Rebalancing Bone Turnover: CTX, P1NP & Modern Protocols
In this episode of The Root Cause Medicine Podcast, Dr. Kate Kresge talks with Margie Bissinger, PT, CDCES, founder of the Bone Health Academy and host of the Happy Bones, Happy Life podcast, about modern, root‑cause approaches to osteoporosis and bone health in 2025. They cover advances in testing, nutrition beyond calcium and vitamin D, targeted exercise prescriptions (including LIFTMOR/ONERO‑style strength training), the role of hormones, and practical tools clinicians can use to help patients build stronger, safer bones.
You'll hear them discuss:
Guest Introduction
Margie Bissinger, PT, is a physical therapist with over 30 years’ experience specializing in bone health, nutrition, and rehabilitation. She co‑leads practitioner training (Restore & Rebuild / Bone Health Academy), hosts the Happy Bones, Happy Life podcast, and teaches integrative approaches to reduce fracture risk and improve bone quality.
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Supplements Mentioned
Guest and Sponsor Details
Timestamps
00:00 Episode intro; topic overview (osteoporosis & bone health in 2025)
03:00 Exercise advances and empowerment through strength training
05:50 Nutrition overview: calcium, vitamin D, absorption & gut health
08:08 Vitamin K2: MK‑4 vs MK‑7 research and dosing discussion
11:50 Importance of magnesium and preferred forms
18:33 Protein needs updated: ≥1.1 g/kg and essential amino acids
24:22 Bone turnover blood markers: CTX and P1NP — interpretation & clinical use
31:05 Common drivers of elevated CTX: inflammation, hormones, parathyroid
36:43 Exercise prescription specifics, posture, stabilization, and BoneFit / BoneFit/PT resources
43:16 Weighted vests: when they help and when they hurt
45:35 Vibration plates: low‑intensity vs high‑intensity, safety considerations
49:01 Hormone replacement therapy: role in bone protection and CTX improvement
55:22 How Margie began focusing on bone health and integrative care
59:25 Strontium: effects on DEXA accuracy and recommendations
01:02:56 Jumping protocols and impact dosing for bone
01:07:05 Homocysteine and bone: thresholds and correction
01:13:33 Resources and recommended reading (Dr. Keith McCormick; Bone Health & Osteoporosis Foundation; BoneFit)
01:17:20 Closing: reframing diagnosis as opportunity; where to find Margie
Frequently Asked Questions
Q: Can strength training actually increase bone density in people with osteoporosis?
A: High‑intensity, supervised resistance training (e.g., LIFTMOR/ONERO protocols) has been shown to increase bone density and improve bone quality.
Q: Are CTX and P1NP blood tests better than DEXA for guiding osteoporosis treatment?
A: CTX measures bone breakdown and P1NP measures bone formation, letting clinicians track turnover and treatment response long before DEXA changes.
Q: Is vitamin K2 important for bone health — and which form should patients take?
A: K2 (both MK‑4 and MK‑7) helps direct calcium into bone and research supports using both forms for fracture risk reduction and cardiovascular benefit.
Q: Could an undiagnosed parathyroid tumor be causing unexplained bone loss?
A: If total serum calcium is >10 mg/dL (especially over age 40), consider parathyroid evaluation because benign adenomas can drive significant bone loss.
Q: Will jumping a few times a day improve bone density?
A: Short daily impact protocols (e.g., 10 jumps twice daily) have produced measurable bone gains in studies when done with proper progression and posture.
Q: Is homocysteine linked to fracture risk and is it reversible?
A: Elevated homocysteine (>15 µmol/L) is associated with lower bone density and higher fracture risk, and levels often improve with targeted B‑vitamin repletion.
Disclaimer: The views expressed on this podcast are those of the hosts and guests and don’t necessarily reflect those of Fullscript or any affiliated organizations. This podcast is for informational and educational purposes only and is not intended to be medical advice. For your safety, always check with your doctor or healthcare provider before making changes to your health routine.