Table 2.

Work-Up for Secondary Causes of Osteopenia and/or Osteoporosis

History and physical examination with focus on secondary causes of osteoporosis

Perform complete blood count

Perform routine blood chemistry tests

Determine creatinine, blood urea nitrogen, total calcium, phosphate, albumin, and alkaline phosphatase levels

Determine serum 25-hydroxyvitamin D level

Perform parathyroid hormone and thyroid-stimulating hormone tests

Perform 24-hour urine test for calcium and creatinine

Determine total and free testosterone (for men)

Determine estradiol, follicle-stimulating hormone, luteinizing hormone, and prolactin levels in young amenorrheic women

Simultaneous serum phosphate and creatinine, spot urine phosphate, and creatinine to calculate the fractional excretion of phosphate (for patients receiving tenofovir)

NOTE. Adapted from Dolin et al [126].