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Interpreting CTX and P1NP Tests
Am I the only one who is frustrated with the mainstream healthcare system not being experienced in offering bone marker tests for those diagnosed with osteoporosis or osteopenia? My doctor kindly ordered these two bone marker tests for me recently; however, she admitted she doesn’t know how to interpret them because they are not “routine” tests. I can’t even find out if a local endocrinologist can interpret them because you first have to become a patient! And, I just learned today she’s booked out until 2026. I’m not waiting THAT long for an interpretation of these two very recent tests! (waiting on the results) My doctor is extremely bright and open-minded and we’re going to figure this out together, which is really cool and exceptional of her — BUT, it’d be nice to know WHO out there in the medical field, is skilled at interpreting these tests. And, I mean for those NOT on medications — for those, like myself, who were given a couple years to naturally bring up my bone density in a more holistic manner, through diet and exercise, and likely supplements and any other means I learn about. I’m early on this osteo journey….which has rather bummed me out, to be honest, but I’m doing everything I can to make a difference. I only learned of this osteoporosis diagnosis two months ago at age 65. I’m wondering if other people have also found it difficult to find a specialist in their LOCAL area, who can interpret these tests, a medical professional who doesn’t JUST order these tests when you’re on medications to see if the medications are doing their job. But a specialist who will go along with you on your holistic journey to better your bones, and then in 8 months or more, be willing to order these tests again to see if the changes you’re making to your life are making a difference in your bone health. I look forward to reading any replies. So far, I’ve felt very alone in this journey. I’m glad I found this support group on the Mayo Clinic. I hope to feel less alone soon.
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Same. Before I started Boniva, they did the bone turnover test and never explained it to me. It was low which means my rate of bone loss was slow) and they still put me on Boniva. I only took Boniva for 2 years. I am going the natural route from now on. Osteostrong could not explain it to me and on line you cannot find any reasonable explanation. For CTX any number over 60 is considered bone turnover loss. Mine has been at 35 for the last 2 years and I am on HRT. 100% agree no one can explain results.
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2 ReactionsI am just starting on my journey also; I was diagnosed in May of 2025. You are lucky to have a doctor like yours; my doctor already had a medication ready for me without doing any labwork! All he saw was that my DEXA scan said osteoporosis! Needless to say, I asked him to refer me to an endocrinologist who I hope will be able to help me figure out WHY/what is causing my OP. The most helpful book I have found is “Great Bones” by Keith McCormick. It is very technical, but sooo educational!! He also has some interviews on YouTube that are very helpful. He does consultations, at a fee of course, but it is for about an hour and he wants to see certain lab works and your medical history before the consult. His book is where I learned about CTX, bone marker tests, etc. Maybe you can try reaching out to him? Good luck!
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3 ReactionsThe main reason for my bone loss is estrogen loss. It takes a whole body approach to find the cause and turn it around. I should have been put on HRT at the time of menopause. I am on HRT now. My OBGYN wanted to put me on meds when I had osteopenia. I deferred until it went osteoporosis. When I did not see a reverse after 2 years of meds my OB said "Oh, Big Pharma just wants to sell their product". So she knew but still pushed to put me on it. Anyway, I am at a good place now and going natural.
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2 ReactionsThe "Great Bones" book by Keith McCormick is wonderful and I have learned so much. I also took Dr. Kim Millman's on line class "100 days to healthier bones" which covered many topics from lab tests to HRT and supplements. Margie Bissinger has good exercise classes called "Happy Bones". It is a life long journey. Best wishes!
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1 ReactionThat statement actually is not true at all. CTX is highly individual. 60 may well be the red line for you, but it's not for others. It has to be evaluated in conjunction with P1NP.
My CTX has never been lower than 150, and I've gained 15% bone density in the past year. My P1NP has never been higher than 80, while others have had much higher numbers when on medication.
The Cleveland Clinic CTX scoring has anyone above 60 as bone turnover loss and you need to go on drugs. That is their measurement. At Quest my CTX was 125 and my functional medicine doctor said my HRT is working. I think reading the scoring is so confusing and most doctors interpret it differently.
Where can I get the book? I am cking internetmom
I bought mine on Amazon
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2 ReactionsI had someone suggest I start taking estrogen to help my bones as well as Tymlos. I am 73!!! And never took hormones after menopause so has anyone started so late in life
Unfortunately, it's out of print. The author's Web site does allow you to order it, but I'd call them to make sure it's actually in stock before you place an order.
https://www.osteonaturals.com/product/great-bones/
I've occasionally seen a copy on eBay.
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