and of course fasting and around 7:30 Am to do the labs.

@drsuefowler they are out of the system in 24 hours.

Thanks @kristie2.

@njx58, thank you for posting the link. I wish the study was done using a single drug, not mixing several bisphosphonates together, as the affinity to bone matrix is so different for each one. It would also be nice in the future to see how CTX changes after stopping BP with shorter treatment durations (1, 2 or 3, and 5 years), which is more common now.

@mayblin The article also states:

"It was beyond the scope of this study to consider other turnover markers, as CTX is currently the only marker that we have available in our clinical setting. It is possible that markers of bone formation such as procollagen type 1 N propeptide (P1NP) could be used to assess bone turnover following BP cessation to indirectly measure BP effect, though changes in levels would not be as rapid. P1NP does have other advantages in terms of having less variability with respect to circadian rhythm and being less affected by food intake."

@njx58 Thank you for the link. This should be very helpful in convincing my new PCP.
My previous PCP finally agreed to CTX and occasionally P1NP during the time I was using Fosomax to protect against rebound from 2 shots of Prolia. I wanted to stop using the BP as soon as possible; due to the test results, I was comfortable with first 'stepping down' and then stopping it a few months earlier than the recommended 2 years post-Prolia.

If a DEXA was available in only one year, I would perhaps find that acceptable for now as it has been almost a year since the last bone marker tests. However, my understanding is that Medicare will not cover DEXA more than every 2 years unless during treatment and if deemed medically necessary.

So I do have some reference points/trends but no baseline take when starting meds.

@njx58, sure; having both markers always offers a fuller picture of bone turnover. However, CTX will be the leading indicator as an early signal during a holiday.

@michieg I know insurers are known to balk at covering these tests but I have had no problem with that if ordered by the PCP. And there is no cost to me for the labs so going to a retail lab service will not result in any cost savings. How are you saving hundreds of dollars going thru Jason Health?

@rjd My insurance has not covered these tests (CTX and P1NP) twice for me when they were ordered as part of a series of labs by my Endo while undergoing Tymlos treatment. They say the tests are 'investigational' and not widely approved. That means they will not cover the charge the lab is billing for that particular test, BEFORE any insurance-negotiated 'adjustment'. So if the lab normally bills my insurance for $250 for a test but if covered they end up receiving no more than $10 for it under their 'negotiated' agreement, the lab turns around and makes me pay the full $250 for the denied test! So it is far cheaper for me to pay Jason Health $50 for it retail than wait for my insurance to deny and have the lab dock me the full $250. It's SUCH a scam!

@oopsiedaisy
Hi,
Thank you for your response. I am not working with an Enodcrinologist bc I live in the high desert outside of Palm Springs where PS is the closest and best, but not really great. There is reportedly one Endo and she is not accepting new patients. This is the reason I went to Mayo for my spinel surgery. The surgeons here said “it won’t do anything”. It was a really complicated surgery that become more complicated once the actual surgery began. Spinal fusion T11-S1 with 2 large screws anchoring the fusion to Sacral area. I am in process of an 18 month recovery. Surgery Sept 2025, started PT at the Mayo hospital, but had to undergo Gall Bladder surgery so was not strong enough to continue. They discharged me in a couple of days. I’m sure for insurance reasons. I restarted PT in January (in my home town in CA)and am still far from “normal”.
In response to why the doc I see isn’t putting me on anything at all is that there has never been a range for normal established since I am 74. He says that the surgery and my age would be a big factors in raising my CTX number
He said he is “waiting to see it lower”. Also I have 6 blood tests done every month so he is looking at those also. I don’t have anything outside of normal and he is monitoring all my numbers
I know I should look for an Endo doctor, but it might mean going to LA which is a couple hour drive. Everyone’s response to my post makes me think I should just do it. My neighbors go to LA and stay a week for the husbands heart condition. I’ll be asking which hospital they use bc I know they are really happy with it.