It is unlikely that important new therapies will be available in the next few years. In younger women, however, new therapies may be developed a decade from now, and it may be helpful to know the bone density response to treatment available now. Males should have testosterone measured. The chemistry panel at the U.W. includes albumin, calcium, creatinine, BUN, alkaline phosphatase, AST, and electrolytes, but it does not include phosphate. At other hospitals the panels may be different.
Alkaline phosphatase is an inexpensive method of checking for osteoblastic activity.
The 24-hour urine calcium measurement is frequently ignored but it is a valuable and inexpensive test. High levels are seen in idiopathic hypercalciuria, and low levels suggest malabsorption. The test should be done on a patient's customary calcium intake. Protein electrophoresis should be done whenever a patient presents with new fractures. Both serum and urine tests should be done some patients with myeloma have abnormalities in only one.