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How long to wait before re-testing bone markers

Osteoporosis & Bone Health | Last Active: Nov 18, 2023 | Replies (9)
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@gently

I would want bone markers at the start of a medication and then again three month in. The difference will indicate whether the medication is working. If your plan is to stay on the medication for a year, you might test again after 6 months provided you have a 10 to 20% increase in P1NP with an anabolic and decrease in P1NP and CTX with bisphosphonates and Prolia.
These need to be early morning fasting serum draws. P1NP is a reliable marker. CTX fluctuates with time of day, prior exercise and food consumption.
I want bone markers every three months because of the concept that the effect of Forteo might be best maintained by a switch to a bisphosphonate every three months. I'm using the markers to determine treatment.
There are other bone markers, some urine, that are equally useful.
Baguette, it is so good to hear of your PCP yielding to your request. But even more exciting that you are taking control of your health.

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baguette | @baguette | Nov 16, 2023

Thanks for your encouragement!

I am not on a bone medication now. I was told I had severe OP (-3.8 for the worst vertebra). As with many others, insurance nixed the anabolic drugs for me. I can't take bisphosonate pills/capsules due to GERD, besides which studies have said that taking that kind of drug before the anabolic undercuts the potential full benefit of the anabolic drug. So for now I am not taking a med.

I am curious whether stopping the PPIs is helping my bones get back on track. That's why I was thinking about a re-test but don't know if six months is enough time for a comparison (without taking a drug).

BTW, I saw another PCP for a second opinion, and again that provider knew nothing about bone marker tests, and expressed no desire to learn. Very frustrating! So snaps to my first PCP, who also has no interest in bone marker tests but at least "humored" me by ordering them.

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