Ok, just found out today my ratio went from 108 (before starting BHRT) to 150, 6 months after(CTX 750, P1NP 81 to 510 and 75) Guess I’m going in the right direction!!!! I had implemented diet/supplements, and resistance/ weight bearing exercise advice one year ago and had the bone markers taken right before the start of BHRT 6 mo ago and then again last week. I have recently started impact training, maybe that will increase the ratio even more. You are doing such a good thing providing us with this info!!!!! Thank you.
In the past I had seen two endochronologists. Neither ordered any labs but prescribed Fosamax and there was no improvement in bone density. Recently I asked my Primary NP to look forthe cause of my lowbone density and she ordered 8 tests including CTX and P!NP which were both in the middle of the normal range. This tells me that my current diet and supplements are fine. I won't be seeing any more "pill doctors".
Thank you for sharing. It seems the Endocrinologist like Fosamax. Thank goodness for my dentist who told me about osteo necrosis. I want to bring this information to my Primary physician and ask for these tests.
Me too. I asked my 1st visit with Endocrinologist about all if the items that Dr Lucas and comments recommend. I asked about K2-D3, Boron, Strontium, vibration, Execute, Bio Identical Hormones. She said coldly flat out "NO". She only prescribed meds that cause necrosis and broken bones. I wish ii could find a Doctor to be my Primary like Dr Doug Lucas. ❤ Please see me Dr Lucas. I am getting so bad and need a hip replacement yet can't get well enough.
Australian here ... my doctor does not support any strategies other than pharmaceuticals for the treatment of osteo. She poo-hoos everything else, other than ensuring and "adequate diet" (whatever she means by that). At my last request for a Dexa, I also asked for retesting all the bloods and asked her to include the bone turnover markers. When I got all my results back, she ran through them with me but nothing about the bone turnover. When I asked if she had them tested, her response was: "I never bother with those tests. You just have to accept you have osteoporosis." It's depressing. Like so many others, I'm just trying to learn as much as I can and make doable adjustments. I've taken on the Liftmor exercises and been doing that for 9 months. I will ask for another Dexa in a few more months. Doctors are not willing to do anything other than prescribe medications.
I'm from Sydney and I encountered the same attitude from my GP and endocrinologist. I finally convinced my GP to monitor my efforts of getting off the drugs and trying to improve my blood markers through diet, supplements and exercise. Still on a bisphosphonate waiving my way out of prolia.
@@NicoletaGiura Best wishes for that. It’s tough….that’s why they should be doing more on helping women prevent developing osteo in the first place. They just figure old woman’s problem and we have drugs for it, so end of story, next patient please.
Hi! Thank you for sharing this. It sounds like you could benefit from attending our next Bone Foundations Masterclass session. You can find further details here --> www.optimalbonehealth.com/build-bone
Thank you for this very clear and helpful explanation. After 10 yrs of OP diagnosis, I finally found a RM who asked for bone markers (blood and urine). However, even this doctor only asked for CTX. I just asked the Lab to add a PN1P and paid for it myself.
It's great to hear that you've taken the initiative to ask for additional tests like PN1P-it's empowering to be proactive in your own health journey. Keep up the great work, and best of luck on your continued health journey!
Hello Dr Lucas ~~ I am a woman, 79 and have osteoporosis and know others of similar age with osteoporosis. Is there age specific information for senior older women? Does your research include those late-70s and 80 + year old females who have osteoporosis ? Would you kindly counsel us elders. Thank you so much, in appreciation. Jan
We focus on a lightly younger audience Jan but our messaging is valuable for any age! Chronologic age is not a contraindication to anything we discuss BUT the older one gets the more difficult things can be to change. I hope that makes sense. We have patients in their 70's and 80's and they do see benefits. There are more tools to use for our younger patients who are in their 40s and 50s. There are so many tools to use that we can come up with a plan for anyone.
Thanks for this terrific information. I'm in Australia and, frustratingly, my GP had never heard of these markers!!! On the other hand, conveniently, both markers are expressed in ug/L, i.e. CTX 0.42 ug/L and P1NP 42 ug/L, giving me a starting ratio of 100.
Dr. Doug, thank you for your informative channel. I just watched your video with the doctor promoting his book LIFTING WEIGHTS IS STUPID. This title is very disrespectful to thousands of fitness professionals (including myself) who have improved the health of their clients on multiple levels by using evidence-based resistance exercises guidelines! As you know, the benefits of resistance exercises go way beyond bone health.
Hi there. Thanks for supporting the channel. John is a very controversial character. He named his book that specifically to be provocative and has sold thousands of copies as a result. It could be viewed as disrespectful BUT consider it for what it is, a perspective on variable resistance training. I agree that weight training has numerous benefits and I recommend weight training for my patients and participate in it myself on a regular basis.
My P1NP to CTx ratio dropped from 137.6 to 121.7, over 6 mos. Following all the nutrition, exercise and protein and (expensive) supplements advice - what should my next step be?
Great question. We’d have to look at the details of each variable. That’s the wrong trend as you have indicated but with subtle fluctuations it’s hard to know if that’s actually worse or just not better.
Thank you for all the information, Dr. Lucas. I recently obtained my first P1NP and CTX results to monitor my osteopenia. About me: male, 46 years old, diagnosed with osteopenia at 40, L2-L4 at -2.4 in Sep24. P1NP: 67.6 - CTX: 372 - Ratio: 181 (Oct24). I also have an osteocalcin result of 16.6 ng/mL, but I haven't found much information about this marker in any of your videos. I'm wondering if it’s worth tracking since I already have P1NP and CTX. My next steps are to include strontium and lactoferrin, switch to a higher intake of animal protein, and incorporate impact exercises. These are the only variables I was unfamiliar with; everything else I've already been working on. I have never taken any medication. Thank you!
Great question! Checkout The OsteoCollective if you have not yet, you get exclusive access to me and a community of people pursuing health and longevity. These are things that we discuss in there and it allows us to go into detail rather than doing short chats through this platform. You can find more information here --> www.optimalhumanhealth.com/osteocollective
Thanks for this! Makes sense to use it as a comparison tool until ref ranges more clearly established. Got these right before starting HRT to have to compare individual numbers, so also have my ratio as well. Estradiol started at lowest amt avail, and increasing it to more reasonable amt. Plan to retest after established on that. Will discuss some in Healthspan Nation comminity soon. Thanks again and Happy Holiday Season and New Year to come!! :) :)
Something I’d like to study but I haven’t looked into it yet. I did some research on PEMF in the past and I didn’t see bone health in the list of studies I observed benefits in.
Would the ratio be "off" if healing from a fracture when CTX and P1NP were done? My labs during healing from sacral fracture showed a ratio of 481.8, and a year later (current) the ratio is 127.48.
Question, I have been in menopause for the past nine years. I have not done any HRT and I am 61 years old. Am I still a candidate for doing HRT? I have been recently diagnosed with osteoporosis, and I am trying to do the things necessary to improve my bone health, but I was wondering if HRT would also be an addition that would be recommended for me.
Hi there. @GiGi-fd6om is right. The traditional thought is that there is a 10 year window of safety. However, this window is relatively arbitrary and not based on great evidence. We use the 10 year concept but expand that to individual risk and consider HRT beyond 10 years as well for some women.
I recently purchaed a WBV for seniors (Vibrant Health by Becky Chambers). There is a lot of information coming to the front regarding how Whole Body Vibration helps osteoporosis. I am taking Ostinol 350 (bone & cartilage stimulatng protein supplemen powered by Cyplexinol (an all natural protein complex which suppports the body's ability to grow new healthy bone and cartilage tissue while promotiig healthy immune signaling, suggested by my functional endocrinologist. Commets?
Hi there. I'm scripting a new video on WBV. Big picture take aways are the frequency of 30Hz and displacement around 2mm is the sweet spot. There are a number of products out there and many fit these metrics. Ostinol is a BMP product that I support the use of.
A talk about post-I131 treatments would be great, as that adversely affects bone (& teeth), and so many people have had I131 treatments, and in some countries, exposure to I131 via radiation leaks, from events like the earthquake in Fukashima, and coastal areas affected. This is a common problem, especially years after exposure, when it has adversely affected bone formation and teeth, as well as adversely affecting some people's savilary glands. Is there any way to mitigate the damage?
Great question! Checkout The OsteoCollective if you have not yet, you get exclusive access to me and a community of people pursuing health and longevity. These are things that we discuss in there and it allows us to go into detail rather than doing short chats through this platform. You can find more information here --> www.optimalhumanhealth.com/osteocollective
Very interesting video. Thank you for sharing Dr Lucas. Can my Family Doctor order P1NP & CTX blood tests for when I have my annual physical? I have labs thru Labcorp late May/ Dr Review results early June/ Dexa mid June & Endocrinologist late June. Thank you
This is incredible information. Thank you for sharing how to get the ratio of these two biomarkers. I've shared before during my last bloodwork in Oct, my P1NP was below average and my CTX was somewhere middle of average. Which is not good. Am working out more, loading my bones more, looking after my diet and lately, started making kefir at home and consuming daily. I have intention to go back for another blood test for P1NP 6 months later but for CTX, gosh, i can't afford it to keep doing it for long term, unfortunately. Maybe every year perhaps. Unlike 1st world country, CTX is not available for testing in my country and we have to send my blood to Australia. And it costs $1000 in my currency, it's a lot. So am still wondering how to go about this. I have all the right intentions but technology fails me here. Worse is, I had to educate my doctor on what P1NP and CTX is when I asked her to include these biomarkers in my blood test! No one here tests for these. Thank you Dr!
If nothing else, I'd suggest keeping up with the keifer, getting enough sun, and perhaps taking vitamin D, and perhaps a Calcium, magnesium, zinc & vitamin K supplementation. Best of luck to you. It isn't always tested for here in the states, either.
@@CarolReidCA Thanks Carol, I will definitely keep up with the kefir. I love it very much! I did the sun baking for a year plus as advised by my GP but my vitamin D levels didn't change. It was the D3+K2 that helped. Now with kefir, hopefully i can improve gut health to be able to absorb the D3 and K2 properly. P1NP and CTX isn't always tested but I am guessing it's doesn't cost as much as $1000 for CTX, right? It's a lot to me and many people won't do it because it's too much to pay for test.
Taking an aromatase inhibitor for ER+ HER2- breast cancer. Any extra advise for bone building in this situation? Also, would switching to tamoxifin be of benefit as I'm post menopausal and can take either. Also, my DEXA showed normal results in R-hip, spine; slight osteopenia in L-hip. They want me to take Zometa - but what happens to normal bone with a bisphospinate? Thank you for your very helpful information!
Hi there. This is an unfortunately common situation. If your doctor gives you the option of tamoxifen or anastrozole tamoxifen would be more beneficial for bone and would possibly prevent the need for bisphosphonates if your starting point is so good.
Hi. I discovered a lady on you tube called Dr Lisa. She is a physical therapist who specializes in exercise for osteoporosis and breast cancer recovery. She has low bone density. Very positive calming and supportive. Called “ brick house bones” . Love her. She makes exercising fun and safe again.
I get my CTx and P1NP at Quest Labs. The reports state that there is no reference range for ages >49. I am 61. How do I know what is the appropriate CTx for me? My initial CTx was 450; it dropped to 283 after 4 months of being on 0.025 mg estradiol patch. I take that as a win, however, what should I be looking for in my CTx values over time?
Hi, this is an interesting question and one we are working on. Our experience is that there isn’t an objective reference range we are shooting for. We are using the ration P1NP / CTX adjusted for units and we will get a number from 50 to 300. Higher is better. P1NP and CTX generally move in the same direction but the amount of change is more relevant.
dr doug, im having a problem understanding how I get my ration between p1np and ctx . my recent ctx results went from 180 to 633 which I think is too steep, I'm not on any drugs, I was on evenity for 12 months. so if my previous bone marker results were 53.1 over 180, and they are now 56.2 over 633 what does that mean?
Great question! Checkout The OsteoCollective if you have not yet, you get exclusive access to me and a community of people pursuing health and longevity. These are things that we discuss in there and it allows us to go into detail rather than doing short chats through this platform. You can find more information here --> www.optimalhumanhealth.com/osteocollective
Hi Dr Doug. I watch all your videos. I live in the UK. Wish we had someone like you to help us. My problem is I cant take any Hormone treatment,too old. Im 66. So,I do feel if this is my problem. Im on all suppliments and I have a Personal trainer in the gym doing heavy weights. Im having a Rems test in 2 weeks time. Would love to get on your Master class. Not sure what time in the UK to contact. Many thanks.
How does supplemented Grown Hormone HGH affect bone density? My endocrinologist prescribed HGH because my IGF-1 level is 0 without. But my bone density hasn't improved with HGH.
Great question! Checkout our health span nation if you have not yet, you get exclusive access to me and a community of people pursuing health and longevity. These are things that we discuss in there and it allows us to go into detail rather than doing short chats through this platform. You can find more information here --> www.drdouglucas.com/healthspan
Great question! Checkout our health span nation if you have not yet, you get exclusive access to me and a community of people pursuing health and longevity. These are things that we discuss in there and it allows us to go into detail rather than doing short chats through this platform. You can find more information here --> www.drdouglucas.com/healthspan
Great question! Checkout our health span nation if you have not yet, you get exclusive access to me and a community of people pursuing health and longevity. These are things that we discuss in there and it allows us to go into detail rather than doing short chats through this platform. You can find more information here --> www.drdouglucas.com/healthspan
Hi! Checkout the video series on my channel about Vibration Therapy. The first Video is called "Vibration Therapy for Osteoporosis (Episode 1 of 3) | Interview with Dr. Clinton Rubin from Marodyne"
If a person fractures the values of CTX and P1NP are affected for a year or so as I understand. I am now 14 months from A tibial plateau right fracture repair and left wrist and left clavicle fracture.I am wondering if appropriate to test now
They do change with fracture repair. I've not seen good studies on this though. I think at 14 months it should be compelling to measure them now. You can always continue to measure and just expect changes based on the experience of fracture healing.
Very interesting. Following a diagnosis of -3.5 lumber spine and -1.7 hip I have used the information on this channel to try and manage the condition without drugs. I first learnt about CTX and P1Np from Dr Doug and I pushed to have the test done in the Uk. I have the results but all I’ve been told is that they are elevated and we seem to have no expertise in interpreting the results. My CTx is 1.09 and p1NP is 130 ug/L. I will calculate the ratio and use it as a benchmark but I wish I could have a better idea of what the ratio should be? For background information I was in a RTA and broke my C1,C2 and T,3,4,5 and tibia plateau so 10 months on that is why I’ve been told that my bone markers are elevated but not what they should be! Thank you for all the valuable information.
Hi! Thank you for sharing this. You could probably benefit from our next free Bone Foundations Masterclass sessions. You can find details at this link --> www.optimalbonehealth.com/build-bone
Thank you for sharing this, unfortunately I cannot provide specific recommendations through this platform, I would need to know a little bit more about you as well. Checkout our health span nation if you have not yet, you get exclusive access to me and a community of people pursuing health and longevity. You can find more information here --> www.drdouglucas.com/healthspan
Can my PCP orders these blood tests when my Endocrinologist declined to order these tests? I have followed you from RUclips for a while and learned very important information about my osteoporosis self treatment. May I make an appointment seeing your team in Durham,NC?
Our program is completely virtual and bloodwork is included! You can find further details on our website and schedule a discovery call at the following link --> www.optimalbonehealth.com/schedule
Wow. Are there labs that will do it privately? Outside of NHS? Those of us in the US who are fighting osteoperosis and/or need HRT - it's a real fight. Doctors push us toward bisphosphonates right out the gate & GYN still won't effectively treat menopause. So we often have to go to docs who don't take insurance & it's freaking expensive!! On top of what we already pay for insurance, deductibles, copays etc etc. And unfortunately, that kind of care can only be accessed by people who have a lot of extra money. Which is a privileged minority.😢
I'd say both actually. The labs give an idea of what's happening quicker than the scans and show short term trends, but the scans are the proof of results in a longer term sense. The scans show the bone density results of the biological building and absorption processes the labs indicate. The scans are done less frequently though, so the labs can help you know better which direction your bones are headed sooner. Both are snapshots, but scans show longer term trends than labs. Bone density (what scans measure) takes longer to respond than the processes that affect it (what the labs measure).
Another very long sales pitch without useful information. All you say is "I don't know". Indeed, you don't know. In people who aren't on drugs you'll see that both P1NP and CTX are in a similar range. If CTX is above average, so is P1NP. If CTX is low, so is P1NP. The numbers indicate the speed of bone turnover. And with each cycle you lose bone, therefore you want both CTX and P1NP to be low. Also, P1NP is highly variable (e.g. after excercise), therefore looking at the ratio is a waste of time.
@@wandamusictube I'm being treated by several bone metabolism experts, who all agree on the interpretation of CTX/P1NP. That's 6 researchers in total, from 2 different universities. All 6 professors could be wrong of course, but since they all agree and have a lot of reference data I must assume they are right.
I'm curious of your comment. What am I pitching? I'm not selling anything? I make no money on lab tests and there is no benefit financially for me to teach patients how to use these labs as we do in our practice. That said I'm always interested in new research on these biomarkers and if you have research to put forward please do so. I'm happy to review. The experts you mention may have opinions and I'd be happy to hear them. I'm presenting mine and what I see in my practice that reverses osteoporosis. You can take it for what it is. We see results. Do your experts see results? I think there is value in measuring the biomarkers. We are collecting data which we will continue to present to this audience as we learn.
Yeah, OK but you’re not telling anyone how to grow bone also, if you had breast cancer with estrogen positive talking about giving hormones to the general public is very dangerous, do you want to give people breast cancer again?
This doctor's approach is much more nuanced than that. The foundations of his program are nutrition and lifestyle, hormones and drugs only where appropriate. Check out his other videos in his channel.
The general public is just fine to take HRT. The research in the last 5 years shows that estrogen does not cause breast cancer. Rather it can fuel it if a woman were to get it. Most women SHOULD be on hormone replacement.
Please watch more than one video! I discuss HRT as an adjunct to lifestyle and never tell anyone to do anything specifically without discussing it with their provider team to evaluate risks and benefits. As mentioned above estrogen DOES NOT cause breast cancer but can cause cancer to grow faster in some situations. However, osteoporosis DOES respond to estrogen positively and those with bone health concerns SHOULD consider estrogen when appropriate.
![Noob To Max With DRAGON REWORK In Blox Fruits [FULL MOVIE]](http://i.ytimg.com/vi/LnBMOinoOvA/mqdefault.jpg)
Ok, just found out today my ratio went from 108 (before starting BHRT) to 150, 6 months after(CTX 750, P1NP 81 to 510 and 75) Guess I’m going in the right direction!!!! I had implemented diet/supplements, and resistance/ weight bearing exercise advice one year ago and had the bone markers taken right before the start of BHRT 6 mo ago and then again last week. I have recently started impact training, maybe that will increase the ratio even more. You are doing such a good thing providing us with this info!!!!! Thank you.
Thank you so much for sharing this. I am glad these videos have been helpful!
My endocrinologist agreed to my request for P1NP, CTx and osteocalcin tests. Got the results today, and will try to test again in about 4 to 6 months.
Thank you for sharing this!
In the past I had seen two endochronologists. Neither ordered any labs but prescribed Fosamax and there was no improvement in bone density. Recently I asked my Primary NP to look forthe cause of my lowbone density and she ordered 8 tests including CTX and P!NP which were both in the middle of the normal range. This tells me that my current diet and supplements are fine. I won't be seeing any more "pill doctors".
Thank you for sharing. It seems the Endocrinologist like Fosamax. Thank goodness for my dentist who told me about osteo necrosis. I want to bring this information to my Primary physician and ask for these tests.
Thank you for sharing this!
Can you provide us with the names of the 8 tests ordered by your NP?
Me too. I asked my 1st visit with Endocrinologist about all if the items that Dr Lucas and comments recommend. I asked about K2-D3, Boron, Strontium, vibration, Execute, Bio Identical Hormones. She said coldly flat out "NO". She only prescribed meds that cause necrosis and broken bones. I wish ii could find a Doctor to be my Primary like Dr Doug Lucas. ❤
Please see me Dr Lucas. I am getting so bad and need a hip replacement yet can't get well enough.
Australian here ... my doctor does not support any strategies other than pharmaceuticals for the treatment of osteo. She poo-hoos everything else, other than ensuring and "adequate diet" (whatever she means by that). At my last request for a Dexa, I also asked for retesting all the bloods and asked her to include the bone turnover markers. When I got all my results back, she ran through them with me but nothing about the bone turnover. When I asked if she had them tested, her response was: "I never bother with those tests. You just have to accept you have osteoporosis." It's depressing. Like so many others, I'm just trying to learn as much as I can and make doable adjustments. I've taken on the Liftmor exercises and been doing that for 9 months. I will ask for another Dexa in a few more months. Doctors are not willing to do anything other than prescribe medications.
I'm from Sydney and I encountered the same attitude from my GP and endocrinologist. I finally convinced my GP to monitor my efforts of getting off the drugs and trying to improve my blood markers through diet, supplements and exercise. Still on a bisphosphonate waiving my way out of prolia.
@@NicoletaGiura Best wishes for that. It’s tough….that’s why they should be doing more on helping women prevent developing osteo in the first place. They just figure old woman’s problem and we have drugs for it, so end of story, next patient please.
Hi! Thank you for sharing this. It sounds like you could benefit from attending our next Bone Foundations Masterclass session. You can find further details here --> www.optimalbonehealth.com/build-bone
Thank you for this very clear and helpful explanation. After 10 yrs of OP diagnosis, I finally found a RM who asked for bone markers (blood and urine). However, even this doctor only asked for CTX. I just asked the Lab to add a PN1P and paid for it myself.
It's great to hear that you've taken the initiative to ask for additional tests like PN1P-it's empowering to be proactive in your own health journey. Keep up the great work, and best of luck on your continued health journey!
This is a great idea! I have been so frustrated not having data in between DEXA scans. Now I know what to do!
Glad you enjoyed this video!
I just had the first blood markers done...CTX is
All the best❤️
What is the range for P1NP?
Thank you for sharing this, I appreciate your support!
What is referent range of P1NP and CTX blood test
Hello Dr Lucas ~~
I am a woman, 79 and have osteoporosis and know others of similar age with osteoporosis. Is there age specific information for senior older women? Does your research include those late-70s and 80 + year old females who have osteoporosis ? Would you kindly counsel us elders. Thank you so much, in appreciation. Jan
We focus on a lightly younger audience Jan but our messaging is valuable for any age! Chronologic age is not a contraindication to anything we discuss BUT the older one gets the more difficult things can be to change. I hope that makes sense. We have patients in their 70's and 80's and they do see benefits. There are more tools to use for our younger patients who are in their 40s and 50s. There are so many tools to use that we can come up with a plan for anyone.
Thanks for this terrific information. I'm in Australia and, frustratingly, my GP had never heard of these markers!!! On the other hand, conveniently, both markers are expressed in ug/L, i.e. CTX 0.42 ug/L and P1NP 42 ug/L, giving me a starting ratio of 100.
Thank you for sharing!
EXCELLENT video and thank you for the easily understood explanation for the necessary blood tests.
Thank you for watching, glad you enjoyed it!
Dr. Doug, thank you for your informative channel. I just watched your video with the doctor promoting his book LIFTING WEIGHTS IS STUPID. This title is very disrespectful to thousands of fitness professionals (including myself) who have improved the health of their clients on multiple levels by using evidence-based resistance exercises guidelines! As you know, the benefits of resistance exercises go way beyond bone health.
Hi there. Thanks for supporting the channel. John is a very controversial character. He named his book that specifically to be provocative and has sold thousands of copies as a result. It could be viewed as disrespectful BUT consider it for what it is, a perspective on variable resistance training. I agree that weight training has numerous benefits and I recommend weight training for my patients and participate in it myself on a regular basis.
My P1NP to CTx ratio dropped from 137.6 to 121.7, over 6 mos. Following all the nutrition, exercise and protein and (expensive) supplements advice - what should my next step be?
Great question. We’d have to look at the details of each variable. That’s the wrong trend as you have indicated but with subtle fluctuations it’s hard to know if that’s actually worse or just not better.
Getting my bone density ultrasound method today at USF Medical Endocrinology. Only place in Tampa Bay area.
Thank you for sharing this!
Thank you for all the information, Dr. Lucas. I recently obtained my first P1NP and CTX results to monitor my osteopenia. About me: male, 46 years old, diagnosed with osteopenia at 40, L2-L4 at -2.4 in Sep24. P1NP: 67.6 - CTX: 372 - Ratio: 181 (Oct24). I also have an osteocalcin result of 16.6 ng/mL, but I haven't found much information about this marker in any of your videos. I'm wondering if it’s worth tracking since I already have P1NP and CTX. My next steps are to include strontium and lactoferrin, switch to a higher intake of animal protein, and incorporate impact exercises. These are the only variables I was unfamiliar with; everything else I've already been working on. I have never taken any medication. Thank you!
Great question! Checkout The OsteoCollective if you have not yet, you get exclusive access to me and a community of people pursuing health and longevity. These are things that we discuss in there and it allows us to go into detail rather than doing short chats through this platform. You can find more information here --> www.optimalhumanhealth.com/osteocollective
Thanks for this! Makes sense to use it as a comparison tool until ref ranges more clearly established. Got these right before starting HRT to have to compare individual numbers, so also have my ratio as well. Estradiol started at lowest amt avail, and increasing it to more reasonable amt. Plan to retest after established on that. Will discuss some in Healthspan Nation comminity soon. Thanks again and Happy Holiday Season and New Year to come!! :) :)
Thank you for watching, I appreciate your support! Happy Holidays!
Thank you thank you!!
You are so welcome! Thank you for watching.
Has anyone used PEMF for osteoporosis?? Does it really work? Already in on the vibration therapy but what about PEMF therapy?
Something I’d like to study but I haven’t looked into it yet. I did some research on PEMF in the past and I didn’t see bone health in the list of studies I observed benefits in.
A friend if mine has recommended pemf. She believes it really helped her bones....@Dr_DougLucas
Kaiser Permanente only tests every 5 years for Dexa. That is what I was told when I asked for a repeat. My last Dexa was 4 1/2 years ago.
They test every 2 yr now. I have Kaiser and osteoporosis
@@cherylkeithley7303 my doctor told me every 10 years but said since I had slight bone loss the allowed 5 years. I just talked to her.
Me too. Every 2 years.
Kaiser sucks. I'd look for new insurance. Js.
That's crazy. Time to pay cash for your next imaging test. Preferably REMS.
LOL, that CTX reminds me of the movie “ The Blob “. Saw it as a child and had nightmares for weeks.
Ahhh yes!
Would the ratio be "off" if healing from a fracture when CTX and P1NP were done? My labs during healing from sacral fracture showed a ratio of 481.8, and a year later (current) the ratio is 127.48.
Potentially, I have read that fracture healing will impact these biomarkers but I haven’t seen evidence to suggest to what degree.
Many thanks😀
Thank you for watching!
Question, I have been in menopause for the past nine years. I have not done any HRT and I am 61 years old. Am I still a candidate for doing HRT? I have been recently diagnosed with osteoporosis, and I am trying to do the things necessary to improve my bone health, but I was wondering if HRT would also be an addition that would be recommended for me.
provided you are in good heath, the rule of thumb or window of opportunity is to begin hrt within 10 years of last period. get om it!
Hi there. @GiGi-fd6om is right. The traditional thought is that there is a 10 year window of safety. However, this window is relatively arbitrary and not based on great evidence. We use the 10 year concept but expand that to individual risk and consider HRT beyond 10 years as well for some women.
I recently purchaed a WBV for seniors (Vibrant Health by Becky Chambers). There is a lot of information coming to the front regarding how Whole Body Vibration helps osteoporosis. I am taking Ostinol 350 (bone & cartilage stimulatng protein supplemen powered by Cyplexinol (an all natural protein complex which suppports the body's ability to grow new healthy bone and cartilage tissue while promotiig healthy immune signaling, suggested by my functional endocrinologist. Commets?
Hi there. I'm scripting a new video on WBV. Big picture take aways are the frequency of 30Hz and displacement around 2mm is the sweet spot. There are a number of products out there and many fit these metrics. Ostinol is a BMP product that I support the use of.
A talk about post-I131 treatments would be great, as that adversely affects bone (& teeth), and so many people have had I131 treatments, and in some countries, exposure to I131 via radiation leaks, from events like the earthquake in Fukashima, and coastal areas affected. This is a common problem, especially years after exposure, when it has adversely affected bone formation and teeth, as well as adversely affecting some people's savilary glands.
Is there any way to mitigate the damage?
Thanks for that recommendation!
Does Medicare pay for tests p1np cycle?
Great question! Checkout The OsteoCollective if you have not yet, you get exclusive access to me and a community of people pursuing health and longevity. These are things that we discuss in there and it allows us to go into detail rather than doing short chats through this platform. You can find more information here --> www.optimalhumanhealth.com/osteocollective
Very interesting video. Thank you for sharing Dr Lucas. Can my Family Doctor order P1NP & CTX blood tests for when I have my annual physical? I have labs thru Labcorp late May/ Dr Review results early June/ Dexa mid June & Endocrinologist late June. Thank you
Not sure, it never hurts to ask though!
This is incredible information. Thank you for sharing how to get the ratio of these two biomarkers. I've shared before during my last bloodwork in Oct, my P1NP was below average and my CTX was somewhere middle of average. Which is not good. Am working out more, loading my bones more, looking after my diet and lately, started making kefir at home and consuming daily. I have intention to go back for another blood test for P1NP 6 months later but for CTX, gosh, i can't afford it to keep doing it for long term, unfortunately. Maybe every year perhaps. Unlike 1st world country, CTX is not available for testing in my country and we have to send my blood to Australia. And it costs $1000 in my currency, it's a lot. So am still wondering how to go about this. I have all the right intentions but technology fails me here. Worse is, I had to educate my doctor on what P1NP and CTX is when I asked her to include these biomarkers in my blood test! No one here tests for these. Thank you Dr!
The next important thing to test for yearly is Vitamin D3. It is also important to eat enough protein daily.
@@bluewaters3100 yes, I do that every year
If nothing else, I'd suggest keeping up with the keifer, getting enough sun, and perhaps taking vitamin D, and perhaps a Calcium, magnesium, zinc & vitamin K supplementation.
Best of luck to you. It isn't always tested for here in the states, either.
@@CarolReidCA Thanks Carol, I will definitely keep up with the kefir. I love it very much! I did the sun baking for a year plus as advised by my GP but my vitamin D levels didn't change. It was the D3+K2 that helped. Now with kefir, hopefully i can improve gut health to be able to absorb the D3 and K2 properly. P1NP and CTX isn't always tested but I am guessing it's doesn't cost as much as $1000 for CTX, right? It's a lot to me and many people won't do it because it's too much to pay for test.
Thank you so much for sharing this story! I am glad to hear this channel has helped you and it sounds like you are moving in the right path!!
Taking an aromatase inhibitor for ER+ HER2- breast cancer. Any extra advise for bone building in this situation? Also, would switching to tamoxifin be of benefit as I'm post menopausal and can take either. Also, my DEXA showed normal results in R-hip, spine; slight osteopenia in L-hip. They want me to take Zometa - but what happens to normal bone with a bisphospinate? Thank you for your very helpful information!
Hi there. This is an unfortunately common situation. If your doctor gives you the option of tamoxifen or anastrozole tamoxifen would be more beneficial for bone and would possibly prevent the need for bisphosphonates if your starting point is so good.
Hi. I discovered a lady on you tube called Dr Lisa. She is a physical therapist who specializes in exercise for osteoporosis and breast cancer recovery. She has low bone density. Very positive calming and supportive. Called “ brick house bones” . Love her. She makes exercising fun and safe again.
I get my CTx and P1NP at Quest Labs. The reports state that there is no reference range for ages >49. I am 61. How do I know what is the appropriate CTx for me? My initial CTx was 450; it dropped to 283 after 4 months of being on 0.025 mg estradiol patch. I take that as a win, however, what should I be looking for in my CTx values over time?
Hi, this is an interesting question and one we are working on. Our experience is that there isn’t an objective reference range we are shooting for. We are using the ration P1NP / CTX adjusted for units and we will get a number from 50 to 300. Higher is better. P1NP and CTX generally move in the same direction but the amount of change is more relevant.
Thanks for your response. Will you provide the formula for calculating the ratio between the CTx and P1NP scores? @@Dr_DougLucas
@@joannelivengood7914 Of course (P1NP/(CTX/1000)). Should look something like 50/0.400
what if no one is listening???? Can I get the CTX and PINP test done at my PCP or do I need an endocrinologist?
You can try either but might end up having to do it yourself. We walk you though how to do it in our free bone foundations course.
dr doug, im having a problem understanding how I get my ration between p1np and ctx . my recent ctx results went from 180 to 633 which I think is too steep, I'm not on any drugs, I was on evenity for 12 months. so if my previous bone marker results were 53.1 over 180, and they are now 56.2 over 633 what does that mean?
Great question! Checkout The OsteoCollective if you have not yet, you get exclusive access to me and a community of people pursuing health and longevity. These are things that we discuss in there and it allows us to go into detail rather than doing short chats through this platform. You can find more information here --> www.optimalhumanhealth.com/osteocollective
Hi Dr Doug. I watch all your videos. I live in the UK. Wish we had someone like you to help us. My problem is I cant take any Hormone treatment,too old. Im 66. So,I do feel if this is my problem. Im on all suppliments and I have a Personal trainer in the gym doing heavy weights. Im having a Rems test in 2 weeks time. Would love to get on your Master class. Not sure what time in the UK to contact. Many thanks.
Hi! Thank you for watching, I appreciate your support. You can register for our masterclass here --> www.optimalbonehealth.com/build-bone
How does supplemented Grown Hormone HGH affect bone density? My endocrinologist prescribed HGH because my IGF-1 level is 0 without. But my bone density hasn't improved with HGH.
Great question! Checkout our health span nation if you have not yet, you get exclusive access to me and a community of people pursuing health and longevity. These are things that we discuss in there and it allows us to go into detail rather than doing short chats through this platform. You can find more information here --> www.drdouglucas.com/healthspan
Do you have enough of the ratio numbers to see what is a good ratio if this if the first time we are getting CTX and PN1P tests?
Great question! Checkout our health span nation if you have not yet, you get exclusive access to me and a community of people pursuing health and longevity. These are things that we discuss in there and it allows us to go into detail rather than doing short chats through this platform. You can find more information here --> www.drdouglucas.com/healthspan
Is C-Telopeptide how Labcorp lists the CTX test? Thank you!
Great question! Checkout our health span nation if you have not yet, you get exclusive access to me and a community of people pursuing health and longevity. These are things that we discuss in there and it allows us to go into detail rather than doing short chats through this platform. You can find more information here --> www.drdouglucas.com/healthspan
Is vibration plate safe to use.
Hi! Checkout the video series on my channel about Vibration Therapy. The first Video is called "Vibration Therapy for Osteoporosis (Episode 1 of 3) | Interview with Dr. Clinton Rubin from Marodyne"
If a person fractures the values of CTX and P1NP are affected for a year or so as I understand. I am now 14 months from
A tibial plateau right fracture repair and left wrist and left clavicle fracture.I am wondering if appropriate to test now
They do change with fracture repair. I've not seen good studies on this though. I think at 14 months it should be compelling to measure them now. You can always continue to measure and just expect changes based on the experience of fracture healing.
Very interesting. Following a diagnosis of -3.5 lumber spine and -1.7 hip I have used the information on this channel to try and manage the condition without drugs. I first learnt about CTX and P1Np from Dr Doug and I pushed to have the test done in the Uk. I have the results but all I’ve been told is that they are elevated and we seem to have no expertise in interpreting the results. My CTx is 1.09 and p1NP is 130 ug/L. I will calculate the ratio and use it as a benchmark but I wish I could have a better idea of what the ratio should be? For background information I was in a RTA and broke my C1,C2 and T,3,4,5 and tibia plateau so 10 months on that is why I’ve been told that my bone markers are elevated but not what they should be! Thank you for all the valuable information.
@susandewhurst6771 where in the UK have you managed to arrange this blood work?
Bournemouth hospital but it looks like they sent the bloods to Norwich for analysis
@@susandewhurst6771 Thank you. I will chase this up.
Hi! Thank you for sharing this. You could probably benefit from our next free Bone Foundations Masterclass sessions. You can find details at this link --> www.optimalbonehealth.com/build-bone
Dr. Lucas - can a 68 yr old female begin HRT with a recent diagnosis of osteoporosis?
Thank you for sharing this, unfortunately I cannot provide specific recommendations through this platform, I would need to know a little bit more about you as well. Checkout our health span nation if you have not yet, you get exclusive access to me and a community of people pursuing health and longevity. You can find more information here --> www.drdouglucas.com/healthspan
I am 69. I took HRT until I was 63, but my doctor recommended I stop. My Dexa went down quite a bit. Is HRT safe to restart at my age?
Wow. That’s interesting. Thanks
You need to watch Dr, (menopause) Taylor on RUclips about HRT.
Your doc was misinformed. new guidelines are to only stop if medically necessary. Go back on.
Just look into bioidenticals -
If you've been off for 6 years it's likely reasonable to start back but everyone's different. 69 yo by itself is NOT a reason to avoid them.
Can my PCP orders these blood tests when my Endocrinologist declined to order these tests? I have followed you from RUclips for a while and learned very important information about my osteoporosis self treatment. May I make an appointment seeing your team in Durham,NC?
Our program is completely virtual and bloodwork is included! You can find further details on our website and schedule a discovery call at the following link --> www.optimalbonehealth.com/schedule
What is the self directed program?
Follow the links below the video to the free bone foundations course.
Hi! You can find further details at this link --> www.optimalbonehealth.com/bonus
Hi,this is brilliant information. But I know here in the U K our doctors will not do these tests. Thank you for thd great information.
Wow. Are there labs that will do it privately? Outside of NHS? Those of us in the US who are fighting osteoperosis and/or need HRT - it's a real fight. Doctors push us toward bisphosphonates right out the gate & GYN still won't effectively treat menopause. So we often have to go to docs who don't take insurance & it's freaking expensive!! On top of what we already pay for insurance, deductibles, copays etc etc. And unfortunately, that kind of care can only be accessed by people who have a lot of extra money. Which is a privileged minority.😢
Typical of the medical system
I did get the tests but had to push hard. Bournemouth’s hospital organised it
Glad it was helpful!
Are labs or scans better to retest?
Good question
I'd say both actually. The labs give an idea of what's happening quicker than the scans and show short term trends, but the scans are the proof of results in a longer term sense.
The scans show the bone density results of the biological building and absorption processes the labs indicate. The scans are done less frequently though, so the labs can help you know better which direction your bones are headed sooner.
Both are snapshots, but scans show longer term trends than labs. Bone density (what scans measure) takes longer to respond than the processes that affect it (what the labs measure).
Both. Labs are good in the interim and imaging at longer intervals like 12 - 24 months.
Another very long sales pitch without useful information. All you say is "I don't know". Indeed, you don't know.
In people who aren't on drugs you'll see that both P1NP and CTX are in a similar range. If CTX is above average, so is P1NP. If CTX is low, so is P1NP.
The numbers indicate the speed of bone turnover. And with each cycle you lose bone, therefore you want both CTX and P1NP to be low.
Also, P1NP is highly variable (e.g. after excercise), therefore looking at the ratio is a waste of time.
You are a medical professional experienced in bone metabolism?
@@wandamusictube I'm being treated by several bone metabolism experts, who all agree on the interpretation of CTX/P1NP. That's 6 researchers in total, from 2 different universities.
All 6 professors could be wrong of course, but since they all agree and have a lot of reference data I must assume they are right.
Is NTX the same as CTX? I had an NTX urine test that came back as 94. What are normal ranges for each of these tests?
Also, what is the normal range for P1NP?
I'm curious of your comment. What am I pitching? I'm not selling anything? I make no money on lab tests and there is no benefit financially for me to teach patients how to use these labs as we do in our practice. That said I'm always interested in new research on these biomarkers and if you have research to put forward please do so. I'm happy to review. The experts you mention may have opinions and I'd be happy to hear them. I'm presenting mine and what I see in my practice that reverses osteoporosis. You can take it for what it is. We see results. Do your experts see results? I think there is value in measuring the biomarkers. We are collecting data which we will continue to present to this audience as we learn.
Yeah, OK but you’re not telling anyone how to grow bone also, if you had breast cancer with estrogen positive talking about giving hormones to the general public is very dangerous, do you want to give people breast cancer again?
This doctor's approach is much more nuanced than that. The foundations of his program are nutrition and lifestyle, hormones and drugs only where appropriate. Check out his other videos in his channel.
The general public is just fine to take HRT. The research in the last 5 years shows that estrogen does not cause breast cancer. Rather it can fuel it if a woman were to get it. Most women SHOULD be on hormone replacement.
Please watch more than one video! I discuss HRT as an adjunct to lifestyle and never tell anyone to do anything specifically without discussing it with their provider team to evaluate risks and benefits. As mentioned above estrogen DOES NOT cause breast cancer but can cause cancer to grow faster in some situations. However, osteoporosis DOES respond to estrogen positively and those with bone health concerns SHOULD consider estrogen when appropriate.
@@Dr_DougLucas I think you're correct. I, for one, appreciate your information and advice. Thank you, and keep it coming.
My case, negrretted by GP. Doctor for 15 years.
Rebound Osteoporosis.
Desaster.