Bone Health.PNG

BONE HEALTH PANEL

  • Parathyroid Hormone (PTH)

  • Corrected Calcium

  • Vitamin D

  • Procollagen Type 1 N Propeptide (P1NP) (bone formation)

  • C-terminal telopeptide of type 1 collagen (CTX) (bone reabsorption)

  • Omega 3 index

TESTING STRATEGY

There typically are no symptoms in the early stages of bone loss and osteoporosis can go undiagnosed. Some signs and symptoms include: back pain, caused by a fractured or collapsed vertebra, loss of height over time, a stooped posture, a bone that breaks much more easily than expected.

Bone formation is regulated by PTH. Testing PTH and calcium helps to exclude hyperparathyroidism. Vitamin D is also important for calcium absorption and deficiency can predispose to osteoporosis. P1NP and CTX are markers for bone formation (osteoblasts) and bone reabsorption (osteoclasts). Ideally these two bone markers should balance out. Therapies directed at increasing bone formation should show an increase in P1NP without an increase in CTX.

The omega 3 index is included as omega 3 fatty acid intakes has been shown to protect against post- menopausal bone loss. 

TREATMENTS

Medications from the bisphosphonate family are a common treatment option, as they stop bone loss and reduce the risk of fractures. Side effects from this class of medication include nausea and heartburn. Addition treatments of calcium, vitamin D, omega 3 fatty acids, and estrogens or phytoestrogens have been used. Exercise has been shown to improve bone strength.

MONITORING

Repeat testing of the entire panel is recommended every 3 months.

ADDITIONAL TESTING

  1. Sex Hormone Panel