Bone Health Panel: Provider Overview
Osteoporosis and Osteopenia
The interplay between bone formation and resorption is a continuous, lifelong process that
favors bone formation in the early years of life, leading to a peak bone mass at approximately
20 to 30 years of age. After reaching this peak, total bone mass gradually declines in both
men and women. Osteoporosis is defined as a “reduction in bone mineral density, leading to
fractures after minimal trauma” and osteopenia as “any decrease in bone mass below the normal”.
Diagnosis of Osteoporosis
Although the pathogenic events involved in the development of osteopenia and osteoporosis
are relatively irreversible, early detection and intervention are key to minimizing bone
density loss. Traditionally, diagnosis has relied on bone densitometry (mineralized bone
mass assay) using radioactive or radiographic techniques performed at a referral facility.
Noninvasive methods to estimate bone mineral density are now available to identify high-risk
patients who have not yet sustained a fracture. These include a number of specific urinary
assays of bone resorption markers for the diagnosis and follow-up of osteoporotic patients.
Pyrilinks-D (deoxypyridinoline) is particularly useful because it is specific to bone
resorption as opposed to general collagen loss.
Bone Health Panel
The Bone Health Panel utilizes saliva samples to assess pertinent hormone levels, along with
a urine sample to assay Pyrilinks-D. Evaluating levels of estradiol, progesterone,
testosterone, cortisol, DHEA/DHEAS and FSH helps to create a more complete picture of factors
that underlie bone metabolism. Sample collection does not require laboratory visits or
radiation exposure, and costs are considerably less. The markers assessed by the BHP provide
valuable data that aid in constructing an appropriate plan for patients with or at risk for
osteopenia or osteoporosis. Additionally, the BHP offers an objective way to monitor the
efficacy of bone loss treatment strategies including: correction of hormonal abnormalities,
calcium and vitamin supplementation, dietary and lifestyle changes, and/or pharmacological