1. < Osteoporosis & Bone Health

Bone turnover markers (CTX and P1NP): do you have a baseline?

Posted by mayblin @mayblin, Mar 27, 2024

Currently i am on forteo therapy with a couple bone markers tests done. However, I didnt have ctx or p1np tested before the start of forteo as a baseline, regrettably.

It is known that the CTX value varies greatly among different individuals, with a very wide range. For post menopausal women, the range could be 34 - 1037 pg/ml; while for perimenopausal women 34-635 pg/ml. Different labs also have a slight different range values.

CTX, a bone resorption (breakdown) marker, is heavily influenced by a number of factors, such as food intake, circadian variation and exercise/life style, etc.

Bone remodeling is a dynamic and complex process. CTX itself may not fully reveal the whole picture. The bone building marker P1NP, is a lot less influenced by external factors. Taking both into consideration at the same time may shed more lights than looking at CTX or P1NP alone.

For those who had their CTX and P1NP tested before treatment with a bone drug, could you share the results if you don't mind? Thanks a lot!

Interested in more discussions like this? Go to the Osteoporosis & Bone Health Support Group.

leslie559 | @leslie559 | 2 days ago
In reply to @mayblin "I see. Below is a chart for the percentage changes of P1NP and CTX during 12..." + (show)
@mayblin

I see. Below is a chart for the percentage changes of P1NP and CTX during 12 month romosozumab (Evenity) treatment, data from its phase 3 study. It looks like the best time to see bone formation marker P1NP surge is during first two months, you might have missed it due to timing, although a concurrent HRT might affect bone markers response.

Curious, has your prescribing physician for HRT discussed various dosage forms for estradiol? Many obgyn prefers transdermal form nowadays due to the benefits of lower risk of blood clots (by bypassing liver’s first passing metabolism) and a more stable hormone level, among others. You might want to ask. From what I read, 1mg oral tablet is approximately equivalent to 0.05mg/day transdermal patches of estradiol.

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My last prescription from my GYN was written on his last day before retirement so I’m still in search of another GYN. My PCP can cover the med portion, if I ask him about it. The only difficult part being is he believes the Estradiol is not beneficial for me, so I’m not sure he would be on board with prescribing any. But in my 25 yrs of being on HRT none my GYN’s or my ND (BHRT) talked about doing a cream. Food for thought though, thank you

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mayblin | @mayblin | 2 days ago
In reply to @leslie559 "My last prescription from my GYN was written on his last day before retirement so I’m..." + (show)
@leslie559

My last prescription from my GYN was written on his last day before retirement so I’m still in search of another GYN. My PCP can cover the med portion, if I ask him about it. The only difficult part being is he believes the Estradiol is not beneficial for me, so I’m not sure he would be on board with prescribing any. But in my 25 yrs of being on HRT none my GYN’s or my ND (BHRT) talked about doing a cream. Food for thought though, thank you

Jump to this post

There are pros and cons for transdermal estradiol (gels, patches or vaginal creams) vs oral tablets, guess each practitioner has his/her own preference.

Please update us with your dxa results if you could when you complete evenity treatment, fingers crossed.

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