Osteoporosis
Osteoporosis is defined by a DEXA T-score of −2.5 or lower at the spine, femoral neck, or total hip. It substantially increases fracture risk, with hip fractures carrying a 20–30% mortality rate in the first year. Treatment reduces fracture risk by 30–70% depending on the site and medication, making early identification and treatment critically important.
When to Book
Book a visit if symptoms are new, persistent, getting worse, or affecting daily life. Early evaluation often prevents complications.
Symptoms
Osteoporosis is asymptomatic until a fracture occurs. Classic presentations include acute back pain from a vertebral compression fracture after minimal trauma, wrist fracture from a fall, or hip fracture. Height loss and thoracic kyphosis develop with multiple vertebral fractures.
Causes & Risk Factors
Postmenopausal estrogen deficiency is the primary driver in women. Male hypogonadism, corticosteroid use (most common secondary cause), hyperparathyroidism, hyperthyroidism, celiac disease, inflammatory bowel disease, chronic kidney disease, and multiple myeloma are important secondary causes to exclude.
How We Evaluate
DEXA scan establishes diagnosis. FRAX fracture risk calculation guides treatment decisions. Lab evaluation includes calcium, phosphorus, 25-OH-D, PTH, complete metabolic panel, CBC, TSH, testosterone (men), and protein electrophoresis when myeloma is suspected. Vertebral fracture assessment (VFA) identifies asymptomatic spine fractures.
Treatment Options
Oral bisphosphonates (alendronate, risedronate) are first-line for most patients. IV zoledronic acid is preferred for GI intolerance or adherence concerns. Denosumab is used for severe cases or as an alternative. Teriparatide or abaloparatide (anabolic agents) are reserved for very high fracture risk. All patients receive calcium and vitamin D optimization.
When It Is Urgent
A hip fracture requires emergency orthopedic care. New severe back pain after minor trauma may indicate a vertebral fracture — seek prompt evaluation with imaging.
Frequently Asked Questions
Do I need a referral to see an endocrinology provider?
No referral is needed at Nomi Beach Health. You can book directly with our team for hormone, thyroid, metabolic, or weight-management concerns.
How long does it take to see results from treatment?
Timeline depends on the condition. Thyroid medication often improves symptoms within four to eight weeks. Weight-loss interventions show measurable changes in four to twelve weeks. Hormone therapy timelines vary by the specific condition and individual response.
Will I need labs before my first visit?
You can come in without prior labs — we order whatever is appropriate during or after your visit. If you have recent results, bring them so we can start the conversation right away.
Are these conditions managed long-term or treated once?
Most endocrine and metabolic conditions require ongoing management rather than a single treatment. We build a follow-up schedule around your specific diagnosis and goals.
Can I be seen for weight loss even if I do not have a hormone diagnosis?
Yes. We evaluate weight holistically — including metabolic markers, lifestyle factors, and, when appropriate, medication options such as GLP-1 agonists.
Get a Clear Plan for Osteoporosis
Our endocrinology team evaluates you as an individual and builds a treatment plan that fits your life — not a template.