Bones are a "living organism" that constantly undergoes reconstruction through osteoclasts (mechanism of bone resorption) and osteoblasts (mechanism of bone synthesis). The two mechanisms are in balance, which can be disturbed for many reasons (menopause, genetic type, hormonal imbalance, poor diet, smoking, lack of exercise, etc.) and can lead to bone loss.
The relatively limited bone loss is called osteopenia and does not have serious consequences. However, increased loss leads to osteoporosis, a pathological condition for bone tissue with serious risks of fractures, mainly of the hips, spine, and wrists.
Osteoporosis is now common in postmenopausal women but is a disease that is often found in men as well.
The analyses are intended to detect early the possibly increased bone loss that leads to or worsens osteoporosis and also to detect possible hormonal disorders and deficiencies of elements necessary for bone health, in order to provide appropriate treatment.
The analyses are recommended for women:
- preventively before menopause, especially for those with parents with osteoporosis problems, so that they can be compared with those that will be done at the onset of menopause.
- with diagnosed osteopenia or osteoporosis before the onset of therapeutic treatment, so that the effectiveness of the treatment regimen can be evaluated with new measurements after treatment.
They are divided into the category of detection of increased bone resorption, decreased bone synthesis, and factors that can affect bone health.
Calcium in 24-hour urine (Ca-U-24h): Its measurement is performed to determine a possibly increased rate of calcium excretion, which is correlated with the rate of bone loss and the development of osteoporosis (without taking calcium supplements).
Alkaline phosphatase (ALP) and electrification of alkaline phosphatase: They show us if there is an overfunction of the mechanisms of synthesis (metabolism) of bones.
Vitamin D3-25(OH): A vitamin that participates in the absorption of calcium from bones. Fifty percent of the elderly have a deficiency of the vitamin, mainly due to the limitation of its absorption.
T3 (triiodothyronine), fT4 (free thyroxine), TSH (thyroid-stimulating hormone): They are checked to determine a possible overfunction of the thyroid gland, which increases the rate of bone resorption.
Parathyroid hormone (PTH): The basic hormone regulating calcium metabolism produced by the parathyroid glands. Necessary examination in individuals who have undergone thyroidectomy, an intervention that often affects the parathyroid glands.
FSH (follicle-stimulating hormone) and oestradiol (E2): Their measurement is performed in women approaching menopause and is a measure of women's hormonal adequacy. In cases with a particularly heavy family history and indications for future osteoporosis, these examinations can determine the time to start hormone replacement therapy.
White cell electrification: It is performed to control and exclude serious metabolic diseases that can affect bone metabolism.
CTx (collagen type I C-terminal telopeptide), NTx (collagen type I N- terminal telopeptide): They are metabolites, elements of bone breakdown. Their measurement in 2-hour urine shows if daily bone loss is within normal levels.
Osteocalcin (BGP): Its measurement checks the rate of bone synthesis and is an important prognostic indicator of osteoporosis.
Cortisol in 24-hour urine (Cort-U-24h) can reveal a possible overfunction of the adrenal glands, which negatively affects bone health.