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Initial lab results
Male in late 60’s, 135#, 5’8” in good health, walk 3-5 miles daily, resistance training 2-3x week, swimmer. Dexa scan results were a surprise. T-Scores: spine -2.8, left femur neck -3.0, right femur neck -2.3, left femur total -2.3, right femur total -2.2, dual femur -2.3. No fractures.
Lab results, just received, of interest: CTX 367, P1NP 64.8, P1np/CTX ratio of 176 (above 150 or “anabolic”). Calcium in blood is normal at 17.6 but 24-hour urine calcium is slightly elevated at 341 mg. Also, 24-hour urine volume was 3.25 L which is high. Vitamin D is on the low end of normal at 33 ng/mL. No celiac disease.
Will be discussing results and next steps with my GP very soon. His preliminary recommendation was an anabolic, likely generic forteo which should be covered by my PDP with approval. One question I have is that it seems odd that my bone turnover markers indicate I am growing bone but still have a -3.0 dexa result. Also, curious about the higher urine calcium and what that may mean.
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The blood calcium value (units?) looks like it needs clarification/rechecking. Was a PTH level checked?
In your shoes, I’d consider seeing an endocrinologist or metabolic bone specialist for a thorough evaluation of secondary causes. In men with osteoporosis, secondary causes are relatively common and may be potentially treatable.
The elevated urine calcium is something to look into before deciding on Forteo/Tymlos.
Bone turnover markers aren’t necessarily contradictory to the DXA: they reflect current bone remodeling at a single point in time, while the DXA reflects the cumulative result over many years.
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1 ReactionThank you for your helpful comment. I made an error in my calcium number above. The Osteocalcin was 17.6 ng/mL. serum calcium was 9.4 mg/dL. Both within Labcorp normal ranges.