Jumping and hopping can slightly displace my kneecap. But it never makes me laugh. You must be very good natured. I can run and skip without trouble.
We share the impression about elders, but it may be more about how much absorption your body can effect. One vexing question is how do you know.
If you look at the mcchanisms of action with bisphosphonates objectively, you'd conclude that a bisphosphonate would "blunt" the effect of Forteo. I have it from a bone expert that alendronate is the bis to use intermittantly because is has the least persistance in the bone. zolendronate (Reclast) is the most persistent in the bone.
While scavenging for ideas, it occurred to me that we need brief periods of osteoclasts. Osteoblasts work most effectively when coupling with osteoclasts. My plan with the bone markers is to follow them until the anabolic window closes and then pause the Forteo. If the CTX or when CTX rises sufficiently or P1NP drops significantly, I'll take either alendronate or Forteo. I'll try to avoid the bisphosphonates because of the type of bone they form.
The very nice curve illustrated by Kim et all might be accurate.
I have it from an endocrinologist that in his long practice the anabolic window in most women drops after three months on Forteo according to the bone markers. While that didn't happen to me or my markers, we may be all quite different from the graph. This being the value of the bone markers.
Neither the bone markers, nor qualitative CT are standard of care or widely used. "Economic feasibility" has a role in adoption of these standards. Both types of measurement are costly and insurers don't like to pay for them.
But to your question about CTX. It isn't as stable as P1NP. Some people say unreliable but it does reflect what is happening with the bone, it is just more variable. Time of day, whether you've eaten or not, whether you've exercised or had a recent fracture affect the CTX results.
I want them both because I'm using them in relation to each other in this way. My CTX reading has increased by 1/3rd, but my P1NP has doubled. I''ll continue with Forteo until CTX reads as a higher percentage increase than P1NP. But this may be an incorrect mcethod.
Your P1NP reading is great and I would say that you wouldn't have been advantaged by having it before treatment. And even that you wouldn't have been advantaged by having a CTX. Clearly Forteo is effective for you. If your P1NP were equivocal, then I'd wish you'd had both bone markers before and after. I get the markers every three months.
It is important and also more interesting to know your source and question the information.
You noticed that the article recommended more protein than the CDC recommends. The author works for the beef and egg industry.
I try take 100 grams of protein a day. Just guessing.
I might have been too eager to give my hip/femor a "load" after seeing the concerning results. Hope I didn't inadvertently damage any parts of my knees, which my strength training coach kept telling us to protect. I'm backing off from the higher impact ones for now. As far as protein goes, I'm uping to 90grams per day from 75. Yes quality and quantity matter yet opinion differs. Hopefully the amount of protein will help me build more muscle mass. I also don't mind having extra adipose tissue as long as they don't all go to my tummy, that might be a tall order.
gently, whats your strategy to get enough calcium?
I don't know much about the anatomy of the bones. Looking at the part where the tech took dexa scan of the femoral bones (the neck), they looks like a trabacular part of the cortical bone, ie, porous part. Am i right? If theoretically the newer made bones by forteo are more porous hence less dense, then would L spine be the same? Mccormick did mention he has seen the wrist bones, which are made of 80-90% dense cortical bones, suffer a decline in bmd after forteo. I'm not too fazed yet since my hips/femur started at ~1.8 which gave me a bit wiggle room. If the speed of the trend continues, then I may regret my decisiom of jumping on the rx bandwagon too early.
If I understand your general strategy correctly, you will be using CTX &P1NP level to exit Forteo? Do the level of these bone markers correlate well to state of bone building vs resorption? Will you do a DEXA at the same time too? Forteo then Forsamax I understand, but whats the rational behind Forteo (i assume followed by a holiday) then Forteo?
Also my impression is that sources of your trust prefer fosamax over reclast. Is this due to their stickiness to the bones? I read fosamax could also stick to bones very long up to 10 years, but I need to read more about this. My doctor is planning reclast for me for 1-2 years after forteo. Now I'm open to reclast, fosamax (I'm searching for a way to get around of the stomach issue since I have mild gerd) . HRT is also on the table since it's a natural way to inhibit osteoclast. But right now i know nothing about hrt. Bisphosphalated bones concern me as well.
The longer term picture (say 10-20years from the start of 1st therapy) is also very uncertain. I felt if we are lucky, maybe we could get bmd to -2 to -2.5 even a bit worse and safely get off the last drug and maintain what we've got just via healthy eating and exercise. If not, a well calculated plan such as anabolic to bis, then maybe back to anabolic... this maybe doable, but for how long? Evenity is an interesting consideration, it seems to be a 'perfect' drug on paper if it mimic real life bone remodeling process. The big question also is, then what?