FAQ's About Bone Loss and Testing

Q. What is healthy bone?

A. Your bones are made up of living tissue, mainly collagen. Strong, healthy bone is continually maintained through bone remodeling. The bone remodeling process has two phases: breakdown (or resorption) and formation. Bone resorption refers to bone removal or breakdown. In this phase, bone-resorbing cells called osteoclasts excavate small pits on the bone surface, releasing bone collagen and minerals in the circulatory system. Once the osteoclasts have done their job, protein-secreting cells called osteoblasts deposit new tissue - this is the formation phase. When resorption and formation are in balance, there is no net change in bone mass. After a resting phase during which the bone is mineralized, the remodeling cycle begins again.

Approximately 20% of bone tissue is replaced annually by this process on a cyclical basis throughout the skeleton. The entire remodeling process occurs over approximately 4 to 8 months, with a range of 3 months to 2 years. This is why adequate nutrition including daily calcium intake is important to maintaining healthy bones.

With age, estrogen levels in women and testosterone levels in men decrease. At the same time, bone breakdown may increase. However, most people rarely know if they have substantial bone loss until they fracture or break a bone.

Q. Does menopause affect my bones?

A. Yes. During and after menopause, estrogen levels go down and bone resorption (breakdown) levels often go up. For many women this can lead to osteoporosis. Your doctor may prescribe hormone therapy (HT) or a similar drug that slows down bone resorption. These are called antiresorptive therapies.

Q. What is BMD/bone densitometry?

A. This is a technique, which uses either X-Ray or ultrasound, to measure bone mineral density (BMD), usually at the hip, spine or wrist. This technique is often used to confirm or deny a suspicion of osteoporosis or to predict a risk of fracture. Based on your and family history, you and your doctor may decide that you should have a bone mineral density measurement. To get a complete picture of your bones, however, you should also have a NTx test.

Q. How does BMD differ from an NTx urine test? Why do I need to have both?

A. NTx tells you your rate of bone breakdown, a dynamic measurement that can determine the probability for a decrease in your bone mineral density (BMD) if nothing is done to alter the current level of bone breakdown. Your BMD provides a static measurement of your current bone density by measuring how much bone you have. To get a complete picture of your bone status, you should consider both tests. BMD requires several measurements spaced 12-24 months apart to identify significant bone loss. The NTx can identify an increase or decrease in bone breakdown in as little as 60-90 days, which offers you a much more immediate check on the success of lifestyle changes or other interventions to improve bone health.

Q. What is NTx?

A. NTx is a molecule that is released during bone breakdown. The NTx molecule is excreted into the urine and is measured using a specialized laboratory procedure. This test result indicates your rate of bone breakdown and risk of osteoporosis.

Q. Can an NTx test tell me if I have osteoporosis?

A. No. Osteoporosis can only be diagnosed with a bone mineral density test or DEXA scan that assesses actual bone mass. Elevated levels of NTx indicate that bone is breaking down faster than it is being replaced and can indicate a risk of osteoporosis, but it cannot confirm a diagnosis. If your bone loss analysis results in a high rate (results greater than 67) of bone breakdown, you may want to consider scheduling a bone mineral density test or DEXA scan.

Q. How do I get an NTx urine test?

A. You can purchase a Restore^® BioBalance NTx Urine Rate of Bone Loss collection kit and analysis, or your doctor can order an NTx urine analysis through Restore^®, Women's Health America's comprehensive program for hormone therapy. In either case, a collection kit will be mailed to you. No dietary changes are needed prior to testing. You simply collect the urine sample in the morning (first or second void) and mail it to Women's Health America in the prepaid mailer. We will perform the analyis and send the results back to you, if you purchased the test, or your doctor, for doctor ordered tests.

Q. What does the test result mean for me?

A. If you are going through menopause, the NTx test result will provide valuable information about your bones, helping you and your doctor make important decisions about therapies that can protect your bones. Results will help your healthcare provider determine if your rate of bone breakdown is elevated and your probability for loss of bone mass without antiresorptive therapy. Results can also be used to monitor whether therapy is working, with changes seen in as little as three months.

Q. Why hasn't my healthcare provider told me about the NTx test?

A. The NTx urine test is relatively new so your doctor may not have heard of it. If you would like for us to send your doctor some information, This e-mail address is being protected from spambots, you need JavaScript enabled to view it to send us an email.

Click here to order the Bone-Loss Analysis Test Kit.