Get your health question answered instantly from our pool of 18000+ doctors from over 80 specialties

143 Doctors Online
Doctor Image
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

I will be looking into your question and guiding you through the process. Please write your question below.

What does this blood report indicate?

Answered by
Dr.
Dr. Mirjeta Guni

Endocrinologist

Practicing since :2006

Answered : 1998 Questions

default
Posted on Fri, 11 May 2018 in Thyroid Problem and Hormonal Problems
Question: severe osteoporosis, seeing Endocrinologist at Univ of XXXXXXX due to pelvic fracture, broken foot, re-fracture of pelvis, all within one year and without accident or injury. I would like your opinion of my blood test results - osteocalcin serum 4.7, a low score; c-telopeptide 52, low score and parathyroid hormone 77, a higher end score. The specialist wants the Prolia out of my system prior to re-test. Please also tell me why a 24 hr. urine is important. All other labs normal. Dexa is -2.5, down from 2 yrs ago -2.9. have taken Forteo daily from Jan-July this year.
doctor
Answered by Dr. Mirjeta Guni 1 hour later
Brief Answer:
About osteoporosis treatment:

Detailed Answer:
Hello and thank you for asking!

From your description, I can understand that you have been on treatment with Forteo and Prolia since January (?) and than Forteo was removed and you continued with Prolia up to now.

Now your treating physician has recommended to stop Prolia for a certain period and retest the above-mentioned exams?

I would say that C/N telopeptide are bone turnover markers and usually they are significantly decreased when the treatment is effective. But, they get back to previous levels after 12 months of Prolia discontinuation.

PTH level increases during treatment with Prolia but as far as I can understand your physician wants to differentiate if PTH is increased by Prolia or there is a parathyroid adenoma increasing it. That is why they suggested retesting after discontinuation of Prolia.

A 24-hour urine, in this case, would be of help to check urine calcium that in cases of parathyroid adenoma it will result high and in case of PTH increase by Prolia calcium will result low in urine.

Hope I have been clear and helpful. Feel free to ask further.
Kind regards,
Dr.Mirjeta


Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
default
Follow up: Dr. Mirjeta Guni 40 minutes later
I am a 12 year breast cancer survivor and have been on infusions since 5 years on Arimidex, first Reclast, then Prolia, followed up by Forteo dates mentioned in my medical history then back to Prolia. Would that change any of your response?
Thank you for so much information on my tests. XXXXXXX XXXXXXX
doctor
Answered by Dr. Mirjeta Guni 38 minutes later
Brief Answer:
About elevated PTH;

Detailed Answer:
Welcome back!
No, It does not change the above-mentioned opinion.

Parathyroid adenomas are common in the women after 60-ies.
That is why they want to rule it out before continuing with Prolia.

An overproduction of parathyroid hormone by the parathyroid gland would aggravate osteoporosis and the treatment in these cases consists in removing the adenoma, improving the outcome of osteoporosis a lot.

Wish you good health.
Best wishes,
Dr.Mirjeta


Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
premium_optimized

The User accepted the expert's answer

Share on
Question is related to
Diseases and Conditions ,   ,   ,  
Drug/Medication
Medical Topics

Recent questions on  Severe osteoporosis

doctor1 MD

Fractured pelvis in 3 places one year ago. Re-fracture 2 weeks ago. No accident or injury . osteoporosis . orthopedic Dr. recommends bone stimulator to use at home. Besides being very costly I can find no good reviews about using this. Most...

doctor1 MD

Hello, my mother is 85 yrs old and weighs 205 lbs. She is reasonably active for her age. She walks around the house and yard without any assistance. She is totally lucid. She has been complaining about her hip hurting and dizziness for the last 2...

doctor1 MD

I am in the middle of changing doctors do to the Affordable Care Act. I was seeing several doctors who are not on my list because I had a PPO for the last 30 years as of. What I need to start off with is where is a doctor that could be my primary care physician. I would prefer to have an internist. I have several different issues. I had severe osteoporosis but the doctor that was seeing me is awesome but he is not on my insurance plan.Since then I had a 90% compression fracture at T-11 which because of my condition I had to undergo surgery and the results are less than just okay. When they went in to repair it my two other vertebrates collapsed. I actually need to find someone who can help me because there are other issues; severe migraines lasting at least half of every month. I had broken my shoulder went thru therapy, I no this sounds hard to believe BUT,My therapist over-extended my arm(shoulder) yelled out oh my...I think I tore it tendon. And she was right. AFTER SURGERY a month went by and I started feeling awful. PAIN IN ABDOMEN and not keeping any food down. a few weeks and 2 hospitals later and not getting any better I was diagnosed w/pancreatitis. (AND NO I DO NOT DRINK!) I COULD GO ON AND ON BUT I WON t.

doctor1 MD

Many years ago I was d iagnosed with Tarlov cysts, which are thought to be congenital .M ine are VERY large and may be symptoms of lower back pains.... or not. There is erosion if L3 (1/4 of L3) ,with about 1/3 of my sacrum. Some nerve fibers go through the cysts. I have U. Colitis in remission, and I have been hospitalized many times for rest ^& blood transfusions. The steroids have caused cataracts, glaucoma & severe osteoporosis. When is surgery necessary? ?

doctor1 MD

Can osteoporosis cause teeth to move? Any problems with dentistry work?
I am 63 years old, 5'71/2" female. I have severe osteoporosis and have taken Reclast and take calcium and vitamen D3 supplements every day. I am also out 13 years out from stage 4 melanoma.
I am an equestrian and wear protective gear. I'm allowed to ride as long as I take no risks.
Robin

doctor1 MD

My Mom is 87 almost 88 and has two breaks at C1 and C2 in her neck from a fall this past Jan. They are not healing after being in a cervical brace for 5 months and told they will never heal and advised to get cervical spinal fusion. She has many health conditions such as Severe Osteoporosis and takes Reclast and us to take Boniva. She had rheumatoid arthritis her while adult live, and fell 2 years ago and broke her hip which was surgically repaired with plate and pins, then fell again and broke her pelvis and 3 ribs just a year ago. She recovered from all that and now facing surgery again if she doesn t want to where a cervical brace the rest of her life. My question is, based on the little information I provided, would you recommend surgery for her considering all the risks involved?