How does diabetes affect bone density. What is the link between lupus and osteoporosis. Can hyperthyroidism lead to bone loss. Why are celiac disease patients at risk for osteoporosis. Does asthma medication impact bone health. Are multiple sclerosis patients more prone to osteoporosis. Which other medical conditions can cause bone loss.

Diabetes and Its Impact on Bone Health

Diabetes, both type 1 and type 2, can significantly affect bone health and increase the risk of osteoporosis. Why does this happen? The relationship between diabetes and bone health is complex and not fully understood, but research has revealed some important connections.

For individuals with type 1 diabetes, the impact on bone health can be particularly severe. Dr. Beatrice Edwards, director of the Bone Health and Osteoporosis Center at Northwestern University Feinberg School of Medicine, explains that people with type 1 diabetes often have lower bone density. This is likely due to reduced bone turnover and decreased bone formation. High blood sugar levels appear to inhibit bone formation, similar to the effects of steroids.

The timing of type 1 diabetes onset is also crucial. Since this form of diabetes typically develops during childhood, it can interfere with the body’s ability to reach peak bone density. This early disruption in bone development can have long-lasting effects on overall bone health.

Type 2 diabetes also poses risks for bone health, albeit through different mechanisms. While bone density might not be significantly lower in people with type 2 diabetes, the risk of fractures is still elevated. This suggests that diabetes affects not just the quantity of bone, but also its quality and strength.

Key Points About Diabetes and Bone Health:

• Type 1 diabetes is associated with lower bone density and reduced bone formation
• High blood sugar levels may inhibit bone formation
• Early onset of type 1 diabetes can prevent individuals from reaching peak bone density
• Both type 1 and type 2 diabetes increase fracture risk, even if bone density isn’t significantly lower

Autoimmune Conditions: Lupus and Rheumatoid Arthritis

Autoimmune conditions like lupus and rheumatoid arthritis (RA) can have a significant impact on bone health. These diseases, which affect nearly 3 million adults in the United States, are characterized by the body’s immune system attacking its own healthy cells and tissues. This misguided immune response leads to chronic inflammation, which can have far-reaching effects on various bodily systems, including bone health.

How do these autoimmune conditions contribute to osteoporosis? The primary mechanism appears to be through increased bone turnover. In a healthy body, bone tissue is constantly being broken down and rebuilt in a balanced process. However, chronic inflammation seems to accelerate this process, leading to a higher rate of bone turnover. Unfortunately, this increased turnover often results in a net loss of bone mass over time.

Another significant factor in the relationship between these autoimmune conditions and osteoporosis is the use of corticosteroids. Many patients with lupus and RA rely on long-term corticosteroid treatments to manage their symptoms. While these medications are effective in controlling inflammation, they also have the unfortunate side effect of slowing the activity of bone-building cells. This dual impact – increased bone turnover due to inflammation and decreased bone formation due to medication – creates a perfect storm for bone loss.

Lupus presents a unique challenge when it comes to bone health. This condition commonly affects women between the ages of 15 and 45, a crucial period for bone development. As Dr. Edwards points out, anything that impedes bone growth during these years can significantly increase the risk of osteoporosis later in life.

Important Considerations for Autoimmune Conditions and Bone Health:

• Chronic inflammation associated with lupus and RA can increase bone turnover
• Long-term use of corticosteroids may slow bone-building cell activity
• Lupus often affects women during peak bone-building years, potentially limiting maximum bone density
• Regular bone density monitoring is crucial for patients with these conditions

Thyroid Disorders and Bone Loss

Thyroid disorders, particularly hyperthyroidism, can have a profound impact on bone health. The thyroid gland, a small butterfly-shaped organ located at the base of the neck, plays a crucial role in regulating various bodily functions through the production of thyroid hormones. When this gland becomes overactive, as in the case of hyperthyroidism, it produces an excess of these hormones, which can lead to a range of health issues, including accelerated bone loss.

Dr. Edwards explains that hyperthyroidism increases the frequency of bone-remodeling cycles. While bone remodeling is a normal and necessary process, it becomes less efficient after the age of 30. In a healthy individual, the balance between bone formation and bone resorption (breakdown) maintains overall bone mass. However, in someone with hyperthyroidism, this delicate balance is disrupted.

The increased frequency of bone-remodeling cycles in hyperthyroidism means that bone is being broken down more rapidly than it can be rebuilt. This imbalance results in a net loss of bone mass over time, increasing the risk of osteoporosis and fractures.

It’s worth noting that hyperparathyroidism, a condition affecting the parathyroid glands (which are located near the thyroid gland but have different functions), can also increase the risk of osteoporosis. The parathyroid glands regulate calcium levels in the body, and when they become overactive, they can lead to excessive calcium removal from bones, further contributing to bone loss.

Key Points About Thyroid Disorders and Bone Health:

• Hyperthyroidism accelerates bone-remodeling cycles
• After age 30, each bone-remodeling cycle tends to result in some bone loss
• Increased frequency of these cycles in hyperthyroidism leads to accelerated bone loss
• Hyperparathyroidism can also contribute to bone loss through altered calcium metabolism

Celiac Disease: A Hidden Cause of Osteoporosis

Celiac disease, an autoimmune disorder triggered by the consumption of gluten, can have far-reaching effects on overall health, including a significant impact on bone density. This condition, which affects the digestive system, can be a silent contributor to osteoporosis if left undiagnosed and untreated.

How does celiac disease affect bone health? The primary mechanism is through nutrient malabsorption. When a person with celiac disease consumes gluten, it triggers an immune response that damages the lining of the small intestine. This damage interferes with the body’s ability to absorb essential nutrients, including calcium and vitamin D – two crucial components for maintaining strong, healthy bones.

Dr. Edwards highlights that even if a person with undiagnosed celiac disease is consuming adequate amounts of calcium and vitamin D in their diet, their body may not be able to properly absorb and utilize these nutrients. This deficiency can lead to low bone density over time, increasing the risk of osteoporosis and fractures.

It’s important to note that celiac disease can be diagnosed at any age, and many people may have the condition for years without realizing it. During this time, silent damage to bone health may be occurring. This underscores the importance of early diagnosis and proper management of celiac disease, not only for digestive health but also for maintaining strong bones.

Important Facts About Celiac Disease and Bone Health:

• Celiac disease damages the small intestine, interfering with nutrient absorption
• Calcium and vitamin D absorption can be significantly impaired
• Even with adequate dietary intake, nutrient deficiencies can occur due to malabsorption
• Undiagnosed celiac disease can lead to silent bone loss over time
• Early diagnosis and proper management are crucial for protecting bone health

Asthma Medications and Their Effect on Bone Density

Asthma, a chronic respiratory condition affecting millions of people worldwide, does not directly cause osteoporosis. However, the medications commonly used to manage asthma can have significant implications for bone health. Understanding this connection is crucial for the approximately 20 million Americans living with asthma, including 9 million children under 18.

The primary concern regarding asthma treatment and bone health revolves around the use of corticosteroids. These medications, which include inhaled corticosteroids and oral steroids like prednisone, are highly effective in controlling asthma symptoms such as shortness of breath and wheezing. However, they can also contribute to bone loss and increase the risk of osteoporosis, especially when used long-term or in high doses.

Dr. Andrew Bunta, associate professor and vice chair of orthopaedics at Northwestern University Feinberg School of Medicine, explains that the impact of asthma on bone health extends beyond medication. Many young people with asthma may have difficulty participating in certain physical activities, which can lead to reduced weight-bearing exercise. This lack of exercise can further compromise bone health, as weight-bearing activities are crucial for building and maintaining strong bones.

Key Considerations for Asthma Patients and Bone Health:

• Inhaled and oral corticosteroids can contribute to bone loss
• Long-term or high-dose steroid use increases the risk of osteoporosis
• Reduced physical activity due to asthma symptoms can impact bone strength
• Regular bone density monitoring may be necessary for asthma patients on long-term steroid therapy
• Balancing asthma management with bone health protection is crucial

Multiple Sclerosis and Its Impact on Bone Health

Multiple Sclerosis (MS), a chronic neurological condition affecting the central nervous system, shares some similarities with asthma when it comes to its impact on bone health. While MS itself doesn’t directly cause osteoporosis, several factors associated with the condition can contribute to increased risk of bone loss and fractures.

One of the primary concerns for MS patients is the use of corticosteroids. These medications are often prescribed to manage MS flare-ups and can help reduce inflammation and alleviate symptoms. However, as with asthma treatments, long-term or frequent use of corticosteroids can lead to decreased bone density and increased risk of osteoporosis.

Another significant factor is reduced mobility. As MS progresses, many patients experience decreased mobility and may spend more time being sedentary. This reduction in weight-bearing activities can have a detrimental effect on bone health. Weight-bearing exercise is crucial for maintaining and building bone density, and its absence can accelerate bone loss.

Additionally, vitamin D deficiency is common among MS patients. Vitamin D plays a vital role in calcium absorption and bone health. Many people with MS avoid sun exposure due to heat sensitivity, which can lead to lower vitamin D levels. Furthermore, some research suggests that vitamin D deficiency may be a risk factor for developing MS in the first place, creating a complex relationship between the condition and this essential nutrient.

Important Points About MS and Bone Health:

• Corticosteroid use in MS treatment can contribute to bone loss
• Reduced mobility and lack of weight-bearing exercise can accelerate bone density decline
• Vitamin D deficiency is common in MS patients and can further impact bone health
• Regular bone density screenings and vitamin D level checks are important for MS patients
• Balanced approach to MS management should consider long-term bone health

Other Medical Conditions Associated with Bone Loss

While we’ve discussed several specific medical conditions that can increase the risk of osteoporosis, it’s important to recognize that there are many other health issues that can impact bone health. Understanding these connections can help individuals and healthcare providers take proactive steps to protect bone density and reduce fracture risk.

Digestive disorders, beyond celiac disease, can also contribute to bone loss. Conditions such as Crohn’s disease and ulcerative colitis, collectively known as inflammatory bowel diseases (IBD), can interfere with nutrient absorption and lead to inflammation throughout the body. This combination of factors can negatively impact bone health over time.

Hormonal imbalances, apart from thyroid disorders, can also play a role in bone loss. Conditions such as hypogonadism (low testosterone in men or low estrogen in women) can accelerate bone loss. Similarly, disorders affecting the adrenal glands, such as Cushing’s syndrome, can lead to decreased bone density due to excessive cortisol production.

Certain types of cancer and their treatments can also impact bone health. For example, breast and prostate cancers, as well as their hormonal therapies, can lead to bone loss. Additionally, chemotherapy and radiation therapy can sometimes have negative effects on bone density.

Chronic kidney disease is another condition that can significantly impact bone health. The kidneys play a crucial role in maintaining the balance of minerals in the body, including calcium and phosphorus. When kidney function is impaired, it can lead to mineral imbalances that affect bone strength and density.

Additional Medical Conditions That May Affect Bone Health:

• Inflammatory bowel diseases (Crohn’s disease, ulcerative colitis)
• Hormonal imbalances (hypogonadism, Cushing’s syndrome)
• Certain types of cancer and cancer treatments
• Chronic kidney disease
• Liver diseases
• Anorexia nervosa and other eating disorders
• Chronic obstructive pulmonary disease (COPD)

It’s crucial for individuals with these conditions to work closely with their healthcare providers to monitor bone health and implement strategies to protect against bone loss. This may include regular bone density screenings, proper nutrition, appropriate exercise, and in some cases, medication to support bone health.

Understanding the connection between various medical conditions and bone health empowers both patients and healthcare providers to take a proactive approach to osteoporosis prevention and management. By addressing these risk factors early and implementing appropriate interventions, it’s possible to maintain strong, healthy bones even in the face of challenging medical conditions.

Asthma, Arthritis, Diabetes, Celiac Disease, Hyperthyroidism, Lupus, Multiple Sclerosis

Are you at risk for bone loss due to your medical condition?

Written by Gina Shaw

• 1. Diabetes Mellitus and Osteoporosis
• 2. Lupus and Rheumatoid Arthritis
• 3. Hyperthyroidism
• 4. Celiac Disease
• 5. Asthma
• 6. Multiple Sclerosis
• More

You probably know some of the leading risk factors for osteoporosis — being female and past menopause, smoking, or having a small frame. But did you know that some fairly common medical conditions are also among the causes of osteoporosis bone loss?

If you have one of these conditions, either because of the disease itself or because of the medications you have to take to manage it, you face an increased risk of developing osteoporosis:

For reasons scientists still don’t fully understand, people with type 1 diabetes tend to have lower bone density.

Studies show that people with type 1 diabetes may have low bone turnover and lower than normal bone formation.

“It seems that high blood sugar may shut down bone formation, just as with steroids,” says Beatrice Edwards, MD, MPH, associate professor of medicine and director of the Bone Health and Osteoporosis Center at Northwestern University Feinberg School of Medicine. Since type 1 diabetes usually develops in childhood, when the body is still building bone, someone with type 1 diabetes may never have the opportunity to reach their peak bone density.

Even if their bone mass isn’t that much lower than normal, people with both type 1 and type 2 diabetes have a much higher risk of fractures than other people, adds Edwards.

Nearly 3 million adults in the U.S. have either lupus or rheumatoid arthritis. Both of these diseases are autoimmune conditions, in which the body attacks its own healthy cells and tissues, causing inflammation.

Any chronic inflammatory disease can put you at greater risk of osteoporosis, says Edwards, because it appears to increase the rate of bone turnover, in which old bone is replaced with healthy new bone. People with both lupus and RA usually take corticosteroids for an extended period of time to manage their symptoms. Long-term use of steroids such as prednisone is also a leading cause of osteoporosis, possibly because they slow the activity of bone-building cells.

Lupus is a particular problem because it is common in women between the ages of 15 and 45 — often during the peak bone-building years up to age 30. “Anything that impedes the growth of bone during these years puts you at greater risk for osteoporosis,” says Edwards.

Hyperthyroidism occurs when the thyroid gland — a small, butterfly-shaped gland at the base of the neck — becomes overactive and produces too much thyroid hormone.

“Hyperthyroidism increases the number of bone-remodeling cycles you go through,” explains Edwards. “And after age 30, every bone-remodeling cycle is inefficient. You lose bone mass rather than building it. So the more cycles you go through, the more bone mass you lose.”

Hyperparathyroidism, a similar condition involving related, but different glands, also ups the risk of osteoporosis.

A number of digestive disorders, such as Crohn’s disease, can be causes of osteoporosis. Perhaps the most common such cause, says Edwards, is celiac disease, an allergy to a protein called gluten that is often found in wheat products.

Left untreated, celiac disease can damage the lining of the digestive system and interfere with the digestion of nutrients — including the calcium and vitamin D that are so important to bone health. So even if you’re getting the recommended daily amounts of calcium and vitamin D in your diet, if you have celiac disease, you probably don’t have enough of those nutrients in your system, and you likely have low bone density.

Asthma itself does not increase your risk of developing osteoporosis, but the medications used to treat it do. Approximately 20 million people in the U.S. have asthma, including some 9 million children under the age of 18.

Many people with asthma use corticosteroids — such as asthma “inhalers” — to help control their disease. During asthma attacks it is not uncommon to start drugs like prednisone for small periods of time. These are very effective in relieving the shortness of breath and wheezing that are common with asthma or emphysema, but they may also contribute to bone loss and osteoporosis.

“In addition to this, many young people with asthma may have more difficulty participating in some activities, which means they might not get as much weight-bearing exercise as they need to help build bone,” says Andrew Bunta, MD, associate professor and vice chair of orthopaedics at Northwestern University Feinberg School of Medicine.

Asthma and multiple sclerosis are two very different conditions, but there are very similar reasons why they both increase the risk of osteoporosis. Like people with asthma, people with multiple sclerosis take steroid-based medications to help manage their symptoms, and steroids are associated with bone loss. Since multiple sclerosis also affects balance and movement for many people, someone with MS may find it more difficult to get as much weight-bearing exercise as they need to in order to build and maintain bone.

“Anything that impedes your ability to walk accelerates bone loss,” says Edwards.

If you have one of these conditions, how can you help protect yourself from osteoporosis? First, don’t assume that your doctor will take care of it for you.

“When you are troubleshooting a primary condition like MS, asthma, or lupus, you’re not thinking about the side effects. Osteoporosis can take a back seat,” says Felicia Cosman, MD, medical director of the Clinical Research Center at Helen Hayes Hospital in Haverstraw, N.Y., and an editor of Osteoporosis: An Evidence-Based Guide to Prevention and Management. “That’s understandable — but you don’t want osteoporosis to add more disability to an already disabling condition.”

So if the doctor treating your celiac disease or rheumatoid arthritis hasn’t already brought up osteoporosis with you, ask to discuss it. Depending on your age and your specific condition, you may have several options to help prevent osteoporosis symptoms:

• Get an early bone density test. Doctors don’t usually recommend bone density tests for premenopausal women, but if you have one of these conditions, you may need to be monitored more closely, and treated for bone loss more aggressively.
• Push for more vitamin D and calcium in your diet, and supplement. Edwards recommends that people with conditions that accelerate bone loss get at least 1,000 to 1,500 milligrams of calcium and 400 to 600 international units (IU) of vitamin D from food and supplements. Look for low-fat dairy and fortified foods.
• Consider getting the vitamin D levels in your blood measured. “That’s not a specific recommendation from the National Osteoporosis Foundation, but it makes so much clinical sense,” says Cosman. “Because vitamin D levels vary so much between individuals, it’s hard to know how much supplementation is needed to reach sufficient levels.”

Top Picks

Asthma, Arthritis, Diabetes, Celiac Disease, Hyperthyroidism, Lupus, Multiple Sclerosis

Are you at risk for bone loss due to your medical condition?

Written by Gina Shaw

• 1. Diabetes Mellitus and Osteoporosis
• 2. Lupus and Rheumatoid Arthritis
• 3. Hyperthyroidism
• 4. Celiac Disease
• 5. Asthma
• 6. Multiple Sclerosis
• More

You probably know some of the leading risk factors for osteoporosis — being female and past menopause, smoking, or having a small frame. But did you know that some fairly common medical conditions are also among the causes of osteoporosis bone loss?

If you have one of these conditions, either because of the disease itself or because of the medications you have to take to manage it, you face an increased risk of developing osteoporosis:

For reasons scientists still don’t fully understand, people with type 1 diabetes tend to have lower bone density.

Studies show that people with type 1 diabetes may have low bone turnover and lower than normal bone formation.

“It seems that high blood sugar may shut down bone formation, just as with steroids,” says Beatrice Edwards, MD, MPH, associate professor of medicine and director of the Bone Health and Osteoporosis Center at Northwestern University Feinberg School of Medicine. Since type 1 diabetes usually develops in childhood, when the body is still building bone, someone with type 1 diabetes may never have the opportunity to reach their peak bone density.

Even if their bone mass isn’t that much lower than normal, people with both type 1 and type 2 diabetes have a much higher risk of fractures than other people, adds Edwards.

Nearly 3 million adults in the U.S. have either lupus or rheumatoid arthritis. Both of these diseases are autoimmune conditions, in which the body attacks its own healthy cells and tissues, causing inflammation.

Any chronic inflammatory disease can put you at greater risk of osteoporosis, says Edwards, because it appears to increase the rate of bone turnover, in which old bone is replaced with healthy new bone. People with both lupus and RA usually take corticosteroids for an extended period of time to manage their symptoms. Long-term use of steroids such as prednisone is also a leading cause of osteoporosis, possibly because they slow the activity of bone-building cells.

Lupus is a particular problem because it is common in women between the ages of 15 and 45 — often during the peak bone-building years up to age 30. “Anything that impedes the growth of bone during these years puts you at greater risk for osteoporosis,” says Edwards.

Hyperthyroidism occurs when the thyroid gland — a small, butterfly-shaped gland at the base of the neck — becomes overactive and produces too much thyroid hormone.

“Hyperthyroidism increases the number of bone-remodeling cycles you go through,” explains Edwards. “And after age 30, every bone-remodeling cycle is inefficient. You lose bone mass rather than building it. So the more cycles you go through, the more bone mass you lose.”

Hyperparathyroidism, a similar condition involving related, but different glands, also ups the risk of osteoporosis.

A number of digestive disorders, such as Crohn’s disease, can be causes of osteoporosis. Perhaps the most common such cause, says Edwards, is celiac disease, an allergy to a protein called gluten that is often found in wheat products.

Left untreated, celiac disease can damage the lining of the digestive system and interfere with the digestion of nutrients — including the calcium and vitamin D that are so important to bone health. So even if you’re getting the recommended daily amounts of calcium and vitamin D in your diet, if you have celiac disease, you probably don’t have enough of those nutrients in your system, and you likely have low bone density.

Asthma itself does not increase your risk of developing osteoporosis, but the medications used to treat it do. Approximately 20 million people in the U.S. have asthma, including some 9 million children under the age of 18.

Many people with asthma use corticosteroids — such as asthma “inhalers” — to help control their disease. During asthma attacks it is not uncommon to start drugs like prednisone for small periods of time. These are very effective in relieving the shortness of breath and wheezing that are common with asthma or emphysema, but they may also contribute to bone loss and osteoporosis.

“In addition to this, many young people with asthma may have more difficulty participating in some activities, which means they might not get as much weight-bearing exercise as they need to help build bone,” says Andrew Bunta, MD, associate professor and vice chair of orthopaedics at Northwestern University Feinberg School of Medicine.

Asthma and multiple sclerosis are two very different conditions, but there are very similar reasons why they both increase the risk of osteoporosis. Like people with asthma, people with multiple sclerosis take steroid-based medications to help manage their symptoms, and steroids are associated with bone loss. Since multiple sclerosis also affects balance and movement for many people, someone with MS may find it more difficult to get as much weight-bearing exercise as they need to in order to build and maintain bone.

“Anything that impedes your ability to walk accelerates bone loss,” says Edwards.

If you have one of these conditions, how can you help protect yourself from osteoporosis? First, don’t assume that your doctor will take care of it for you.

“When you are troubleshooting a primary condition like MS, asthma, or lupus, you’re not thinking about the side effects. Osteoporosis can take a back seat,” says Felicia Cosman, MD, medical director of the Clinical Research Center at Helen Hayes Hospital in Haverstraw, N.Y., and an editor of Osteoporosis: An Evidence-Based Guide to Prevention and Management. “That’s understandable — but you don’t want osteoporosis to add more disability to an already disabling condition.”

So if the doctor treating your celiac disease or rheumatoid arthritis hasn’t already brought up osteoporosis with you, ask to discuss it. Depending on your age and your specific condition, you may have several options to help prevent osteoporosis symptoms:

• Get an early bone density test. Doctors don’t usually recommend bone density tests for premenopausal women, but if you have one of these conditions, you may need to be monitored more closely, and treated for bone loss more aggressively.
• Push for more vitamin D and calcium in your diet, and supplement. Edwards recommends that people with conditions that accelerate bone loss get at least 1,000 to 1,500 milligrams of calcium and 400 to 600 international units (IU) of vitamin D from food and supplements. Look for low-fat dairy and fortified foods.
• Consider getting the vitamin D levels in your blood measured. “That’s not a specific recommendation from the National Osteoporosis Foundation, but it makes so much clinical sense,” says Cosman. “Because vitamin D levels vary so much between individuals, it’s hard to know how much supplementation is needed to reach sufficient levels.”

Top Picks

symptoms and causes of the disease

Contents

• 1 Osteopenia: symptoms, causes and treatments
  • 1. 1 Osteopenia: causes, symptoms and treatment
    • 1.1.1 Causes of osteopenia
    • 1.1. 2 Symptoms of osteopenia
    • 1.1.3 Treatment of osteopenia
  • 1.2 Osteopenia: the essence of the disease and its symptoms
  • 1.3 Causes of osteopenia
  • 1.4 Heredity as a risk factor
  • 1.5 Symptoms of osteopenia
  • 1.6 Diagnosis of osteopenia
    • 1.6.1 Clinical manifestations
    • 1.6.2 Instrumental research methods
    • 1.6.3 Laboratory tests
  • 1.7 Osteop treatment in women over 50
  • 1.8 Treatment of osteopenia
    • 1.8.1 Main directions treatment of osteopenia:
    • 1.8.2 Additional treatments:
  • 1.9 Exercises to strengthen bones
    • 1.9.1 Exercises with weights
    • 1.9.2 Stretching exercises
    • 1.9.3 Balance exercises
  • 1.10 Nutrition for osteopenia
    • 1.10.1 Basic principles of nutrition
    • 1. 10 .2 Foods rich in calcium
    • 1.10.3 Foods that delay absorption calcium
    • 1.10.4 Foods rich in vitamin D
    • 1.10.5 Foods rich in protein
    • 1.10.6 Foods containing vitamin K
  • 1.11 Prevention of osteopenia 9 0004
  • 1.11.1 Healthy lifestyle
  • 1.11.2 Adequate levels of calcium and vitamin D
  • 1.11.3 Avoiding excessive alcohol and coffee consumption
  • 1.11.4 Taking medication correctly
  • 1.11.5 Seeing a doctor on time
• 1.12 Findings of osteopenia
  • 1.12.1 Unsafe consequences of treating suspected cases of osteopenia
  • 1.12.2 Preventive measures and treatment
  • 1.12.3 Expert advice
• 1.13 Related videos:
• 1.14 Q&A:
  • • 1.14.0.1 What is osteopenia?
    • 1.14.0.2 What are the symptoms associated with osteopenia?
    • 1.14.0.3 Who is at risk of developing osteopenia?
    • 1.14.0.4 How can osteopenia be diagnosed?
    • 1. 14.0.5 How to prevent the development of osteopenia?
    • 1.14.0.6 What medications are used to treat osteopenia?

Osteopenia is a decrease in bone density that can lead to weak bones and osteoporosis. Symptoms may be subtle, and the causes are calcium metabolism disorders, vitamin D deficiency, hormonal disorders, etc. Learn more about the causes and symptoms of osteopenia on our website.

Osteopenia is a skeletal disease in which bone density decreases, i.e. bones become more fragile and thin. It can occur in people of any age, but most often occurs in older people. Osteopenia is a precursor to osteoporosis, which is characterized by an even greater loss of calcium and phosphorus, which is very dangerous.

Osteopenia can be caused by several causes, including poor circulation to the bone, metabolic disorders, vitamin and mineral deficiencies, and genetic factors. Some other causes may be related to lifestyle, including lack of physical activity, alcohol use, and smoking.

Osteopenia is a serious disease that requires proper attention and treatment to prevent possible consequences such as injuries, fractures and skeletal deformities. It is important to understand the possible causes and symptoms of this disease in order to find the best treatment and prevent its development.

Osteopenia: causes, symptoms and treatment

Causes of osteopenia

Osteopenia is a skeletal condition in which the bones become thinner and thinner. This is due to a violation of the processes of formation of bone tissue. The most common cause of osteopenia is calcium and vitamin D deficiency in the body.

However, in addition to calcium and vitamin D deficiency, many other factors can contribute to the development of osteopenia. For example, bad habits (smoking, alcohol abuse), low physical activity, thyroid disease, hormonal imbalance and other diseases.

Symptoms of osteopenia

• Pain in bones and muscles;
• Weakness and discomfort in the bones;
• Excessive sweating;
• Frequent fractures and injuries;
• Decreased height and detrimental effect on posture;
• Development of kyphosis and scoliosis;
• General health reduction.

Treatment of osteopenia

The treatment of osteopenia depends on the underlying cause. However, common treatments are:

1. Nutrition rich in calcium and vitamin D;
2. Moderate physical activity.

Medications such as bisphosphonates and hormones may also be prescribed.

It is worth noting that the prevention of bone disease, aimed at increasing bone density and strengthening the skeleton, is the main method of combating osteopenia at any age.

Osteopenia: the essence of the disease and its symptoms

Osteopenia is a disease in which the bones become more fragile and weak. This can happen due to a decrease in bone density. In the process of aging, a person undergoes changes in the body, and thus there is a significant increase in the risk of developing this disease.

One of the main risks for developing this disease is low levels of calcium and vitamin D in the body. The lack of these elements leads to the development of weakening of the bone tissue and, as a result, to the appearance of osteopenia. In addition, this disease can be associated with the use of alcohol, certain drugs, as well as genetic factors.

• Risk factors :
  • Age;
  • Low levels of calcium and vitamin D in the body;
  • Certain medicines;
  • Heredity;
  • Alcoholism;
  • Lack of physical activity.

Causes of osteopenia

Lack of calcium in the body. Calcium is the main element of bone tissue, and if it is not enough, the bones become brittle and prone to fracture.

Disorder of hormone metabolism. Decreased estrogen levels in women after menopause and in men as they age can lead to bone loss and weak bones.

Eating disorders. Insufficient intake of protein, vitamin D and other nutrients may lead to osteopenia.

Susceptibility to genetic diseases. Osteopenia may be hereditary. For example, a genetic defect can cause abnormal bone metabolism.

Long-term use of certain drugs. These include glucocorticosteroids, antidepressants and antiepileptics.

Low level of physical activity. Lack of physical activity can lead to a decrease in bone density.

Heredity as a risk factor

Osteopenia can be caused by various factors, among which heredity occupies an important place. If one of the close relatives had this disease, then other family members are at a higher risk of developing it.

Certain conditions can also increase the chance of developing osteopenia, such as early menopause, anorexia, vitamin D and other nutritional deficiencies, and certain hormonal and endocrine disorders. If you have a family history or any of the risk factors listed above, it is important to know that you must take steps to prevent and detect the disease early.

Symptoms of osteopenia

Osteopenia is a possible cause of bone fractures and a slowdown in general physical activity. Symptoms of osteopenia can be subtle or very obvious, depending on the degree of the disease.

One of the first signs of osteopenia is bone tenderness, starting in the upper back and neck. In more advanced cases, there may be a general feeling of weakness and fatigue.

A sharp decrease in height or curvature of the spine can also become a symptom of osteopenia. In people living in regions with low levels of sunlight, blurred vision, conjunctivitis, and skin disease may indicate a vitamin D deficiency, which in turn may be the cause of osteopenia.

There may be no noticeable symptoms of osteopenia in the early stages, but monitoring calcium levels, vitamin D, and bone mass can help patients recognize the disease early and avoid future complications.

Diagnosis of osteopenia

Clinical manifestations

Symptoms of osteopenia may not be noticeable at the initial stage of the disease. However, over time, the patient begins to feel pain and discomfort in the bones, especially in the spine and pelvis. A characteristic sign is a deterioration in posture, a decrease in height and an increase in the risk of fractures.

Instrumental research methods

The main method for diagnosing osteopenia is the measurement of bone density using densitometry. This method is the most accurate and allows you to detect pathological changes in bones in the early stages.

In addition, radiography, computed tomography and magnetic resonance imaging can be used to clarify the diagnosis. These methods allow you to determine the degree of bone damage and identify possible complications.

Laboratory tests

One of the additional methods for diagnosing osteopenia is a biochemical blood test. In osteopenia, the levels of calcium, phosphorus, and vitamin D in the blood may be reduced, and the level of alkaline phosphatase may be elevated.

In addition, general and biochemical blood and urine tests are performed to identify possible diseases that can lead to osteopenia.

In general, the doctor uses an integrated approach to diagnose osteopenia, which includes clinical, instrumental and laboratory research methods.

Osteopenia in women over 50 years old

Osteopenia is a disease that is manifested by a decrease in bone density. Women over 50 are more prone to this disease due to changes in hormonal balance caused by menopause. The lack of calcium in the body also affects the development of osteopenia in women at this age.

There are several symptoms that may indicate the presence of osteopenia in women. Among them are pain in the back, neck and arms, bone weakness and increased fatigue. In addition, bone damage can occur even with slight stress or trauma, which is also a sign of the disease.

To prevent osteopenia in women over 50, it is recommended to increase the intake of calcium and vitamin D, which will help strengthen bones. Regular exercise and physical activity are also important for keeping bones healthy and preventing osteopenia in older women.

• Risk factors: family history of the disease, short height and weight, lack of hormones.
• Diagnosis: measurement of bone density, analysis of calcium and vitamin D levels in the blood, X-ray examination.
• Treatment: lifestyle changes, calcium and vitamin D supplements, bisphosphonate drugs.

Treatment of osteopenia

Main directions of osteopenia treatment:

1. Correction of nutrition. In osteopenia, it is recommended to increase the amount of calcium, vitamin D, phosphorus and magnesium in the diet.

2. Physical exercises. Regular exercise helps to strengthen bone tissue, increase its mass and density. It is recommended to go in for walking, running, swimming, gymnastics, yoga.

3. Drug therapy. Mostly drugs that strengthen bones are used: calcium, vitamin D, bisphosphonates, zyudova hormone, relsek, etc.

4. Refusal of bad habits. Smoking and alcohol consumption have a negative effect on bone health. With osteopenia, these habits must be abandoned.

Additional treatments:

• Massage – improves blood circulation and bone metabolism;
• Physiotherapeutic methods – improve blood circulation and general condition of tissues;
• Diet – helps to control weight and not overload the bones;
• Daily regimen – get quality sleep and avoid excessive exercise.

Osteopenia should be treated under medical supervision. You should not take medicines without his recommendation and you should not self-medicate. It is important to follow the doctor’s recommendations and undergo regular check-ups to evaluate the effectiveness of the chosen treatment.

Bone strengthening exercises

Weight training

One way to strengthen bones is to use weights during exercise. Classic exercises such as squats, dips, barbell presses, and biceps and triceps exercises can be done using dumbbells or barbells.

Exercise example:

• Dumbbell squat. Take dumbbells in each hand and place them on your shoulders. Squat down, keeping the correct form and vertical back.

Stretching exercises

Stretching is an important element of any workout, as it allows you to soften the muscles and ligaments. Regular stretching also promotes bone health.

Sample exercise:

• Leg extension. Lie on your back, lift one leg and keep it extended for about 30 seconds. Repeat with the other leg.

Balance exercises

Balance exercises can improve coordination and help develop bone strength. To perform this type of exercise, you need to look for a platform point on which you can maintain balance.

Sample exercise:

• Stand on one leg and lift the other. Hold the balance for about 30 seconds, then repeat with the other leg.

Nutrition for Osteopenia

Nutrition Basics

It is important to eat a proper osteopenia diet to provide the body with the nutrients it needs to maintain bone health.

Nutrition guidelines for people with osteopenia:

• Increased intake of foods rich in calcium
• Reduced intake of foods that slow calcium absorption (phosphate, oxalate, fatty foods)
• Increased intake of foods rich in vitamin D adequate intake of foods containing vitamin K

Calcium-rich foods

The following foods are recommended to provide calcium to the bones:

• Dairy products (cheese, cottage cheese, yogurt)
• Nuts and seeds (almonds, sesame)
• Leafy vegetables (broccoli, spinach)
• Fish (sardines, salmon)

900 02 In addition, it is recommended to consume calcium in the form of supplements, the intake of which should be coordinated with a doctor.

Foods that slow calcium absorption

In case of osteopenia, the following foods should be limited:

• Phosphate-containing foods (carbonated drinks, salted nuts, sausage)
• Oxalate-containing foods (spinach, rhubarb)
• Fatty foods (fatty meats, mayonnaise)

Foods rich in vitamin D

Vitamin D is essential for proper absorption of calcium. It is found in the following foods:

• Fish oil (codfish, sardines)
• Egg yolk shell
• Foods fortified with vitamin D (milk, yogurt) spend time outdoors with plenty of sunshine.

  Protein-rich foods

  Protein plays an important role in strengthening bones. Recommended foods high in protein:

  • Meat (chicken, beef)
  • Fish (tuna, salmon)
  • Nuts (hazelnuts, walnuts)
  • Seeds (sunflower seeds, pumpkin)

  9 0130 Products containing vitamin K

  Vitamin K is essential for strengthening bones and preventing osteoporosis. It is found in the following products:

  • Green leafy vegetables (broccoli, spinach, cabbage)
  • Fish oil (sardines, anchovies)

  Prevention of osteopenia

  Healthy lifestyle

  Exercise mi, proper nutrition, avoidance of bad habits are the main components of a healthy lifestyle life. It is the basis for the prevention of osteopenia.

  Adequate levels of calcium and vitamin D

  Calcium and vitamin D are important for bone health. The diet should include a sufficient amount of foods rich in calcium and vitamin D, such as dairy products, fish, eggs, leafy vegetables. In case of deficiency of these vitamins, it is necessary to take the appropriate supplements on the recommendation of a doctor.

  Avoiding excessive alcohol and coffee

  Avoiding excessive alcohol and coffee not only reduces the risk of osteopenia, but also improves overall health.

  Taking Your Medications Correctly

  Medications such as glucocorticosteroids or antidepressants may increase the risk of osteopenia. If you need to take such drugs, you must always consult with your doctor and follow his recommendations.

  Timely visit to a doctor

  In case of any changes in the state of health, it is necessary to consult a doctor for examination and prevention. As a prevention of osteopenia, it is recommended to undergo annual examinations for the content of calcium and vitamins in the body.

  Findings of osteopenia

  Unsafe consequences of treating suspected cases of osteopenia

  Osteopenia is a serious disease that can lead to bone fragmentation and loss of bone density. Often it occurs without any symptoms, so patients may not be aware of their problem. However, its detection can be very important, since osteopenia is a major risk factor for osteoporosis and bone fractures.

  Therapy depends on the stage of the disease, restoration of bone density can take up to 6 months or more. Therefore, if patients want to speed up the recovery process, medical professionals can prescribe calcium supplements, vitamin D and others, but this can increase the risk of negative effects in the body. Therefore, medications for osteopenia should only be taken at the discretion and supervision of the treating physician.

  Prevention and treatment

  Many signs and factors have been identified that may explain why patients develop osteopenia. Including age, gender, racial traits, genetic factors, lack of calcium and vitamin D, metabolic disorders, long-term medication, etc.

  It is important to note that in the process of treating osteopenia, specialists are guided not only by the main goal – to restore bone density, but also accumulate data that will help improve the prevention and treatment of this disease in the future. Among the main measures that are recommended for those who are experiencing osteopenia are bone mass exercises, regular medical check-ups, a balanced diet, avoiding bad habits, etc.

  Expert advice

  Tracking the dynamics of the disease, experts emphasize that static indicators are the main ‘link;’ between osteopenia and osteoporosis. Assessment of bone density and control of all factors affecting this indicator play a high role in the treatment of osteopenia.
  More information about risk factors and warnings is needed, especially in women and the elderly. The optimal way out will be to consult a doctor and individual selection of therapy to improve the condition of bone tissues.

  The only way to avoid osteopenia is to lead a healthy lifestyle, including exercise, diet, control of their diseases. Only in this way can we provide our bones with maximum protection in life and cope with malignant changes in bone tissue.

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  Q&A:

  What is osteopenia?

  Osteopenia is a bone disease in which bone density decreases, resulting in poor bone structure and an increased tendency to fracture.

  What are the symptoms of osteopenia?

  Osteopenia usually does not show obvious symptoms in the initial stage of development. However, with age, patients may develop soreness in the bones, a tendency to fracture, and a decrease in height due to compression of the spinal discs.

  Who is at risk of developing osteopenia?

  Osteopenia most often develops in women after menopause, in patients with a low level of physical activity, with insufficient dietary calcium intake. Also, this disease can occur while taking certain medications, such as glucocorticoids.

  How can osteopenia be diagnosed?

  Osteopenia requires a densitometry test, which measures bone density. It is a safe and simple procedure recommended for women over 65 and men over 70.

  How to prevent the development of osteopenia?

  To prevent the development of osteopenia, calcium-rich foods such as milk, yogurt, cheese, cottage cheese should be consumed regularly. It is also important to exercise regularly, especially strength-training exercises that help strengthen bones.

  What medications are used to treat osteopenia?

  Preparations containing calcium, vitamin D, bisphosphonates, reparations are used to treat osteopenia. The choice of method of therapy, dosage and duration of treatment depend on the severity of the disease and the individual characteristics of the patient.

  Osteoporosis Prevention

  Bone metabolism marker test that evaluates osteoblast activity, detects changes in bone remodeling processes, and suspects the development of osteoporosis and other bone diseases.

  Test results are issued with a free doctor’s commentary.

  Synonyms Russian

  Markers of bone tissue formation.

  Synonyms English
  Osteoporosis screening, Bone formation markers.

  Test method

  Immunochemiluminescent assay, kinetic colorimetric method.

  Units

  Ng/mL (nanogram per milliliter), U/L (unit per liter).

  What biomaterial can be used for research?

  Venous, capillary blood.

  How to properly prepare for the examination?

  • Do not eat for 12 hours before the test.
  • Avoid physical and emotional stress and do not smoke for 30 minutes prior to the examination.

  General information about the study

  Remodeling processes continuously occur in the bones, which include the resorption (destruction) of existing bone tissue and the formation of a new one. During cell resorption, osteoclasts and enzymes destroy bone tissue. The new protein scaffold of bones, which is mineralized and converted into new bone tissue, is formed by osteoblast cells that secrete the protein osteocalcin and collagen precursors. Every year, 8-10% of all bone tissue is renewed in the human body.

  In childhood, bone formation is much more intense than resorption processes. The maximum bone mass is reached at the age of 25-30 years. Then resorption processes begin to predominate and the bone mass gradually decreases. Bone metabolism is regulated by vitamin D, calcium, hormones estrogens, androgens, parathyroid hormone, calcitonin. An imbalance between the destruction and restoration of bone density can occur with hormonal or dietary changes, insufficient calcium intake. The predominance of resorption processes leads to osteopenia (decrease in bone density), which progresses and turns into osteoporosis.

  Osteoporosis is a pathology of the musculoskeletal system associated with a decrease in bone density and strength and an increased risk of fractures. It can be primary (associated with bone loss due to aging) and secondary (due to another disease or certain medications).

  Risk factors for the development of primary osteoporosis: female sex, age (the risk of fractures in people over 50 increases by 2-3 times every 10 years), underweight (body mass index ? 21 increases the risk of fractures by 1. 2-2 times) , insufficient intake of calcium and vitamin D in childhood, hereditary predisposition, previous fracture (risk increases by 8 times), smoking (risk increases by 1.2-2 times), alcohol consumption.

  Secondary osteoporosis may occur with medications (glucocorticoids, immunosuppressants, thyroxine, aromatase inhibitors, thiazolidine, anticonvulsants), Itsenko-Cushing syndrome, chronic kidney disease, rheumatoid arthritis, thyrotoxicosis, vitamin D deficiency, malabsorption Crohn’s disease, celiac disease), hypogonadism, amenorrhea, myeloma, anticancer treatment.

  Osteoporosis most often develops due to age-related bone loss and is diagnosed in 74% of all women over 80 years of age, which is associated with a decrease in blood estrogen levels. In some women, in the first 5-7 years after menopause, bone mass loss can be up to 20%. A decrease in testosterone levels in men can also lead to a decrease in bone density.

  Usually there are no clinical manifestations of osteoporosis and fractures of the hip, wrist bones or vertebrae are its first signs. Osteoporosis can be suspected with bone pain, kyphosis, and decreased growth in people of older age groups. Fractures in patients with osteoporosis lead to limited mobility, disability, deterioration in general health, and may even be predisposing factors for death in patients of older age groups.

  Bone alkaline phosphatase and osteocalcin reflect the activity of osteoblasts in bone tissue. Stimulation of osteoblasts occurs during intensive processes of bone destruction that accompany osteoporosis, Paget’s disease, fractures, bone tumors. In osteoporosis, levels of osteocalcin and alkaline phosphatase increase in concert, and bone metabolism disorders occur before the first changes in bone density, which can be detected by densitometry (radiological diagnostic method).

  Early detection of osteoporosis and treatment can prevent disease progression and fractures, which significantly improves the quality of life of older people.

  What is research used for?

  • For the early diagnosis of osteoporosis.
  • To assess the risk of bone fractures.
  • To predict bone loss in postmenopausal women and older men.
  • For monitoring bone metabolism during hormone replacement therapy.
  • To determine the appropriateness of antiresorptive therapy.
  • To assess the success of osteoporosis therapy.
  • To select the most effective drug for the treatment of osteoporosis and its optimal dose.

  When is the test ordered?

  • In the presence of risk factors for osteoporosis (female gender, age over 50 years, low weight, hereditary predisposition, smoking, alcohol consumption, endocrine diseases, long-term use of glucocorticosteroids, intestinal malabsorption, rheumatic diseases).
  • In the preventive examination of women in the postmenopausal period.
  • For preventive examination of men over 70 years of age.
  • If there is a history of fractures not associated with severe trauma.
  • Before initiation of antiresorptive therapy and every 3-6 months thereafter for treatment of osteoporosis.

  What do the results mean?

  Reference values ​​

  • N-Osteocalcin: 2 – 22 ng/ml.
  • Total alkaline phosphatase

  Age	Reference values ​​
  Less than 4 years	104 – 345 U/l
  4-7 years	93 – 309 U/L
  7-10 years old	86 – 315 U/L
  10-13 years old	42 – 362 U/L
  13-16 years old	74 – 390 U/l
  16-18 years old	52 – 171 U/L
  Over 18 years old	30 – 120 U/l

  Causes of elevated levels of N-osteocalcin:

  • osteoporosis,
  • rickets, osteomalacia,
  • primary and secondary hyperparathyroidism,
  • Paget’s disease,
  • tumors and bone metastases,
  • acromegaly,
  • bone fractures,
  • diffuse toxic goiter,
  • renal osteodystrophy,
  • chronic renal failure.

  Causes of decreased N-osteocalcin levels:

  • hypoparathyroidism,
  • growth hormone deficiency,
  • Itsenko-Cushing’s disease and syndrome,
  • taking glucocorticoids, bisphosphonates, calcitonin.

  Causes of an increase in the level of total alkaline phosphatase:

  • Paget’s disease – osteitis deformans (significant increase),
  • bone tumors and metastases, osteosarcoma,
  • osteoporosis,
  • rickets and osteomalacia,
  • acromegaly,
  • too much vitamin D,
  • fracture healing,
  • pathology of the liver and biliary tract, eg, obstruction of the biliary tract, cholangitis, infiltrative liver diseases (sarcoidosis, tuberculosis, amyloidosis, abscess), cirrhosis (more than fivefold increase in ALP), postoperative cholestasis, liver tumors and metastases,
  • pathology of the pancreas (pancreatitis, cancer, cystic fibrosis) – due to compression of the common bile duct,
  • chronic alcoholism,
  • leukemias,
  • myelofibrosis,
  • myeloma (rare),
  • hyperthyroidism (thyrotoxicosis),
  • primary and secondary hyperparathyroidism,
  • metastatic lung carcinoma,
  • sepsis,
  • viral infections (infectious mononucleosis, cytomegalovirus),
  • pulmonary infarction (1-3 weeks after embolism), healing sites of infarction in other organs, including the liver,
  • healing of extensive superficial wounds (e. g. bedsores),
  • hypernephroma (malignant tumor of the kidneys),
  • Fanconi syndrome (congenital pathology of the kidneys with multiple metabolic disorders),
  • gastric ulcers and erosions, intestinal obstruction, ulcerative colitis,
  • malabsorption (due to secondary vitamin D deficiency),
  • congestive heart failure,
  • chronic renal failure,
  • familial hyperphosphatemia,
  • excessive parenteral administration of glucose, albumins,
  • physiological causes (bone growth in children, pregnancy).

  Causes of a decrease in the level of total alkaline phosphatase:

  • hypophosphatasia (a hereditary disease with impaired bone calcification with normal levels of calcium and phosphorus and a significant decrease in the activity of alkaline phosphatase),
  • hypothyroidism, cretinism,
  • scurvy,
  • kwashiorkor (severe malnutrition due to dietary protein deficiency),
  • pernicious anemia and severe anemia (rare),
  • zinc and magnesium deficiency,
  • blood transfusion and heart bypass surgery (short-term decrease in enzyme activity),
  • celiac disease (gluten enteropathy),
  • Burnett’s syndrome (food hypercalcemia syndrome, milk-alkaline syndrome).

  What can influence the result?

  • Age (in children, due to intensive growth, indicators of bone tissue formation are increased).
  • Pregnancy (physiologically high levels of alkaline phosphatase).
  • Daily fluctuations in osteocalcin levels.
  • Intravenous administration of albumin (increased ALP may persist for several days).
  • Taking anticoagulants (eg warfarin).
  • Renal failure (increased levels of osteocalcin due to impaired glomerular filtration processes or renal osteodystrophy).
  • Diseases of the liver and biliary tract (increased alkaline phosphatase).
  • Any drug that has hepatotoxic properties or causes cholestasis will increase serum ALP activity, sometimes significantly. About 250 such drugs have been described.
  • Drugs and substances that can increase the level of ALP in the blood: oral contraceptives, methyltestosterone, phenothiazines, oral hypoglycemic agents, erythromycin, antiepileptics, many antibacterial and antifungal drugs, methotrexate, sulfonamides, large doses of vitamin C, non-steroidal anti-inflammatory drugs (aspirin, diclofenac), barbiturates, diltiazem.
  • Blood alkaline phosphatase drugs: acyclovir, alendronate, aluminum-containing antacids, azathioprine, vitamin D, danazol, calcitonin, calcitriol, carvedilol, clofibrate, colchicine, norethindrone, pamidronate, penicillamine, oral contraceptives, prednisolone, tamoxifen, trifluoperazine, ursodiol, cyclosporine, estrogens in combination with androgens, etidronate.

  Important Notes

  • The results of this test do not constitute a definitive diagnosis. If changes in N-osteocalcin and total alkaline phosphatase are detected, additional laboratory and instrumental examinations are necessary to clarify the causes of the pathological process.
  • If the test results are normal and there are risk factors for osteoporosis, it is recommended to repeat the analysis after 1-2 years.

  Also recommended

  • Serum calcium
  • Calcium, ionized
  • Daily urine calcium
  • Serum phosphorus
  • Beta-CrossLaps (marker of bone resorption)
  • Parathyroid hormone, intact
  • Pyrilinks-D (bone resorption marker)
  • P1NP Bone Matrix Marker
  • Somatotropic hormone
  • Thyroid Stimulating Hormone (TSH)
  • Vitamin D, 25-hydroxy (calciferol)
  • Complete blood count (without leukocyte formula and ESR)
  • Erythrocyte sedimentation rate (ESR)
  • Laboratory examination for osteoporosis

  Who orders the examination?

  General practitioner, rheumatologist.