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P1NP decrease with 9 month drug holiday
I just had my lab results come in and from Sept of 24 at my last appt, my P1NP dropped from 74 to 19. My CTX results haven’t come back yet. I was on Tymlos for 2 years and ended that protocol in July of 24. I decided to go on bioidentical hormones to hopefully hold my gains and have been taking Estradiol, testosterone and progesterone as well as D3, K2, Calcium and magnesium. However, it’s obvious that not taking any osteo meds is depleting my bones again. My rheumatologist has wanted me on Evenity since August but I wanted to try the hormones with my cardiologist and integrative doctors both agreeing that hormones could help. I wish I could go back on Tymlos because I had minimal side effects with great gains. Because we travel pretty extensively, monthly Evenity injections will be difficult but the other options (Prolia, Fosamax) are out. I don’t think I can take Forteo after Tymlos so my options are limited.
Any feedback is welcome. Thanks, Rose 🌹
Has anyone taken a drug holiday and had their numbers change so drastically?
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Thank for sharing @dooshie. P1NP reading of 19 in your case doesn’t mean you are losing bone. When you are on HRT, estradiol suppresses osteoclasts’ function so very likely your CTX will be pretty low. It won’t be surprising to see CTX at 200s even 100s --you will soon find out! With a low CTX, your bmd gained with tymlos will be preserved unless there are other reason(s) for bone loss.
You could decide after next Dexa to see if you need further bone building. I’m not sure if prescribing second round of tymlos is a common practice now or whether insurance will cover another round of it. However, nothing should be in the way to have Forteo or its generic for you.
@mayblin…thanks so much for ur reply. I was a bit devastated when I saw my P1NP number and I did get my CTX back yesterday and it’s 153. You’re much more educated with these numbers than I am so any info is greatly appreciated. I don’t have another dexa till the end of the year so we’ll see then.
I knew it was very possible that my numbers would drop after going off Tymlos but I had hoped the bio hormones would hold them.
I’m extremely active playing pickleball, lifting weights, jumping, heel stomps, so I hoped that would help. I’ve never fractured but I do try to do everything with great care that I don’t fall.
Thanks so much for ur reply. Have a great day! Rose 🌹