Genes & Biomarkers — Paget's Disease of Bone
Biomarker / Gene
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BIOMARKERS
GENES
BAP / Total ALP
>30 µg/L (F); >41 µg/L (M)
or Total ALP >147 U/L
Exercise 30 min/day; anti-inflammatory
diet; sun exposure 15–30 min
Vit D3 + K2 MK-7 + Mg glycinate;
bisphosphonate therapy
P1NP
>74 µg/L
(5–30× normal in PDB)
Low-impact exercise; ensure
Ca + Vit D adequate pre-treatment
Omega-3 2–4 g/day; hydrolyzed
collagen 10–15 g; zoledronic acid
CTX (β-CrossLaps)
>0.573 ng/mL
(postmenopausal women)
Anti-inflammatory diet; protein
1.2–1.6 g/kg; impact exercise
Vit K2 MK-7 100–200 mcg;
quercetin 500–1,000 mg; boron 3–6 mg
25-OH Vitamin D
<40 ng/mL
(optimal: 40–60 ng/mL)
Midday sun 15–25 min; fatty fish,
sardines, egg yolks
Vit D3 2,000–6,000 IU/day
+ K2 MK-7 + Mg; UVB lamp ($50–$150)
Serum Calcium
<8.5 or >10.5 mg/dL (total)
ionized <4.6 or >5.3 mg/dL
Diet 1,000–1,200 mg Ca/day;
hydration 2–3 L/day; weight-bearing
Calcium citrate 200–300 mg × 2–3/day;
bisphosphonate (hypercalcemia)
PTH (intact)
>55 pg/mL
(target: 20–55 pg/mL)
Correct Vit D; low-Na diet;
limit caffeine; weight-bearing exercise
Mg glycinate; Vit D3; K2 MK-7;
endocrinologist if PTH >65 pg/mL
SQSTM1 (p62)
Pathogenic variant
(e.g., p.P392L)
IF 16:8 (5–6 days/wk); HIIT 3×/wk;
stress management; no smoking
Quercetin 500–1,000 mg; resveratrol
250–500 mg; berberine 500 mg ×2/day
VCP
Pathogenic variant
(IBMPFD)
Time-restricted eating; aerobic
+ resistance training; 7–9 h sleep
Urolithin A 500–1,000 mg;
spermidine 1–2 mg; specialist referral
RANK (TNFRSF11A)
Risk variant
(gain-of-function)
Calcium 1,000–1,200 mg/day;
weight-bearing exercise; sex hormone support
Vit K2 MK-7 100–200 mcg;
boron 3–6 mg; omega-3 2–3 g EPA+DHA
OPG (TNFRSF11B)
Risk variant
(loss-of-function)
Impact exercise (OPG upregulator);
sex hormone optimization
Vit K2 MK-7; Vit D3
(40–60 ng/mL); denosumab (specialist)
RIN3
Risk variant
(GWAS locus)
7–9 h sleep; low alcohol;
Mediterranean diet pattern
Quercetin; resveratrol;
NAC 600–1,200 mg/day