Bone & Calcium
Osteoporosis & Metabolic Bone Disease
Bone loss is silent until a fracture. Identifying and treating it beforehand — with a DXA scan, correction of deficiencies and the right medication — prevents the hip fracture that changes a life.
Symptoms that bring people in
- A fracture after a minor fall or knock
- Loss of height, or a stooping upper back
- Persistent back pain
- Bone or muscle pain, or difficulty rising from a chair
- Early menopause, or long-term steroid use
Having one of these does not mean you have this condition — several overlap with far more common problems. It means the question is worth asking properly.
Osteoporosis is loss of bone mass and quality, leaving bone that breaks under forces it should withstand. It causes no symptoms whatever until a fracture occurs — and a hip fracture in an older adult carries a serious risk of permanent loss of independence. This is a condition worth finding early, and one of Dr Ghosh's particular clinical interests.
Who should be assessed
Postmenopausal women and men over about fifty with risk factors; anyone who has broken a bone after a low-impact fall; anyone on glucocorticoids for more than three months; and people with early menopause, hyperparathyroidism, thyrotoxicosis, coeliac disease, chronic kidney or liver disease, or a strong family history of hip fracture.
What assessment involves
A DXA scan of the hip and spine measures bone mineral density and provides the baseline against which future scans are read. Blood tests look for the causes that are correctable — calcium, phosphate, alkaline phosphatase, vitamin D, parathyroid hormone, kidney and liver function, thyroid function, and in men testosterone. Spine imaging is added where a vertebral fracture is suspected, since these are frequently silent. A fracture-risk calculation puts the numbers into clinical context.
Treatment
Adequate calcium — preferably from diet — and correction of vitamin D deficiency underpin everything but are rarely sufficient alone. Specific therapy includes the bisphosphonates, denosumab and, for severe or established disease, the bone-building anabolic agents. Choice depends on severity, kidney function, dentition and what the patient can realistically maintain. Sequence and duration matter: these drugs are not simply started and forgotten, and treatment is reviewed at defined intervals.
Resistance and weight-bearing exercise, stopping smoking, moderating alcohol, and a genuine look at fall hazards at home — loose rugs, poor lighting, wet bathroom floors, sedating medicines — are part of the prescription, not an afterthought.
Related conditions
Osteomalacia from severe vitamin D deficiency, renal bone disease, Paget's disease of bone and the rarer inherited bone disorders are all assessed and managed in the same clinic.
This page is general information. Doses and treatment choices in endocrinology are individual, and are decided at a consultation with your reports in front of us. Please do not start, stop or change a medicine based on this page.
Common questions
Before your first visit
How do I book an appointment?
Use the appointment form on this website and the clinic will telephone you to confirm a time, usually within one working day. For a same-day or urgent request, please ring the number in the page header instead — a phone call is always faster than a form.
Hospital OPDs at CMRI and Narayana Memorial are booked through the hospital's own reception. For district chambers, it is worth calling the chamber number listed on its page before travelling.
Which chamber should I choose?
Whichever is easiest for you to reach and return to. Endocrine conditions need review over months and years rather than a single visit, so the chamber you can get to comfortably every few months is nearly always the better choice than the one that seems most impressive.
That said: if your problem needs same-day tests, an ultrasound, or admission, a hospital OPD is the better setting. The Chambers page lists every location with its days and timings, and the weekly timetable shows them all side by side.
Do chamber timings ever change?
Yes — and this is worth taking seriously if you are travelling any distance. Several district visits run on a monthly rotation, such as the 1st and 3rd Saturday, and a hospital OPD can be rescheduled at short notice. Timings shown on this website are kept up to date and any known cancellation appears on the chamber's page, but please telephone ahead before a long journey.
What should I bring to the first consultation?
Bring everything you have, even if it seems old or irrelevant:
- all previous prescriptions, including from other doctors
- every blood report and scan you hold, in date order if possible
- the actual strips or boxes of the medicines you take, or a written list with doses
- your home blood sugar or blood pressure diary, if you keep one
- for a child, the growth chart and immunisation record
Old reports are genuinely useful. A five-year-old thyroid result or an earlier scan often changes the plan, because what matters in endocrinology is frequently the trend rather than today's number.
Consultation
Request an appointment
Tell us which chamber suits you and when. We will confirm your slot by phone.