Evaluation of Osteoporosis

A 24-hour urine collection can show if there is a problem with intestinal absorption of calcium or leakage of calcium through the kidneys. Blood tests are done to check things such as blood chemistries (to see if your calcium or phosphorous level is too high or too low, or if there is a problem with liver or kidney function), blood count (checking for anemia), proteins (to be sure there is no multiple myeloma), vitamin D level (a low level causes trouble with getting calcium to your bones), thyroid function (high thyroid function can cause osteoporosis), and antibodies for celiac disease- a condition that may cause poor intestinal absorption of important nutrients. A simple “fasting second-void morning urine” specimen shows the rate of bone metabolism or “turnover”- an important factor in determining bone density and bone strength. With this test, natural bone protein products such as N-telopeptide (NTX) are tested. X-rays may detect previous fractures of the spine, which can occur with or without back pain and may result in loss of height. Sometimes a nuclear bone scan can identify other kinds of bone disease that cause fractures. In rare cases, a bone biopsy provides helpful information. Other tests may be necessary depending on your particular situation.