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Bone Profile

Bone

6 parameters

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Report in 12Hrs

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At Home

nofastingrequire

No Fasting Required

Details

Comprehensive metabolic bone panel.

₹1,999₹3,500

43% OFF

Parameters

  • List of Tests
    • Calcium
    • Alkaline Phosphatase
    • Phosphorous
    • PTH - Intact
    • 25 OH Vitamin D
    • Zinc (Serum)

Bone Profile

  • Why is it done?
    • Comprehensive assessment of bone health and mineral metabolism by measuring key electrolytes and hormones involved in bone formation and remodeling
    • Diagnosis and monitoring of bone disorders including osteoporosis, osteomalacia, hyperparathyroidism, and metabolic bone disease
    • Evaluation of vitamin D status and calcium-phosphate regulation in patients with chronic kidney disease, malabsorption syndromes, and nutritional deficiencies
    • Assessment of fracture risk in postmenopausal women, elderly patients, and those with endocrine disorders
    • Monitoring of patients on medications affecting bone metabolism such as corticosteroids, bisphosphonates, or vitamin D supplements
    • Evaluation of musculoskeletal symptoms, bone pain, muscle weakness, and suspected metabolic disorders
    • Individual tests work synergistically: Calcium and Phosphorous reflect mineral homeostasis, PTH and 25-OH Vitamin D control their regulation, Alkaline Phosphatase indicates bone turnover and liver function, and Serum Zinc supports bone formation and immune function
    • Routine screening in high-risk populations including postmenopausal women, elderly individuals, and patients with chronic medical conditions affecting bone health
  • Normal Range
    • Calcium (Total): 8.5-10.5 mg/dL (2.1-2.6 mmol/L) or 2.2-2.6 mmol/L depending on laboratory; critical for bone structure, muscle contraction, and nerve function
    • Alkaline Phosphatase (ALP): 30-120 IU/L (varies by age and sex; higher in children and adolescents); indicates bone formation rate and hepatic function
    • Phosphorous (Inorganic Phosphate): 2.5-4.5 mg/dL (0.8-1.4 mmol/L); essential for bone mineralization and energy metabolism
    • PTH - Intact (Parathyroid Hormone): 10-65 pg/mL (1.0-6.9 pmol/L); controls calcium and phosphate regulation through kidney and bone
    • 25-OH Vitamin D (Calcifediol): 30-100 ng/mL (75-250 nmol/L); indicates vitamin D status with levels <20 ng/mL considered deficient, 20-29 ng/mL insufficient, and >30 ng/mL adequate
    • Zinc (Serum): 60-120 mcg/dL (9-18 micromol/L); higher levels in males compared to females; important for bone collagen synthesis and immune function
  • Interpretation
    • Calcium - Elevated (>10.5 mg/dL) suggests hyperparathyroidism, excessive vitamin D intake, malignancy, or immobilization; Low (<8.5 mg/dL) indicates hypoparathyroidism, vitamin D deficiency, malabsorption, or renal disease; critically affects neuromuscular and cardiac function
    • Alkaline Phosphatase - Elevated (>120 IU/L) indicates increased bone turnover, Paget's disease, rickets, osteosarcoma, or liver disease; Low (<30 IU/L) may suggest hypophosphatasia or hypoparathyroidism; assess bone-specific ALP (BSAP) for bone-specific elevation
    • Phosphorous - Elevated (>4.5 mg/dL) occurs in renal failure, hypoparathyroidism, or bone disorders; Low (<2.5 mg/dL) suggests hyperparathyroidism, vitamin D deficiency, or malabsorption; reciprocal relationship with calcium must be considered
    • PTH - Intact - Elevated (>65 pg/mL) indicates primary hyperparathyroidism or secondary hyperparathyroidism from hypocalcemia; Low (<10 pg/mL) suggests hypoparathyroidism or vitamin D intoxication; must correlate with calcium levels for proper interpretation
    • 25-OH Vitamin D - Deficiency (<20 ng/mL) causes osteomalacia, rickets, and increased fracture risk; Insufficiency (20-29 ng/mL) associated with impaired calcium absorption; Optimal levels (30-100 ng/mL) support bone mineralization; Excess (>150 ng/mL) may cause hypercalcemia
    • Zinc (Serum) - Low levels (<60 mcg/dL) impair bone formation, immune function, and wound healing; High levels (>120 mcg/dL) are rare but may cause copper deficiency; levels affected by nutritional status, infections, and certain medications
    • Factors affecting interpretation: Age-related changes in bone metabolism, sex hormone status, dietary intake, sun exposure, medications (corticosteroids, bisphosphonates, diuretics), chronic diseases (kidney disease, GI disorders), and seasonal variations in vitamin D
    • Patterns of abnormalities help differentiate diagnoses: Elevated PTH with low 25-OH vitamin D suggests secondary hyperparathyroidism; Elevated calcium with elevated PTH indicates primary hyperparathyroidism; Low calcium with low vitamin D suggests nutritional deficiency
  • Associated Organs
    • Calcium - Primary association with bones (skeletal system) where 99% is stored; secondary effects on kidneys (reabsorption), intestines (absorption), parathyroid glands (regulation); abnormalities may indicate kidney disease, parathyroid dysfunction, or intestinal malabsorption disorders
    • Alkaline Phosphatase - Primary sources are bone (osteoblasts during mineralization) and liver; reflects bone formation activity and hepatic synthetic function; elevated levels may indicate osteosarcoma, metastatic bone disease, Paget's disease, or liver pathology; helps diagnose cholestasis and hepatobiliary disorders
    • Phosphorous - 85% stored in bones as hydroxyapatite; regulated by kidneys (excretion) and intestines (absorption); closely linked to bone mineralization; abnormalities often reflect kidney disease, vitamin D deficiency, or parathyroid dysfunction; critical for ATP production in cells
    • PTH (Parathyroid Hormone) - Produced by parathyroid glands; acts on kidneys and bone to maintain calcium homeostasis; abnormalities indicate parathyroid disorders (hyperparathyroidism or hypoparathyroidism); secondary hyperparathyroidism common in chronic kidney disease and vitamin D deficiency
    • 25-OH Vitamin D - Synthesized in skin (from UV exposure) and liver (metabolic conversion); activated in kidneys to 1,25-dihydroxyvitamin D; affects intestinal calcium absorption (70-80% of dietary calcium), renal calcium reabsorption, and immune function; deficiency linked to kidney disease and malabsorption syndromes
    • Zinc - Essential cofactor for alkaline phosphatase and collagen synthesis in bone; involved in immune function (thymus and lymphocytes); required for wound healing and protein synthesis; serum levels affected by liver disease (storage), GI dysfunction (absorption), and nutritional status; deficiency impairs bone formation and fracture healing
    • Integrated organ involvement: Kidneys crucial for regulation of all parameters (calcium reabsorption, phosphate excretion, vitamin D activation); Parathyroid glands control PTH secretion; GI tract responsible for mineral absorption; Liver essential for vitamin D metabolism and ALP production
  • Follow-up Tests
    • Calcium abnormalities: Ionized calcium measurement for accurate assessment when total calcium is abnormal; Serum albumin to correct for low albumin causing falsely low total calcium; PTH level to determine if calcium abnormality is related to parathyroid dysfunction; imaging studies (skeletal X-ray, CT) if hyperparathyroidism suspected
    • Alkaline Phosphatase elevation: Bone-specific alkaline phosphatase (BSAP) to differentiate bone from hepatic source; Liver function tests (AST, ALT, bilirubin) if hepatic origin suspected; Imaging (bone scan, X-rays) for osteosarcoma or Paget's disease; Tumor markers if malignancy concerns
    • Phosphorous abnormalities: PTH and vitamin D levels to assess regulatory hormones; Renal function tests (creatinine, eGFR) as kidneys are primary regulators; Urinary phosphate excretion; Imaging if chronic kidney disease-mineral bone disease (CKD-MBD) suspected
    • PTH abnormalities: Serum calcium, phosphate, and 25-OH vitamin D to contextualize PTH levels; Parathyroid imaging (sestamibi scan, ultrasound) if hyperparathyroidism confirmed; Genetic testing if familial hyperparathyroidism suspected; Monitoring every 6-12 months for stable disease
    • 25-OH Vitamin D deficiency: 1,25-dihydroxyvitamin D measurement if kidney disease suspected; Parathyroid hormone level to assess secondary hyperparathyroidism; Intestinal absorption tests (72-hour fecal fat) if malabsorption suspected; Bone mineral density (DEXA scan) for osteoporosis risk; Renal function panel if CKD present
    • Zinc deficiency: Albumin and protein levels (zinc-albumin relationship); Zinc in 24-hour urine for assessment of zinc metabolism; Thymic size assessment or thymic hormone levels (thymulin) as zinc affects immunity; Copper level if considering supplementation; Assess dietary intake and absorption
    • Comprehensive follow-up for abnormal bone profile: Bone resorption markers (CTX, NTX, P1NP) to assess bone turnover; DEXA scan for bone mineral density assessment and fracture risk estimation; Parathyroid function tests; Renal function panel; Liver function tests; Tissue transglutaminase (tTG) if celiac disease suspected
    • Monitoring frequency: For newly diagnosed vitamin D deficiency, recheck after 8-12 weeks of supplementation; For hyperparathyroidism, monitor PTH and calcium every 6-12 months; For renal disease, check bone profile every 3-6 months; For osteoporosis treatment, assess response after 1-2 years; Annual screening for high-risk populations
  • Fasting Required?
    • Fasting: NO - Fasting is not required for the Bone Profile test package; all individual tests (Calcium, Alkaline Phosphatase, Phosphorous, PTH, 25-OH Vitamin D, and Serum Zinc) can be performed on non-fasting samples
    • Blood draw timing: Early morning collection (8:00-10:00 AM) recommended for consistency as mineral and hormone levels may have circadian variations; avoid collection immediately after meals when possible for optimal results
    • Medications to avoid or disclose: Calcium and vitamin D supplements (preferably stop 1-2 weeks prior or disclose timing of last dose); Bisphosphonates; Corticosteroids; Thiazide diuretics; Loop diuretics; Estrogen or hormone replacement therapy; Antiseizure medications; Phosphate binders
    • Dietary considerations: Maintain normal calcium and vitamin D intake; excessive dietary calcium or phosphate intake 24 hours before test may affect results; avoid excessive vitamin D supplementation; normal dietary zinc intake should not be altered; maintain consistent hydration status
    • Patient preparation: Wear loose-fitting clothing for easy venipuncture; remain seated or lie down for 5 minutes before blood draw to ensure proper sample quality; inform phlebotomist of recent illness, infection, or inflammation as these may affect results
    • Sample collection and handling: Serum samples required (yellow-top or gold-top SST tube); samples remain stable at room temperature for 48 hours or refrigerated for up to 1 week; avoid hemolysis as it may affect calcium and phosphate measurements
    • Important: Consult with healthcare provider regarding specific medication adjustments; vitamin D and calcium supplementation timing should be discussed with physician; some patients on specific bone-active medications may require special instructions

How our test process works!

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