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Tymlos prior to P1NP?
I don't think I've read any guidance on this: if you're taking Tymlos, and you're going in for bone marker blood tests (P1NP and CTX), do you take your injection beforehand, or not?
It occurs to me that someone who takes the injection at night might have 10 hours before the blood test, but someone who normally does it in the morning and skips it prior to the test would have 24 hours "free" and that could make a difference.
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Th kinetics of P1NP was studied after a single dose of teriparatide (Forteo) with two different doses. Serum levels P1NP decreased during the first 24 hours (10-15%drop, nadir at ～24h) followed by a 10-15% increase from baseline for 14 days. There weren’t any differences between the two doses studied. Considering the magnitude in increase of P1NP after a few months of daily dosing of Forteo, as well as the persistent increase in P1NP for days 2-14 after just a single shot, the dip during first 24 hr dosing probably has minimal effect on our p1np labs. I havent come across similar studies done on abaloparatide (Tymlos) and am not sure if we could extrapolate a comparable pattern for Tymlos. Hope other members will chime in.
I did Tymlos after my labs. Can't even remember why but I think I asked my doctor or McCormick. That said, at 18 months my P1NP was not very high!
I'm having a DEXA the same day, so that's really of more importance to me than the P1NP at this stage.
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