Evaluation for Low BMD (BMD < –1.0)

• Serum 25-hydroxyvitamin D
• Serum calcium
• Complete blood count with differential
• Thyroid-stimulating hormone
• Parathyroid hormone
• Bone-specific alkaline phosphatase
• 24-h urine for calcium
• Screening for cortisol excess: morning cortisol or 24-h urine for cortisol
• Celiac disease: serum tissue transglutaminase antibodies, total IgA, tissue transglutaminase IgG (in the IgA-deficient adolescent)
• Markers of bone formation and resorption: serum osteocalcin and urine N-telopeptide
• Reproductive hormone evaluation: estradiol, FSH, LH in girls, testosterone in boys
  • FSH, follicle-stimulating hormone; IgA, immunoglobulin A; IgG, immunoglobulin G; LH, luteinizing hormone.