P1NP - Understanding more about your bone health 

P1NP | Procollagen-1-term-peptide

P1NP is a marker of bone turnover, and made during collagen synthesis.  Collagen is a component of bone.  

Why do P1NP?

• If you have osteopenia or osteoporosis we can monitor P1NP as a marker of is the management plan decreasing bone turnover.  

• P1NP can be done at baseline, prior to bisphosphonate or HRT initiation and then 3 months after treatment.  We would expect that the level should have decreased.  This would demonstrate decreased breakdown.  In cases of no, or minimal drop if one is on oral bisphosphonates this would demonstrate suboptimal absorption and another mode of administration should be used.  In cases of HRT it may be that we increase the dose, or add in another medication.

Be aware that

• supplementary biotin may cause falsely low results (so please inform the provider if you are taking this)

• P1NP isn’t reliable in cases of renal failure

The P1NP test can vary by 20-30%, but you can minimize this variability by having the blood test done in the morning while fasting. Bone turnover is highest in the early morning and decreases significantly by midday. Additionally, eating meals suppresses markers of bone breakdown, particularly those linked to resorption.