P1NP number on Tymlos

maryaj7,
very exciting. 30% is satisfying; 50% is excellent. What is your CTX doing, just out of curiosity. It took me six months and then I wasn't qute 50%. I've been off Forteo this month and am curious what P1NP will indicate. I hope you keep posting the numbers.
Congratulations.

Thanks for your response! My CTX score hasn't been reported yet, but I will post when it does. I am also dealing with extreme excess calcium in my 24 hour urine test and have skipped the past two days of shots until I hear from my doctor, so I don't know if I'll even be able to stay on the Tymlos. Regarding P1NP, I just read that it peaks at about 93% above baseline at one month, and then slowly recedes. So my 50% at three months isn't excessive after all. I'm not sure how this correlates with Forteo, but I would think that it's similar. Did you have your P1NP checked before the six month mark as well? From what I read, your P1NP would have been at the highest at the one month mark. Regarding the CTX, the Tymlos literature indicates that CTX would be expected to increase quite a bit at first before decreasing. I did not expect that but am glad I read it before my lab result comes in.

I actually misspoke. My P1NP doubled, so it was a 100% increase. Dr. McCormick's book says P1NP peaks at about 150% by month five or six before it starts to recede. That's different than what the Tymlos site says. Still no CTX result.

I've been on Tymlos full dose for about 3 months. I just had my 3 month bone markers and I'm alarmed with the changes. I don't understand what's happening. Please assist.

p1np baseline 62 3 month 500
ctx baseline 213 3 month 1560

Hi @zooie you had a huge response to tymlos, there is no doubt. Interestingly the ctx jumped greatly also although p1np percentage increase is larger than that of ctx, which is good because this means the bone formation is relatively higher than the resorption compared to baseline. It is observed that CTX responded to tymlos somewhat less when compared to Forteo in clinical studies. Please share what your endo thinks about your numbers.

During my treatment with Forteo, I had a humongous increase in p1np also at 13mo (400), but ctx wasn't done at the time. At 17mo, my CTX was still a high of 910. I suspect both my p1np and ctx were a lot higher during early months of treatment had i have them tested. When treatment was finished, I had a slight lower than average lumber spine bmd gain, but decent and better than average bmd gains in hips and femur neck - a surprise with Forteo. To be honest, I was worried with my high bone marker numbers too during treatment. It turned out all is good.

I think it might be interesting to monitor bone markers periodically to see how they trend. Your endo might do further lab testing(s) if they look out of place to rule out a few things. Getting a yearly dexa scan to confirm bone building to just make sure and have a peace of mind.

Wish you the best!

zooie, your P1NP indicates that you are having a very good response to Tymlos. CTX is often not ordered with anabolics because the significance is unknown. We can speculate that the bones are remodeling evenly but more actively. CTX is more variable than P1NP. CTX numbers are affected by time of day, biotin intake, food intake before a draw, and intense exercise.
Rest assured; these are the changes that we hope for when taking Tymlos.

Thank you for sharing your experiences.
I'm especially unnerved due to my osteoporosis is primarily self managed. And the little knowledge I have was gained from this forum and Keith McCormick's book. I see an NP in an endocrinology office that does not prioritize osteoporosis.
I requested the Tymlos and had to persuade them to order the bone marker tests, so I'm not expecting alot of input regarding the results.
I had a REMS scan in July and had planned to repeat it in a year; however now, I may consider doing another one at 6 months. I cannot use DXA due to osteoarthritis. (no spine reading)

You are doing great, @zooie! Great drug choice, monitoring bone markers... I don't know much about REMS but it seems it suits you consdering your situation. Please keep us updated with your progress!

Happy Holidays!

I so appreciate this group! I too had concern after4 months of Forteo. My P1np went from 19 to 120 ! Lab marked it as above normal. More concerning my CTX jumped from 99 to 541! I was worried about the ratios. So scary the unknown. Thank you all.