P1NP after 1-3 months Evenity

Supposedly P1NP peaks very early with Evenity, so at this point, it may not be helpful.

Here is an older thread that you will find helpful.
https://connect.mayoclinic.org/discussion/evenity-and-bone-markers/

I checked mine 6 weeks after 1st Evenity shot. My P1NP was 82 before Evenity and went up to 232 at the 6 week mark. The spike in P1NP can tell you if Evenity is working from what I understand, but it does peak early on. I only ended up taking 3 shots of Evenity due to issues with it, but I had 10% gain in the bone density of my spine.

@tshcpa, What did you go on after the Evenity? Thank you.

I am taking Alendronate (Fosamax) weekly, and I plan to take it for 1 year. I will recheck my bone markets and have a DEXA 6 months after stopping the Alendronate to determine the next course of action. At that time, I may take a drug holiday, continue Alendronate, or take Tymlos to build more bone. I am consulting with Dr. McCormick and I am primarily following his guidance so far.
My TBS was normal (1.313) before starting Evenity, and it increased 5% during the 3 months, so now it is above normal (1.383). My spine was -3.3 before Evenity and is now -2.6. I am one of those who had never taken any drug prior to Evenity.

Thank you.

Some docs say the P1NP and CTX labs aren't helpful because they have to be done under strict circumstances with regard to time of day, diet, and other things that quite frankly I can't remember. However, my impression from watching Dr. Doug Lucas' videos is that if done right, they can be very useful for monitoring how an osteoporosis drug is performing in your body.

@tshcpa, could you please tell me what kind of issues you had with Evenity? Thanks!

I was fine until the 3rd shots. I had a series of migraines with aura (visual disturbances) in the week following the 3rd shots. I had not had one in over 10 years, so this was concerning to me since people who have these types of migraines are at a higher risk for stroke. The second week, I had a high fever that lasted a full week and it continued at a lower temp the third week. My heart rate was high as well (normal for me is 60 and it was 90 or above). I had no symptoms of a virus, and my doctor did numerous tests and bloodwork and could not find a cause for the fevers. I spoke with the Evenity nurse and she said Evenity could be the cause, but it is difficult to know for sure. It was a very tough decision, but I felt absolutely terrible for 2 weeks and I didn't think it was a good idea to continue due to the fevers and migraines.

For what it is worth, I had been told that as well. I was careful to have my bone markers tested at the same time and by the same lab each time I checked them. I also had my blood drawn at 8:00 am; my understanding is your CTX numbers fall as the day goes on. I believe P1NP is unaffected by time of day and tends to be more stable. I was also told not to have any biotin supplements within 48 hours of your blood draw and to fast for 12 hours before testing.

@tshcpa, thanks much for this information. I wish I had known to go in fasting and as early as 8 a.m. My results are probably worthless, but I felt I needed to push my very resistant doc into allowing me to have the bone marker labs. I regret that she didn't know (or care?) enough to inform me about best circumstances for testing.