Table 1 List of most important causes related to changes in laboratory findings, according to the DVO guideline 2014 [4]

Serum-calcium

↑Primary hyperparathyroidism, tumour hypercalcaemia

↓e.g. secondary hyperparathyroidism, malabsorption, hypercalcaemia and hypocalcaemia as contraindications for several drugs against osteoporosis

Serum-phosphate

↑Renal insufficiency stage IV

↑Secondary renal hyperparathyroidism

↓Malabsorption

Serum-sodium (optional)

↓Greater risk of vertebral and non-vertebral fractures

Alkaline phosphatase (AP) (serum)

↑e.g. osteomalacia

Gamma-GT

For differential diagnosis of AP-increase caused by hepatitis, evidence for coeliac disease or alcohol abuse (risk of falling)

Creatinine-clearance

↓Renal osteopathy

Severe renal insufficiency as contraindication for various drugs

ESR (erythrocyte sedimentation rate)/CRP (C-reactive protein)

↑Differential diagnosis for inflammatory causes of vertebral body deformities, inflammatory rheumatic diseases, multiple myeloma

full blood count

Evidence of inflammatory and malignant diseases or coeliac disease

Serum-protein electrophoresis

Evidence of monoclonal gammopathy or hypogammaglobulinaemia as evidence of MGUS or multiple myeloma; polyclonal hypergammglobulinaemia in systemic inflammatory diseases

TSH

<0.3 mU/L caused endogenously or by L-Thyroxine medication as a risk factor for fractures

If necessary, testosterone for men

Testosterone deficiency

If necessary, 25-hydroxy-vitamin D3 in individual cases

Vitamin D deficiency

If necessary, bone resorption parameter in individual cases (inconsistent data for men)

Fracture risk due to a high rate of bone re-formation