Your bones are not dry, dead sticks holding your body together. They’re made from living tissue that is constantly breaking down and rebuilding itself. Old bone cells are being replaced with new ones in a process known as “remodeling.”
When you were young, your body made large numbers of new cells to keep up with your bone growth. But when you were in your 30s, your bones stopped growing and your need for new cells decreased.
At this time, your body began to make fewer new cells. Your bone tissue still kept breaking down, however. This increased the gap between your bones breaking down and building up. As we get older, this gap continues to widen. By the time we reach menopause, our bone tissue may very well be breaking down faster than it can build. The consequence is thinner bones and a higher risk for fractures.
You’re never too old — or too young — to take a look at how your bones are being formed. The problem is, doctors are relying on one method alone, and it’s not enough. They usually measure bone density — one marker for osteoporosis — with tests like dual X-ray absorptiometry (DEXA) and ultrasound. I’ve never particularly liked either as accurate predictors of bone health. All they do is take a snapshot of your bone that says, “This is what your bone looks like today.” They can’t tell you how quickly your bones are breaking down and how well they’re rebuilding themselves.
But I’ve found a simple urine test that can do this very thing. It’s not expensive and most insurance companies, including Medicare, pay for it. This test will tell you if your rate of bone loss is high before anything can be detected with common bone scans. Just how important is it to identify how fast your bones are breaking down? One study I just read shows that bone resorption (breakdown) is a better predictor for hip fractures than the more familiar tests that measure bone mass.
This urine test does not subject you to even minute quantities of harmful radiation. What’s more, instead of having to wait a year or two for another bone density test to measure your progress or deterioration, you can repeat this urine test in three months and find out whether or not the particular therapy you’ve chosen is working.
It’s about measuring your Dpd
Let me explain how this test works. When bone breaks down, it produces a byproduct called deoxypyridinoline (Dpd) that’s excreted into the urine. A simple urine test, called Pyrilinks-D, measures the Dpd in your urine and determines whether or not your bones are breaking down faster than they’re being rebuilt. If they are, you can talk with your doctor about some form of bone-saving therapy: exercise, hormones, medications, dietary changes, supplements, etc.
Then you can try the therapy of your choice and repeat this test in three months to see how well you’re doing. No guesswork or waiting until it’s too late. Combined with the DEXA or ultrasound, Pyrilinks-D gives a more complete evaluation than either one alone.
How accurate is this test?
A group of researchers compared the Pyrilinks-D test to other bone resorption tests like Osteomark and CrossLaps. The Pyrilinks-D test had less variability than the others. In addition, its precision and accuracy was either equal or superior to the other two tests in all areas. This is an accurate test to measure your rate of bone loss.
The Dpd urine test is most valuable for pre- and perimenopausal women whose bones are beginning to thin. They can use the information to begin a bone-conserving program before a great deal of damage has been done. But it can be helpful for postmenopausal women as well, especially for those who are using either hormone therapy or bisphosphanates (drugs like Fosamax) that could reduce bone turnover. After all, if you’re being told to take Fosamax for the rest of your life, don’t you want to know it’s working? How about your exercise program? If you want to know whether or not it’s working, or whether or not you’re taking the proper balance of supplements, this test will take the guesswork out. The normal range for this test is 2.5-6.5. If your results are 6.5 or greater, you will want to take action.
Where to get it
A number of different kinds of health care practitioners can order this test, including MDs, osteopaths, chiropractors, acupuncturists, and nurse practitioners. Once you’ve found someone to order the test, you need to find a lab to run it.
Check with your local labs to see if they perform the Pyrilinks-D test. If they regularly check for hormone levels, there’s a good chance that they do. Many labs charge a reasonable $80. Be sure to ask about coverage with your current insurance plan. You need a doctor’s order in most states before your insurance will pay for it.
If you can’t find a lab near you to run this test, contact Aeron Life Cycles Laboratory (877-222-3766). Their staff can answer your questions, and Donna, a personal friend of mine, will help you solve any problem if no one else can. She’s a true magician! By the way, Aeron accepts Medicare for payment in full for this test.
The test itself couldn’t be simpler. You or your doctor contact the lab with the doctor’s order and ask to have a test kit mailed to you. Then you collect some of your urine the next morning and put it into the vial that’s included in the kit. Mail it back in the enclosed pre-paid padded envelope, and the lab will take care of the rest.
Making “young bones”
Any information I give you on osteoporosis would be incomplete without my frequently stated caveat about bone structure. When bone tissues are both thinner and brittle, you’re at an increased risk for fractures. All of the tests I’ve mentioned measure bone density. They don’t measure fragility — or brittleness. There is no test for this. However, it’s a huge factor in whether or not you’ll break any bones if you fall.
High amounts of calcium create brittle bones. Magnesium makes bones less brittle and more flexible. I’ve talked about this in greater length in past articles, available on my website, and in my book, User’s Guide to Calcium and Magnesium (800-728-2288). If you’re taking supplemental calcium, or eating a lot of dairy, make sure you get as much magnesium as calcium. That way, any bone you have is more likely to be supple, like young bones.
Garnero, P., “Markers of bone resorption predict hip fracture in elderly women the EPIDOS prospective study,” Journ of Bone and Min Res, vol. 11, no. 10, 1996.
Ju, H-S.J., et al. “Comparison of analytical performance and biological variability of three bone resorption assays.” Clinical Chemistry, 1999.
Miller, P.D., MD, et al. “Practical clinical application of biochemical markers of bone turnover,” Journ of Clin Densitometry, vol. 2, no. 3, 1999.