Tibial Stress Fracture — Biomarkers & Genes Summary
Biomarker / Gene
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BIOMARKERS
Vitamin D (25-OH)
<30 ng/mL
Midday sun; fatty fish
D3 3–5k IU; K2 MK-7; Magnesium
P1NP
<35 mcg/L
Non-impact load; 8+ hrs sleep
Collagen peptides + Vit C; Zinc
CTX
>0.573 ng/mL
Reduce load; fix energy deficit
Omega-3 2–3g; Calcium 1000mg
PTH
>55 pg/mL
Weight-bearing exercise; sun
D3 + K2 + Magnesium glycinate
Estradiol & Testosterone
<30 pg/mL (women)
Restore energy; sleep 8–9h
Zinc 25mg; Boron 3–6mg; HRT
IGF-1
<150 ng/mL
Sleep 8–9h; resistance training
Zinc 15–25mg; Creatine 3–5g
GENETIC VARIANTS
COL1A1 (rs1800012)
TT genotype
Soft surface; 10% mileage cap
Vit C; Collagen 10g; Copper 2mg
VDR (multiple variants)
Variant alleles
High-calcium foods; exercise
D3 to 60–80 ng/mL; Magnesium
ESR1 (rs2234693)
PvuII/XbaI variants
Resistance training; soy/flax
Boron 3–6mg; Vit D 60–70 ng/mL
LRP5 (rs4988321)
A1330V variant
50–100 jumps 3–5×/week
Vit D 60–70 ng/mL; Vibration
TNFRSF11B / OPG
Low-OPG expression
Anti-inflammatory diet; fish
Omega-3 2–4g; K2 MK-7; Mag
Sources: peer-reviewed literature on tibial stress fractures, bone biomarkers and sports genomics