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Making sense of pre-treatment bone turnover markers

Posted by soggybones @soggybones, 2 days ago

I just got the results of my first bone turn over marker test. I haven't started any medications and I'm not sure what to make of these....My CTX is 525 and my p1NP is 56. These values are within the "normal" reference range of the lab, but...don't they indicate that I'm losing bone? How bad are these results?

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oknowwhatpixie | @oknowwhatpixie | 2 days ago

Not sure what information you already have. So here goes.
CTX is bone Resorption you want that number to be lower and P1NP is bone Formation you want that number to be higher. The best way to use this data it to understand if a treatment path is working or not. Depending on the type of treatment the numbers are affected differently.

Here are my baseline bone markers (before treatment) and my most recent March results.
CTX (Resorption) Baseline = 385
P1NP (Formation) Baseline = 45.5
March Result
CTX = 295
P1NP = 29.5

Because I am using BHRT it has a antiresorptive effect on the bone makers. So my CTX would be lower due to less bone resorption occurring and P1NP would also be lower because of less bone building needed with less resorption happening.
These results are telling me that my treatment path is working at this time and has stabilized my bone loss.
Bone Markers are just one of the pieces in the puzzle. Your Doctor should be able to help better interpret you numbers.

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soggybones | @soggybones | 2 days ago
In reply to @oknowwhatpixie "Not sure what information you already have. So here goes. CTX is bone Resorption you want..." + (show)
Profile picture for oknowwhatpixie @oknowwhatpixie

Not sure what information you already have. So here goes.
CTX is bone Resorption you want that number to be lower and P1NP is bone Formation you want that number to be higher. The best way to use this data it to understand if a treatment path is working or not. Depending on the type of treatment the numbers are affected differently.

Here are my baseline bone markers (before treatment) and my most recent March results.
CTX (Resorption) Baseline = 385
P1NP (Formation) Baseline = 45.5
March Result
CTX = 295
P1NP = 29.5

Because I am using BHRT it has a antiresorptive effect on the bone makers. So my CTX would be lower due to less bone resorption occurring and P1NP would also be lower because of less bone building needed with less resorption happening.
These results are telling me that my treatment path is working at this time and has stabilized my bone loss.
Bone Markers are just one of the pieces in the puzzle. Your Doctor should be able to help better interpret you numbers.

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@oknowwhatpixie Thank you! This is all so confusing for me and I'm just trying to understand it. When I looked at my bone markers it looked bad to me so I wasn't sure why the lab didn't flag it as concerning....maybe it's because it's "normal" to lose bone as we age. Is your only treatment BHRT? It sure looks like it's working for you! I'd like to get that myself since I'm only 59, but my doctors are all scared to give it to me!

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oknowwhatpixie | @oknowwhatpixie | 2 days ago

I am 59 as well, started BHRT topical creams only almost a year ago.
I did a lot of reviewing of information before getting started.
Am also taking a supplement that has some controversy around it, but that was also a choice after considering all options.
The BHRT has also helped with other issues, such as much better sleep.
I had to find a different Doctor that works specifically with BHRT. They did blood work and a DUTCH test to understand my hormone levels before starting.

Here is one piece of many that helped in my decision making.
American Heart Association article on Hormone Therapy.
Rethinking Menopausal Hormone Therapy: For Whom, What, When, and How Long?
https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.122.061559

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