The Bone Turnover Panel
P1NP and CTX are two key bone turnover lab markers most standard lab testing does not include. Order yours today for a closer look at your bone health between bone scans.
Your skeleton is constantly breaking down old bone and building new bone. CTX and P1NP are two blood markers that let you see what is happening inside of your bones without having to wait for your next DEXA or REMS scan.
→ P1NP stands for procollagen type 1 N-terminal propeptide. It is a formation marker. When your body builds new bone, the cells doing that work (osteoblasts) release a byproduct called P1NP into your blood as they lay down fresh collagen. It is essentially a signal that new bone construction is underway. A higher P1NP generally suggests your body is actively rebuilding bone.
→ CTX stands for C-terminal telopeptide of type 1 collagen. It is a breakdown marker. When your body removes old bone, specialized cells called osteoclasts break down collagen and release small fragments into your bloodstream. CTX measures those fragments. The higher your CTX, the faster bone breakdown is likely happening. Tracking this number over time can reveal whether bone loss is accelerating, slowing down, or staying stable.
Together, they give you a real-time picture of what your bones are doing and can provide valuable feedback on how your interventions are working for you when monitored over time.
No. You can purchase this panel directly and complete your blood draw at a Labcorp near you without a doctor’s visit. That said, we always encourage you to share your results with your healthcare provider.
You certainly can! However, in our experience, many doctor’s deny the request for these markers for various reasons, such as unfamiliarity with the markers and how to interpret the results, facility protocol, or potential lack of insurance coverage.
Our lab package is intended to be straightforward so you don’t have to wait around for doctors visits, referrals, or receive surprise bills from insurance.
We do not accept traditional insurance. However, our services are eligible for payment through HSA and FSA accounts. Please be aware that we are unable to guarantee approval or authorization on behalf of your card issuer. We are also unable to provide superbills or letters of medical necessity.
Unfortunately, our lab partner is unable to place orders for residents in these states due to local restrictions on lab ordering.
Certain medical conditions may impact your lab results, such as:
We recommend getting a baseline test first, then retesting every 3, 6, or 12 months depending on your goals:
No, bone turnover markers are not a replacement for a DEXA or REMS scan. DEXA and REMS are used to diagnose osteoporosis and assess fracture risk, which bone turnover markers cannot do.
Where bone turnover markers add value is in between scans. Since DEXA and REMS test are typically done every 1-2 years, CTX and P1NP can give you earlier insight into whether your bone is responding to treatment or lifestyle changes, without having to wait for your next scan. Think of them as more of a real-time window into what your bone is actively doing right now.
Yes. Please review the entire set of lab instructions before scheduling your lab draw. We recommend scheduling your test in the morning while fasted, discontinuing certain nutritional supplements leading up to the test that may alter results, and avoiding intense or unusual exercise in the days prior. For the most meaningful comparison of your results overtime, it’s best to try to keep as many factors as similar as possible leading up to each test.
You have 3 months to complete your lab from the date of receiving your lab requisition form.
Results are typically available within 7–10 days, though turnaround time may vary depending on lab processing.
The goal is to understand whether your bone turnover is within a healthy range and how your building and breakdown markers relate to each other. Looking at both P1NP and CTX together gives you a clearer picture of whether your bone is trending in the right direction. From there, you can use your results to assess whether your current plan is working and make adjustments to your training, nutrition, or supplement routine accordingly.
We will attach education on how to interpret your results, but this panel does not include additional feedback or recommendations. If you are looking for more education and guidance, consider our program The Dottie Bones Method, which includes an in-depth lab panel (including P1NP and CTX) and self-paced educational modules.
The Dottie Bones Method is our 5-phase nutrition and lifestyle program built specifically for women with osteoporosis and osteopenia. Receive a bone-focused lab panel and learn exactly how to eat, supplement, and live to support stronger bones.
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