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Bone Marker Tests (CTX and P1NP)
My last bone scan indicated a t-score of -2.5 in my left femoral neck. Everything else is in the osteopenia range. My doctor did bone marker tests, and the CTX, she said, was 841, which is within normal range but on the high side, and P1NP was high (146)! My parathyroid was normal, and my vitamin D is good. I'm 65 years old, so well past menopause. I'm guessing that the high score could be due to chronic inflammation. I have multiple inflammatory conditions, such as IBS, GERD, allergies, asthma, and osteoarthritis.
She's going to repeat the texts in April, since that was the baseline. I am not taking any osteoporosis medications (yet) as I am trying to address bone loss through diet and exercise first. I am tracking my food intake, avoiding added sugar, eating plenty of protein, and ensuring I get enough vitamins and minerals.
One question I have is, should I try seeing a rheumatologist? Any other insights or suggestions would be appreciated!
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High P1NP is good. High CTX is not good depending on the person. Dr. Doug Lucas (who I don't endorse because of his exorbitant pricing) does use a ratio to determine the balance of bone building vs. breakdown:
• CTX measures osteoclasts that break down bone. We want this number to be low, but not too low, since some bone breakdown is needed.
• P1NP measures osteoblasts that build bone.
• To calculate the ratio that Dr. Lucas uses to gauge whether treatment is working, he uses the following calculation: P1NP / (CTX / 1000). Yours is 146 / (841/1000), or 173.
• If we are dealing with “natural” levels of CTX and P1NP, this calculation usually results in a 3-digit number between 100-300, and a higher number is better. Yours falls in the "OK, but could be better" category, I think.
I'd recommend seeing an endocrinologist who knows osteoporosis.
I don't understand why Lucas has ro make it so complicated when simply dividing CTX by P1np gives the nfo in a more easily to remenber way
@normahorn
Example:
4:1 is good.
10:1 stinks