CTx, short for C-terminal telopeptide, is a biochemical marker used to assess bone resorption, the process by which bone is broken down and minerals are released into the bloodstream. Specifically, CTx measures fragments of type I collagen, which is a major protein found in bone. When bone is resorbed, these fragments are released into the blood and can be detected as an indicator of bone turnover.

How CTx Supports Osteoporosis Management.

1. Monitor Treatment Effectiveness: Tracking CTx levels over time can show if treatments aimed at reducing bone resorption, like anti-resorptive medications, are working.
2. Assess Bone Loss Rate: Elevated CTx levels may suggest higher bone loss rates, putting patients at greater risk for fractures.
3. Guide Treatment Decisions: High CTx levels may lead a doctor to recommend treatments aimed at slowing down bone resorption.

Generally, a baseline CTx measurement is taken before treatment, and follow-up measurements are done to monitor changes and adjust treatment if necessary.

The best time to perform a CTx test is typically in the morning, while fasting. CTx levels can fluctuate throughout the day and are influenced by food intake, so fasting overnight and testing early in the morning helps ensure consistent and reliable results.

Important Guidelines for Accurate CTx Testing.

• Fast for 12 hours before the test.
• Schedule the test in the morning (between 7:30–8:30 am).
• Avoid collagen, bone broth, and biotin (check supplements for biotin) 24–48 hours before testing.
• Repeating the test? Schedule it at the same time as the previous test, or as close as possible.
• Stop all supplements 48 hours before testing.

Following these guidelines ensures reliable CTx results, providing a clearer understanding of bone health and treatment effectiveness.

Why Timing and Preparation Matter for CTx Testing.

1. Diurnal Variation: CTx levels peak in the early morning and decrease throughout the day. Morning tests provide more accurate and comparable results.
2. Fasting Requirements: Food affects CTx levels. Fasting ensures consistent and reliable measurements by removing variability from recent meals.
3. Consistency: Testing at the same time each day, ideally in the morning, helps track bone resorption rates more accurately over time.

Additionally, P1NP (Procollagen Type 1 N-Terminal Propeptide) is a key marker of bone formation. It reflects the activity of osteoblasts—cells responsible for creating new bone. When new collagen (type I) is formed, P1NP is released into the bloodstream, making it a valuable indicator of the bone formation rate.

How P1NP Supports Osteoporosis Management.

1. Monitoring Bone Formation: P1NP levels reveal how actively new bone is being produced, especially helpful when assessing bone-building treatments like anabolic therapies.
2. Evaluating Treatment Response: In patients undergoing treatment, particularly with anabolic agents that stimulate bone formation, P1NP levels indicate if the therapy is effectively boosting bone production.
3. Providing a Balanced View of Bone Turnover: Alongside bone resorption markers like CTx, P1NP offers a comprehensive picture of bone health by showing both breakdown and formation rates.

P1NP testing does not require fasting and can generally be done at any time of the day. Unlike CTx, P1NP levels do not have significant diurnal variation, making it a more flexible test in terms of timing.

Why P1NP Testing is More Flexible:

1. Stable Levels Throughout the Day: P1NP levels don’t fluctuate significantly based on the time of day or food intake, so fasting isn’t necessary.
2. Convenience: Because it can be done at any time, P1NP testing is convenient for patients and is easier to integrate into routine check-ups or follow-ups.

I typically get both tests done together.

This flexibility allows healthcare providers to monitor bone formation without the strict timing constraints required for CTx.

👉 Like CTx, P1NP is often measured before starting treatment and then periodically to track changes, allowing for adjustments to treatment plans based on bone health needs.

Bone Turnover Markers Help Confirm Protocol Effectivenes whether through:

• Nutraceuticals 💊 (supplements)

• Bone-healthy food regimens 🥑

• Weight-bearing exercise programs 🏋️‍♀️

• Pharmaceuticals 💉

These tests validate the effectiveness of strategies aimed at improving bone health and preventing fractures.

The post Understanding CTx and P1NP - Key Bone Markers appeared first on Food For Healthy Bones.

Hello friends of bones:

I’m happy to present my Bone Turnover Marker PDF from my interview with Dr. McCormick.

We discussed:

What are Bone Markers?

Why are they necessary?

What is the best way to get an effective test?

My gift to my community is the easy-to-navigate clickable transcript.

Bone Turnover Markers:

"Therapeutic targets provide medical information a doctor can use to monitor physiological improvements on repeat testing. These can enhance an assessment of bone loss and are key to managing therapy. Just as you would practice hitting the bull's eye to improve your skills as a competitive marksman, we can refine treatment by targeting abnormal physical signs, symptoms, and laboratory test results and then applying therapy to rectify those abnormal findings."

R. Keith McCormick, DC from his upcoming book:
Great Bones -- Taking Control of Your Osteoporosis.

This transcription will be your guide in understanding the need for Bone Turnover Markers, what they are and the importance of "test don't guess".  These tests can be done between your Bone Density Tests (DXA).  The Bone Marker PDF is a clickable guide to make navigating the document easier.

Highly recommended: 

Click below to receive a copy of my Bone Turnover Markers guide PDF.

The link will ask for your email so the guide can be emailed to your inbox.

This action will add your name to my email list which I email bi-monthly on "all things bones".

You can unsubscribe at any time.

Please enjoy the transcript below.

Interview PDF

This PDF is clickable. You can select a Bone Marker you'd like to know more about and then return to the table of contents.

Already know you want to work with my team?

Best to start with a comprehensive private session where a plan will be designed just for you and your bones.

Investment in your bones:

$200 which includes next steps and email follow-up notes.

The post Bone Turnover Markers with Dr. McCormick appeared first on Food For Healthy Bones.

I’m happy to present my bone supplement interview with Dr. McCormick. We discussed his full line of bone supplements which are an important ingredient for healthy bones and why calcium in lower doses matters.

A number of attendees mentioned they were not able to get into the zoom call.  

My 2022 gift to my community is the recording and the transcript.

Please note:  

I am not an affiliate of Dr. McCormick’s supplements.  I find good bone-loving products and bring them to my community.  I cut through the marketing hype.  I currently take his Mineral Whey and his Collagen.  My bones are strong.

As Dr. McCormick mentioned, supplements are just that; they supplement our food.  They don’t take the place of food.  This is an important part of bone health; food.  Calcium and mineral-rich food which I provide in my private sessions and my monthly membership Bones Tribe.

Dr. McCormick is one of a dozen doctors I refer my clients to.  I have a team. My work has grown considerably and I am able to help more clients understand their diagnosis, bone markers, and blood work. And find the appropriate bone doctor, functional gut doctor and serve as an advocate on private calls with their doctors.

A few of my referral doctors are: Dr. McCormick, DC, Dr. Lani Simpson, DC, CCD Certified Densitomitrist, Dr. Paul Miller, Dr. Jessica Starr, HSS Dr. Aly Cohen, Integrative Rheumatologist, Dr. Lorraine Maita, Dr. Deva Boone, Parathyroid Surgeon, Dr. Kim Zamito, Orthopedic Surgeon who offers Echolight and functional and integrative doctors: Dr. Kristann Heinz, RD, Dr. Adi Benito.

I've found DXA/TBS facilities for my clients all around the country as well.

Highlights:

** Dr. McCormick had severe osteoporosis at 45 years old. He endured 22 fractures during his bone journey of 5 years. He used bone drugs for a few years (Forteo and Fosamax). He is fracture-free and to continues to run long distances.

** Dr. McCormick's OsteoSustain supplement has 500mg of calcium. He uses 4 different types of calcium, dicalcium malate, calcium citrate nitrate, calcium bis-glycinate chelate, calcium ascorbate.

** The rest should come from food

** All of his supplements can be taken together: 

OsteoSustain, OsteoStim, Mineral Whey, and Collagen

** His Mineral Whey is from goats that are not exposed to pesticides, herbicides, antibiotics or growth hormones.  Often those challenged by dairy do not have a reaction to goat milk.

** Gluten intolerance/celiac play a huge role in bone health.

** Dr. McCormick mentioned Echolight.  This new procedure is making its way into the world of bone health. 

** Vitamin K2 / MK-4 is important for bone health.

** 500-1000 micrograms of K2 / MK-4.  OsteoStim has 700 micrograms and OsteoSustain has 100 micrograms totaling 800 micrograms.

** K2 / MK-7 has a longer half-life.  Osteostim has 50 micrograms.

** Those diagnosed with osteopenia should track your CTx

** High CTx anything above 400 is high.

** An osteoporosis patient reported she lowered her CTx substantially taking Dr. McCormick’s products

** Always test your vitamin D levels.  Dr. McCormick's range is 30-50ng/ml.  I test my levels twice a year.  At the end of summer and during the winter months.

You can purchase Dr. McCormick's supplements HERE

Please enjoy the recording below.

Prefer to read the transcript? Scroll down beyond my signature.

Already know you want to work with my team?

Best to start with a comprehensive private session where a plan will be designed just for you and your bones. Private sessions are $200 includes full session notes.

The post Bone Supplements with Dr. McCormick appeared first on Food For Healthy Bones.