Table 4.

Exclusion of secondary causes of osteoporosis

Consider the following diagnostic studies for secondary causes of osteoporosis
Blood or serum
Complete blood count (CBC)
Chemistry levels (calcium, renal function, phosphorus, and magnesium)
Liver function tests
Thyroid-stimulating hormone (TSH) +/− free T4
25(OH)D
Parathyroid hormone (PTH)
Total testosterone and gonadotropin in younger men
Bone turnover markers
Consider in selected patients
Serum protein electrophoresis (SPEP), serum immunofixation, serum-free light chains
Tissue transglutaminase antibodies (IgA and IgG)
Iron and ferritin levels
Homocysteine
Prolactin
Tryptase
Urine
24-h urinary calcium
Consider in selected patients
Protein electrophoresis (UPEP)
Urinary free cortisol level
Urinary histamine