What is a reasonable C-Telopeptide marker value

@hungnrybirder my endo considered a CTX of 145 as adequate suppression and okayed me delaying my next Reclast. I read (and was told by McCormick) that under 100 is too much suppression, under 150 is moderate, and if on bisphosphonates they are ideally given with a CTX over 150.

@windyshores Thank you for your prompt reply. It reaffirms my thoughts that doing nothing for the time being is a good course of action. We’ll see what my endo says. My hope is to eventually build bone. It’s unfortunate that in the early 2000s bisphosphonates were the only option. Thanks again.

This is lifted from:
THE IMPORTANCE OF BONE MARKERS
KEITH MC CORMICK, DC AND
IRMA JENNINGS, INHC - HOLISTIC BONE COACH
page4.
http://www.food4healthybones.com

It is up to you to decide if McCormick is the ultimate authority or not, being placed on a pedestal.

Dr. McCormick Bone Marker Ranges
C-Telopeptide of Type-1 Collagen (CTx) 100 - 375 pg/mL
Vitamin D 30 - 50 ng/mL
Ionized calcium 48 - 56 mg/dL
24-hour urine calcium
women less than 200 mg/24 hours
men less than 250 mg/24 hours
TSH 0.5 - 4.5 mU/L
hsCRP less than 1 mg/L
Homocysteine less than 8 μmol/L
Total serum calcium 8.9 - 10.0 mg/dL
Bone Specific Alkaline Phosphatase (BSAP )
postmenopausal women - less than 22 μg/L
men less than 20 μg/L
Osteocalcin 8-32 ng/mL
P1NP 30 - 50 μg/L

I've consulted with McCormick and I like him, but to be honest, he was completely off base on my bone markers. He thought they showed that I wasn't getting a good response from Tymlos. In fact, I had a whopping 15% gain after ten months.

This isn't a dig at him. It's more to show that bone markers don't always reflect what is going on. My P1NP never even reached 60 during my (ongoing) Tymlos treatment.

@normahorn Food for thought; I’ll have to see what other numbers are revealed in my tests. Thank you

@njx58 Obviously bone markers are not the ultimate answer to what’s going on in our bones. Wish it were. Thanks for sharing your experience.

My doctor does not generally do bone markers, saying they do not adequately reflect what is going on in bones. My bone markers have also not matched results on meds. I believe they vary from individual to individual.

I was surprised when he did order a CTX last month and commented that my turnover was adequately suppressed. If I weren't hoping to do an anabolic again after my March appointment, I would probably go ahead with my next Reclast anyway.

Kidney disease and Biotin can increase CTX. I checked because I was concerned about accuracy. So if my CTX errs in any direction, it would actually be lower.

I have occasionally seen Keith McCormick since 2006, because of his first book and my inability to get on meds, despite my best efforts. I have seen my endocrinologist for the same amount of time. They sometimes differ, and when they do, I generally rely on my endo. In that I am very lucky because he is so good and so willing to work with me.

In my case, the DEXA could be wrong because of fractures, the bone markers are unreliable, I cannot do the TBS, so my main criteria for success is no fractures since April 2021!

@windyshores No fractures is a great goal. I've been lucky so far even though I've taken some unexpected falls. The falls were directly related to user error and the first thing I think of from ground level is "what would Dr. Z (the endo) say". Continued success on the avoidance of fractures!