Already a member? Sign in
What - Inspire is a place where you can connect with people who share your health concerns and find information and advice in groups sponsored by organizations you know and trust.
Why - As a member you can use Inspire to let friends and family know how you're doing, contact others who share your health concerns, receive personalized updates and information about participating in surveys and clinical trials, and more.
How - Joining Inspire is completely free and usually takes less than a minute. Join now!
my endocrinologist has always used this second void urine to follow my severe osteo... i just got it done and am usually around 7 (norm is 17-90) and it's good to be low as it means there is low boneturover
i had to switch off the premarin onto the vivelle 0.05 mg dot patch and now it's coming back at 14 which is twice what it has been for 17 years....anyone know much about this test and it's relationship to osteo as a marker?
Hi mjamja, did your premarin have a higher does of estradiol in it compared to the vivelle 0.05 (which is low dose estrogen-right)? If so, that could explain the increase, but if the lab is telling you that the reference range (normal) is between 17-90, then you are still within that. All antiresorptives will lower an NTx score, unless they aren't working for some reason or the dose you are taking currently isn't as strong as what you were taking during the previous test. Did you have a baseline test done on NTx (n-telopeptide) prior to starting the hormones? If so this may give you some more info since I would imagine the baseline would be higher and the follow up testing would drop while you're on HRT.
One other thing, even though I have this test 3 times a year, and many Dr's feel that it's a good indicator for tx response, it is still a highly variable test, because lab mistakes can occur very easily. If you have a choice, be sure to use a lab that does *a lot* of these bone marker tests, to try and eliminate some of the mishandling that can happen and will affect your score. I used to get the 2 hour urine NTx, but my Dr has switched to the 24 hour one that includes the creatinine clearance test, and 24 hr calcium along with the NTx, but I can't say if one is better than another. The main problem is that some labs just don't store or handle the specimen correctly and this can throw off the test. If your insurance will pay for a repeat test you could have it again making sure that the instructions for transport are followed.
I'll send you a link that explains this test further.
Good luck.
thanks for writing
i was on the premarin for 17 years with the NTX being in the 7 range...for all those years
then switched to the vivelle and it probably is less strong but i'm up at hefty level for me as i only weigh 82 pounds...
i just don't want to lose bone but going higher on the patch may not be the answer
the endo doc said it was fine but depsite being the best of boston, she doesn't want me to be on a higher dosel..
is vivelle or HRT considered an antiresoprtive? she says it has been keeping my bone loss at bay but over the years, i'll hit a year and lose...i'm at -4.1 now in hips and spine so am concerned
and her lab is at the brigham and they do these all the time so it can't be a lab error but maybe i should repeat it again and see...in a few weeks...what do you think?
and i'd love the link too
many thanks again!
Hi mjamja, I have a link on bone marker tests in my favorite links section, but I'm not sure if it's working. Click on my picture and then scroll to "favorite links" and look for the one that say's bone markers (Medscape). If that doesn't work, then I'll have to send an email explaining how to get to the article.
HRT is an antiresorptive, and I agree it doesn't sound like your test was a lab error, and I wouldn't think increasing your dose would be recommended, but it still *could* explain the change if the dosing is quite different.
Let me know about the link and if it doesn't work I'll send it to you via the mail system here.
Good luck...
Windblown, Isn't a 14 really good? Mine was tested in May, came back at 43, tested a couple of weeks ago, came back at 30. Taking calcium, magnesium and vit d. What does your NTX results look like.
Also, 24 hour urine test = 258, scale 42-353. Is this bad? One dr says it is normal, the other says I should take HCTZ. I have low blood pressure.
Why cannot doctors agree? So confusing!
Thank You!
dear windblown,
i couldn't find the article but i'm not a member of medscape but could get it thru a friend if in knew the name of the article
and you're right about the premarin giving me reallly high levels of estradiol (77) while the vivelle dot is really low... i saw a second opinion doc and he said i had estrone and other types of estrogen so i should be ok...i stayed up at the .0375 and it's a bit high (soreness in breasts, etc.) but am scared to go down...will have to wait until decemeber to find out what is going on with the bone density...if it drops down i may have to try the forteo which will be hard if not impossible as i have chemical senstitivies and the preservatives may make me sick...right now recovering from gall bladder surgery (thanks to 18 years of premarin)....all so crazy...thanks again for you thoughtful response and i'd love to read that article
marcia
Hi osteochick and mjamja: Here's the title of the article "Use of Biochemical Markers of Bone Turnover for Osteoporosis: Where Do We Stand?"
Douglas C. Bauer, MD
Published: 10/17/2003; Updated: 10/30/2003
Anyone can join Medscape, and it doesn't take long either (free).
Add to the discussion