Welcome to my podcast. I am Doctor Warrick Bishop, and I want to help you to live as well as possible for as long as possible. I’m a practising cardiologist, best-selling author, keynote speaker, and the creator of The Healthy Heart Network. I have over 20 years as a specialist cardiologist and a private practice of over 10,000 patients.

Episode Summary

EP329: Bloods For Bone Health

Dr. Auric Bishop, a cardiologist and CEO of the Healthy Heart Network, discusses the essential blood tests for evaluating bone health in patients with suspected osteopenia or osteoporosis. With statistics showing that 40% of women and 30% of men will experience an osteopenic or osteoporotic fracture in their lifetime, Dr. Bishop emphasizes the importance of early detection through bone mineral density (DEXA) scans and follow-up blood work to assess underlying causes and risk factors.

Key Takeaways:

• Osteopenia and osteoporosis are prevalent conditions affecting approximately 40% of women and 30% of men over their lifetime, making early screening and intervention critical regardless of current symptoms.

• DEXA (dual x-ray absorption) scans are the gold standard for measuring bone mineral density and cost approximately $150-200 out of pocket without Medicare rebates, providing a baseline comparison to a healthy 30-year-old.

• Kidney function tests (ECU—electrolytes, creatinine, and urea) are essential first-line blood work to rule out renal impairment, which can affect calcium metabolism and bone health.

• Liver function tests (LFTs) including alkaline phosphatase should be checked, as liver health is central to bone metabolism and calcium regulation.

• Calcium, magnesium, and phosphate (CMP) levels must be monitored together as they interact significantly; abnormal calcium may indicate hyperparathyroidism or renal problems requiring further investigation.

• Thyroid function (TSH) is critical because excess thyroid hormone increases bone turnover and can accelerate osteoporosis development over time.

• Vitamin D deficiency is common, particularly in cooler climates like Hobart during winter, and adequate vitamin D is essential for calcium reabsorption and bone health.

• Sex hormones (testosterone, estradiol, progesterone) and their markers (DHEAS, FSH, LH) directly influence bone mineral density, making hormonal assessment particularly important for women approaching or in menopause.

• Erythrocyte sedimentation rate (ESR) serves as a general inflammatory marker; significantly elevated levels warrant further investigation as they may indicate conditions like myeloma, which can cause osteoporosis-like skeletal changes.

• A comprehensive bone health evaluation should include growth hormone markers (insulin-like growth factor-1) and, for men, annual PSA testing to monitor prostate health, as these factors impact bone metabolism.