Osteoporosis and Metabolic Bone Disorders

Osteoporosis & Metabolic Bone Disorders Care at UVM Health

Osteoporosis and other types of metabolic bone disorders affect bone strength and growth. These conditions cause bones to become weak and brittle and lead to bone loss over time.

Endocrinologists at University of Vermont Health Osteoporosis and Metabolic Bone Disorders Program offer advanced care for metabolic bone disorders designed to protect your bone health and your quality of life.

A medical provider points to a model of a bone while a patient looks on.

Why Choose UVM Health?

As the oldest — and only — program in Vermont and northern New York providing comprehensive care for common to complex metabolic bone disorders, we offer:

Dedicated bone disease experts: You receive care from board-certified, fellowship-trained endocrinologists who specialize in metabolic bone disorders. Your care team may also include orthopedic specialists, pharmacists, physical therapists and others.
State-of-the-art bone density tests: We have the most advanced dual-energy X-ray absorptiometry (DXA) scanners in Vermont. This technology enables our team to conduct highly specialized bone density tests to assess bone health.
Research-based care: We’re the only endocrinology team in the region that’s part of a health system anchored by an academic medical center. Our team’s research and clinical trials give you access to the latest treatments, including therapies still in development.

Types of Metabolic Bone Disorders

We offer a full range of treatments for all types of metabolic bone disorders, including:

Osteoporosis: Osteoporosis means “porous bone.” Your body loses bone or doesn’t make enough bone. It’s the most common metabolic bone disorder.
Osteopenia: Low mineral levels in bones (bone mineral density) cause bones to weaken. Osteopenia can progress to osteoporosis.
Hypophosphatasia (HPP): This rare, inherited condition affects bone formation, leading to soft bones and fractures.
Osteogenesis imperfecta (OI): Also known as brittle bone disease, this often-inherited condition causes soft, misshapen bones that break easily.
Osteomalacia: This vitamin D deficiency causes bone to break down faster than it forms. It leads to soft, weak bones that bend and break easily.
Paget disease of bone: Your body continuously makes abnormally large, misshapen bones that don’t fit with other bones as they should.
X-linked hypophosphatemia (XLH): This rare inherited form of rickets (soft bones) is the result of low levels of phosphate levels in the blood (hypophosphatemia). It causes soft, misshapen bones that are prone to bending and breaking.

Metabolic Bone Disorder Symptoms

Symptoms of metabolic bone disorders vary depending on the condition. In general, these disorders cause:

Bone pain
Joint pain or arthritis
Lower back pain or unexplained spinal fractures
Misshapen bone
Muscle weakness or pain
Soft, weak bones that bend or break easily

Metabolic Bone Disorder Risk Factors

You’re more likely to develop a metabolic bone disorder if you:

Are female
Have a diet low in vitamin D or other nutrients
Have a family history of bone disorders
Inherit a gene change that causes a bone disorder
Take certain medications like steroids for a prolonged time

Diagnosing Metabolic Bone Disorders

Our experts use the latest technology to diagnose metabolic bone disorders. Our complete suite of diagnostic tests includes:

Blood Tests

Blood tests check your levels of:

Enzymes, such as alkaline phosphate (ALP)
Hormones, such as cortisol and parathyroid hormones
Minerals, including calcium and phosphorous
Vitamins, such as vitamin D and vitamin B6

Bone Density Test (DXA Scan)

A bone density test measures the concentration (density) of minerals in your bones. Bones that have high mineral density are thicker, stronger and less likely to break. Our experts use the latest DXA scan technology to measure bone mineral density. DXA scans use low-dose X-ray beams to produce images of bones and surrounding tissue.

Our state-of-the-art DXA scanner has advanced diagnostic features that measure bone loss, as well as:

Trabecular bone score (TBS): Analyzes the structure and quality of bones in the spine to gauge the risk of spinal fractures
Vertebral fracture assessment (VFA): Detects vertebral fractures that can cause pain, height loss or spinal curvature
Body composition: Measures body fat and muscle in people who have obesity or eating disorders, which affect bone density
3D-Shaper® technology: Turns two-dimensional DXA images of the hip and spine into 3D images that enable our team to gauge bone density and fracture risk

Gene Tests

Gene tests are specialized blood tests that identify gene changes (mutations). These gene changes can cause inherited bone disorders like hypophosphatasia that affect members of the same family.

Imaging Tests

CT scans, MRIs and other imaging tests show tumors on glands that cause certain bone disorders.

More commonly, you’ll get X-rays to check for:

Bone fractures
Misaligned or misshapen bones
Oversized, overly dense bones

Urine Test

A 24-hour urine collection test checks for high levels of:

Calcium
Cortisol
Phosphorous

Treating Metabolic Bone Disorders

Most metabolic bone disorders respond well to medications. Our endocrine specialists will discuss treatment options with you and customize a care plan for your unique diagnosis and needs. We partner with pharmacists in UVM Health and community to provide complete medication management.

Medications for Metabolic Bone Disorders

Medications for metabolic bone disorders vary depending on the condition. Your provider may prescribe:

Anabolic agents: These injections help build bone, decreasing fracture risk.
Bisphosphonates: These medications strengthen bones and lower the risk of future fractures. You may take a pill or receive IV medication at one of our conveniently located infusion centers.
Enzyme replacement therapies: These drugs treat genetic bone disorders, such as HPP and XLH.
Hormone therapies: You may benefit from taking lab-made hormones, such as estrogen, testosterone or calcitonin.
Monoclonal antibodies: Your provider injects a monoclonal antibody (lab-made protein) underneath your skin every six months. This treatment slows bone loss.
Supplements: Calcium, phosphate or vitamin D supplements can strengthen bones.

Awards & Certifications

Bone Health and Osteoporosis Foundation

We were among the first health systems in the country chosen to participate in the Bone Health and Osteoporosis Foundation’s™ Healthy Bones/Healthy Community initiative.