BONES & JOINTS

Pyrilinks-D: A Simple Bone Loss Test Option

An inexpensive osteoporosis test you can order from home, the
Pyrilinks-D test is one of the least known but most useful
tools for identifying accelerated bone breakdown, predicting
the probability of bone loss, and providing an early warning
sign before a conventional DEXA scan might reveal a
problem.

BY KATHLEEN JADE, ND • NOV 7, 2017

Are you currently losing bone at

an accelerated rate? Bone loss is
much easier to prevent than to
reverse, so wouldn’t you rather
start treatment before you have
actual bone loss? Or, if you
already know you have low bone
density and are trying to improve One of several new simple osteoporosis tests,
Pyrilinks-D provides unique value over density
your bone health, how do you
scans.
know if your current treatments © Olivier Le Queinec | Dreamstime.com

are working? You could wait until

your next DEXA scan, but that
might be two or more years away.
The tests that make it possible to answer these important questions, such
as the Pyrilinks-D, are called bone resorption tests and are available to
you right now. In fact, Pyrilinks-D and other bone resorption tests have
been available for at least a decade, but until recently their benefits were
not widely known.

How Are Bone Resorption Tests Different Than DEXA

Scans?
Although tests for bone resorption like the Pyrilinks-D are still not
regularly utilized in the conventional medicine world, many integrative and
natural healthcare practitioners are taking advantage of them for
osteoporosis treatment and prevention. These tests go beyond traditional
DEXA scans which measure bone density by taking a static image of
bone and don’t show changes for at least a year or two.

DEXA scans are still essential for osteoporosis diagnosis but they provide
no information about the rate of bone loss. That’s where Pyrilinks-D and
other bone resorption tests come in—they use urine or blood to measure
markers of bone resorption (breakdown), allowing for the identification of
bone loss before it has become excessive.

What Is Bone Resorption?

Bone is not stable; rather, it is an active, changing tissue, it is an active,
changing tissue, continually being remodeled, which means that new
bone is being formed while old bone is simultaneously being resorbed
(broken down). Osteoporosis results when new bone formation does not
keep up with bone break down. When the rate of resorption exceeds the
rate of formation, the bones become progressively more porous, brittle,
and fragile. Numerous tests to measure bone remodeling have been
developed and researched during the past two decades and today there
are multiple bone resorption tests, such as the Pyrilinks-D, to choose
from.

The remainder of this article will focus on Pyrilinks-D, also called

deoxypiridinoline or DPD. In Part 2 of this article, you will learn about
two more well-researched and widely used bone resorption tests: the
CTX test and urine NTX test.

What Does the Pyrilinks-D Test Measure, Exactly?

The Pyrilinks-D test is based on the fact that the mineral structure of bone
accumulates upon a protein matrix which consists of collagen. This
collagen contains unique protein structures that are linked in a crossing
pattern in order to strengthen it, this giving bone greater stability. Bone
resorption involves a breakdown of this collagen protein structure. The
resulting protein fragments from this breakdown get excreted in the urine.
The Pyrilinks-D test measures one of these specific protein fragments,
deoxypyridinoline (DPD), to test the rate of bone resorption. The test also
goes by the name deoxypyridinoline, or just DPD.

DPD is found in bone only and urine DPD levels reflect the true rate of
bone turnover. It is one of the most useful markers for identifying
accelerated bone breakdown and predicting the probability of bone loss.
The “normal” DPD level varies, depending on the laboratory’s
measurement methods and other factors, but for women generally ranges
from 3 to 7.4. In one recent study, DPD levels above the upper limit of the
normal premenopausal range were found to be associated with an
increased hip fracture risk.[1] Another recent study in 522 Japanese
postmenopausal women found that high levels of DPD in the urine was
associated with spinal fractures and could predict spinal fractures in
women up to ten years out.[2]

Pyrilinks-D Test Details

Many of the major national laboratories, such as LabCorp, as well as
some specialty laboratories, such as Genova Diagnostics and
Metametrix, perform the Pyrilinks-D or similar tests for DPD. Like most
lab tests now, you can order the Pyrilinks-D or DPD test yourself without
a doctor’s involvement in most states in the United States through various
online companies that offer direct-to-consumer access to lab tests, such
as DirectLabs (they offer Genova’s Bone Resorption Assessment, for
instance). However, given the complexity of bone resorption testing, it is
recommended that you work with a healthcare practitioner experienced
using and interpreting Pyrilinks-D or another bone resorption test.

If you want to get a Pyrilinks-D or similar test to measure your DPD

levels, experts suggest that you stick with the same lab for serial
measurements since different labs have different methods of
measurement and different reference ranges. The best way to take
advantage of bone resorption tests like the Pyrilinks-D is to find out your
initial level of bone resorption and then plan to re-test every 3 to 6 months
using the same laboratory. The retail cost of the Pyrilinks-D or similar
DPD test is about $105 to $150, and insurance typically covers the test if
it is ordered by your doctor.

[1] J Bone Miner Res. 1996 Oct;11(10):1531-8.

[2] Osteoporos Int. 2013 Mar;24(3):887-97.

Originally published in 2013, this blog has been updated.

 Comments
Ram November 7, 2017

Hello Friends, This blog is very nice blog. When i was searching for
osteoporosis test in Bangalore i got to know the Anand Lab is one of the
best centers in Bangalore. To know more Just click on the
link http://www.anandlab.com/