Regular exercise can for the treatment of these metabolic disorders. Several limitations of our study should be considered. Firstly, we recognize the limitations of the classification model: it is based on BTM values proposed as treatment targets, the cutoffs are arbitrarily chosen, the two markers analysed reflect mainly the function of osteoblasts and osteoclasts, but biochemical indicators of the osteocyte activity, important factors in the maintenance of skeletal integrity, are not included currently these markers are used for research purposes. Although the proposed classification brings a conceptual shift in our understanding of the pathophysiology and clinical applications of bone turnover status, additional biochemical indicators of the complex multilayered regulatory mechanisms need to be found and considered in future classification. Thirdly, the study has been done in a single centre, and the patients were mainly Caucasian; that could affect the generalizability of the results.

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Given the increasing amount of scientific evidence, including since the last response above, on the effectiveness and safety of the Ivermectin drug, including its prophylactic properties, why is the Scottish Government not considering its use? Given that it is now adopted in some Indian States e. Given the current concerns regarding the Indian variant in the UK and the fear that the vaccines may not be effective against it, why does the Scottish Government not allow the NHS to treat people with Ivermectin, a medicine used by millions of people across the globe safely, and proven to work agains the virus, as a matter of urgency? These are clinical decisions, and it would not be appropriate for the Scottish Government to intervene in clinical decisions involving individual patients. We are aware that there is an ongoing clinical trial involving Ivermectin in the UK, and results are awaited. Please see link: WHO: Ivermectin should only-be-used-to-treat-covidwithin-clinical-trials. The decision of which medicine to prescribe to a patient is a clinical one, and the Scottish Government does not intervene in clinical decisions involving individual patients. Should a clinician wish to prescribe Ivermectin to a patient, then they must do so in line with local Health Board governance processes around the prescribing of unlicensed medicines.

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