By Susan Brady | 02/25/2016

Everything You Need to Know About Osteoporosis Testing and Treatment

Everything You Need to Know About Osteoporosis Testing and Treatment

In our previous article, we discussed osteoporosis screening, focusing on Bone Mineral Density (BMD) screening. However, BMD screenings are not the only option for osteoporosis testing and determining bone health.

Are There Other Methods of Determining Bone Health?

The strength of a bone is not dependent on its density alone. There are several other characteristics that make up the quality of a bone and its ability to resist fracture. These include the quality of collagen, the size of the mineral crystals, and the rate of bone turnover.

The rate of bone turnover is the rate at which old bone is broken down and reabsorbed and new bone is formed. It can be evaluated through specific biochemical markers. Bone reabsorption tests measure how aggressively osteoclasts (bones cells that break down and reabsorb old bone cells) are breaking down the bone. Bone formation markers measure osteoblast (bone cells that generate new bone) activity or new bone formation. The most commonly used biomarkers of bone turnover are:

Bone Resorption Markers

N-telopeptide (NTX) is used to measure the small molecules of bone collagen being excreted through the urine. High levels are associated with rapid bone resorption and low bone mass in both men and women.

Deoxypyridinoline (DPD) is used to measure one of two pyridinium cross-links that provide structural stiffness to type I collagen found in bones. This test is done using a urine sample. Elevated DPD in the urine indicates increased rate of bone resorption. This is the most consistent test for a bone resorption marker.

Bone Formation Markers

Osteocalcin is a protein produced by bone-forming cells. It can be used as a marker for cell activity and bone formation.

Bone-specific alkaline phosphatase is used to detect early signs of bone-forming cell activity.

These markers are a useful way for both determining the quality of bone and monitoring therapeutic intervention. Unlike a DXA scan, which is a type of bone mineral density scan, these tests can be repeated every few months. This allows for closer assessment of the effectiveness of nutritional and lifestyle intervention. However, if you are currently using medication to treat osteoporosis, these tests may not be accurate because medications can alter or suppress the bone reabsorption and creation process.

What Are Your Treatment Options?

If you’ve been screened for osteoporosis via a bone mineral density scan or bone turnover test and your doctor has found that you have or are at risk for osteoporosis, it’s time to consider your treatment options.

Treatment for osteoporosis may involve:


Lifestyle changes, such as diet, exercise, and stress reduction

Taking supplements that include bone building nutrients like calcium, magnesium, vitamin D, and vitamin K

Bisphosphonates are the main drug prescribed to treat and prevent osteoporosis in postmenopausal women. Unfortunately, these medications are often prematurely prescribed in lieu of a conservative or holistic approach. Medications can also have many side effects, including the risk of atypical fractures of the femur bone.

One of the best ways to combat osteoporosis is through early detection. Taking advantage of all of the methods for early osteoporosis testing and considering all risk factors, particularly from an early age, will help to detect the onset of bone loss. Early detection allows for a full spectrum of treatment options, including a holistic approach that addresses all of the patient’s risk factors. Osteoporosis can often be prevented and even reversed by employing holistic principles addressing lifestyle, diet, digestion, stress, exercise, and proper supplementation. Start your bone health regimen now by scheduling osteoporosis testing and finding out what you need to keep your bones in tip top shape.

Susan Brady is a Physical Therapist, Doctor of Integrative Medicine and holds a Post Master’s Certificate in Nutrition and Integrative Health. Practicing in the healthcare field for over 25 years, her background give hers a unique perspective in treating bone disorders. By providing a comprehensive approach, Susan can evaluate your risk factors and address all avenues for strengthening your bones. For more information on Susan and her practice visit


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