C-terminal telopeptide

So one of the questions I want practitioners to be asking is, is this predominantly an excessive resorption problem, an inadequate formation problem, or both? And that's where bone turnover markers become really interesting and really important.

One of my favorite markers to look at is the serum CTX, or C-terminal telopeptide.

It's released when type I collagen in bone is broken down.

So think about CTX as a window into what's happening with bone resorption.

When CTX is high, it can suggest that bone breakdown is happening at an accelerated rate, and that changes the questions I like to ask.

So why are those osteoclasts breaking down the bone so actively? It could be menopause-related estrogen loss.

It could be hyperparathyroidism or hyperthyroidism or inflammation.

It can also be excessive stress and glucocorticoid exposure.

It really is.

So today we are breaking down why that is such a dangerous assumption, and how you should actually be using alkaline phosphatase, P1NP and CTX in your daily practice.

It is a critical topic, um, especially because these markers are just so frequently misunderstood.

We are gonna look beyond the static numbers, you know, and explore the dynamic metabolically active engine of the human skeleton.

Exactly.

But if P1NP tells us about the construction crew, we need a way to track the demolition crew.

Which brings us to the final member of our triad and frankly, the most finicky and difficult one to handle in clinical practice, CTX.

Oh, the pre-analytical nightmare.

What do you think about some of the like blood markers that get measured? There's some in functional medicine that look at like the rate of bone loss or bone breakdown.

CTX.

Is that what you're talking

about? Yeah.

Like a CTX measurement.

I

am just starting to use those clinically and I'm very curious about them.

didn't know if you had.