Table 4.

Additional biochemical tests if indicated by clinical assessment^a

Hyperparathyroidism—if persistently elevated serum calcium	PTH
Multiple myeloma—in patients with multiple or atypical vertebral fractures	Protein electrophoresis
	Immunoelectrophoresis
Celiac disease—if symptoms/signs of malabsorption or nonresponse to vitamin D therapy	Antibodies associated with gluten enteropathy
Hypogonadism—in men with signs and symptoms of androgen deficiency	Testosterone (free and total)
	Serum prolactin
Hypercalciuria—consider in patients with history of kidney stones or high-dose glucocorticoids for prolonged periods	24-hour urine for calcium

^aAdapted from Papaioannou et al.'s (2010) Clinical Practice Guidelines Osteoporosis: Background and Technical Report (http://www.osteoporosis.ca/multimedia/pdf/Osteoporosis_Guidelines_2010_Background_And_Technical_Report.pdf).