Diagnostic tests for causes of osteoporosis

by | Jul 18, 2025 | Testing

I can’t help but draw attention to the fact that generally when a man is shown to have osteoporosis by bone mineral density testing or because of a needless fracture, he is immediately given a series of tests looking for the causes of his bone weakening.

Women with osteoporosis, on the other hand, are immediately told to take bone drugs. Most often no tests are done and no attempt made to uncover the causes of osteoporosis.

As a result, many women take bone drugs to cover up the real problem. It’s never discovered that they might be suffering from hyperparathyroidism, excessive loss of calcium in the urine, Celiac Disease, hypercortisolemia or any other of the hidden causes of osteoporosis.

Get thoroughly tested for hidden causes

I believe that any woman experiencing excessive bone weakening should be thoroughly tested for hidden causes.  After all, if a doctor thinks the problem is serious enough to tell a woman to take bone drugs, then it is serious enough to warrant a full diagnostic workup looking for hidden causes of bone weakening.

Just today I saw yet another woman who was told to take bone drugs because of excessive bone loss without any testing looking for the causes.  After working with me she discovered she was losing bone due to an overactive parathyroid gland, which I’ll write about more in an upcoming blog.

What are common diagnostic tests?

Here are some common diagnostic tests that can be used to uncover the underlying causes of osteoporosis:

  • Vitamin D 25(OH)D blood test
  • Ionized calcium test
  • Intact parathyroid hormone blood test (iPTH)
  • 24-hour urine calcium excretion test
  • Thyroid hormone function test (TSH)
  • Dpd urine marker of bone resorption test (deoxypyridinium crosslinks test)
  • Vertebral deformity assessment
  • Free cortisol test (blood or saliva)
  • DHEA test (blood or saliva)
  • C-reactive protein test (high sensitivity if possible)
  • Homocysteine test (plasma or serum)
  • Celiac disease
  • Gluten sensitivity test
  • Sex hormone test

Markers of bone breakdown

  • N-telopeptides crosslinks (NTx) serum marker of bone resorption test
  • N-telopeptides crosslinks (NTx) urine marker of bone resorption test
  • CTx serum bone breakdown test

Markers of Bone Formation

  • P1NP test of bone formation
  • Osteocalcin
  • Bone alkaline phosphatase

Learn more about assessing bone breakdown and bones loss 

You can read more about each diagnostic test in my article What’s the cause of your osteoporosis? Diagnostic tests and what they mean. If you suspect excessive bone weakening I suggest you read, print out and discuss this article with your medical practitioner.

 

Everyone deserves the full story on their health

It seems like today’s health care has become a knee-jerk reaction of “see a symptom, take a pill.” But we at the Center for Better Bones believe that everyone deserves better than that. Your bone loss is a symptom of something that’s just not right in your body — and rather than treating the symptom with medications (and living with the side effects involved, some of which are plain frightening!), I encourage everyone to dig deeper and find out the source of the problem.

New Offering from the Better Bones Foundation

Skip the doctor and order your tests online! So many times we hear from our clients and readers that their MDs are not willing to order the tests that they request. This is such a frequent occurrence that we wanted to find a way for women to obtain these necessary tests. In partnership with The Better Bones Foundation and Evexia Labs, we are now able to offer low-cost self-pay tests for those who want to know WHY they are losing bone.

The process is easy . . .

#1 Select the tests that you are interested in and submit your form below. Make sure you include your full address with city, state, and zip code. We will pass this information on to the lab on your behalf.

#2 Wait for an email from Evexia Lab with your username and password (also check your spam folder). Once you log in you will then be able to see the cost of the tests and can choose to self pay (no insurance accepted). After you pay Evexia will email you a requisition form for the lab.

#3 Print your requisition and take it to the nearest Labcorp facility. You can find a Labcorp close to you using this link: https://www.labcorp.com/labs-and-appointments. Self-pay testing is not available in NY, NJ, and RI.

#4.  In 2 to 4 weeks after getting the tests done, you will receive your lab results via an email notifying you that the results are ready. They can be viewed in your account or you can print them out and take them to your doctor for interpretation.

Low Cost Testing Offered by the Better Bones Foundation

One of the key initiatives of the Better Bones Foundation is to help people understand the root cause of their bone loss. We now have a partnership with the a lab who can offer this testing as a self-pay service.

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Dr. Susan E. Brown

Dr. Susan E. Brown

Dr. Susan Brown, PhD, is a medical anthropologist, a New York State Certified Nutritionist, and the author of Better Bones, Better Body — the first comprehensive look at natural bone health. She has more than 40 years of experience in clinical nutrition, bone health research.

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