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Why Bone Health Assessment Matters

Osteoporosis is a silent disease — most women don't know they're losing bone until a fracture occurs. Early risk identification and targeted prevention can dramatically reduce your lifetime fracture risk.

The Silent Epidemic

Osteoporosis affects approximately 200 million women worldwide. In the U.S., prevalence reaches 27% in women 65 and older. Most fractures occur in women with osteopenia — the stage before osteoporosis where intervention has the highest impact.

The Menopause Window

Women lose bone density at an accelerated rate of 1–2% per year during perimenopause and the years following menopause. This critical window is where prevention strategies deliver the greatest return — yet most screening happens too late.

Beyond DEXA Scans

DEXA provides a snapshot of bone density, but bone turnover markers like P1NP and CTX reveal the dynamic rate of bone formation and resorption — catching problems before density loss shows up on a scan.

Bone-Toxic Medications

Many common medications accelerate bone loss: glucocorticoids, PPIs, SSRIs, aromatase inhibitors, and anti-seizure drugs. Systematic screening for these medications is a critical gap most risk tools miss entirely.

Inflammation & Bone Loss

Chronic inflammation drives bone loss through the RANKL/OPG pathway. TNF-alpha, IL-1, and IL-6 stimulate osteoclast activity while inhibiting bone formation — making your inflammatory markers directly relevant to bone health.

The Gut-Bone Axis

Emerging research shows probiotics significantly improve bone turnover markers, especially in postmenopausal women. The gut microbiome regulates calcium absorption, immune function, and hormonal signaling that directly affects bone metabolism.

Bone Loss Across the Menopause Continuum

Premenopausal
~0.5%/yr
Slow, gradual loss begins mid-30s. Peak bone mass already achieved. Prevention window is wide open.
Perimenopausal
1–2%/yr
Accelerated loss as estrogen declines. The critical intervention window. Highest ROI for prevention strategies.
Postmenopausal
1–3%/yr
Sustained loss for 5–10 years post-menopause, then slows. Treatment may be needed. DEXA screening recommended.

Don't Have Lab Results Yet?

Optional blood biomarkers like vitamin D, calcium, PTH, bone turnover markers (P1NP, CTX), thyroid panel, and inflammatory markers provide a much deeper bone health assessment. You can still use BoneWise™ without labs — but labs unlock the most precise analysis.

🔬 Order Labs — ULTA Lab Tests 👨‍⚕️ Ask Your Doctor

Note: Direct-to-consumer lab ordering is not available in NY, NJ, RI, or HI due to state regulations.

Assess Your Bone Health Risk

Required fields marked with *. Optional lab values significantly enhance your analysis.

1 Demographics & Menopause Status
Used to calculate BMI and detect height loss
Loss >1.5″ suggests vertebral compression fractures
Early menopause (<45) is a major risk factor
2 Fracture & Family History
3 Lifestyle & Nutrition
Walking, jogging, dancing, stair climbing
4 Medical History & Medications
5 DEXA Results (Optional — if available)
Normal >1.35, Partially degraded 1.20-1.35, Degraded <1.20

If you have recent lab results, entering these values unlocks a significantly deeper bone health assessment. All fields are optional.

Bone Turnover Markers
ng/mL
Bone formation marker
ng/mL
Bone resorption marker (fasting AM)
ng/mL
U/L
U/L
Hormones & Nutrients
ng/mL
mg/dL
pg/mL
pg/mL
mIU/L
ng/dL
Inflammatory & Metabolic Markers
mg/L
mm/hr
U/L
g/dL
mg/dL
mg/dL
mg/dL

Analyzing Your Bone Health Risk

Please wait — do not press back or refresh

  1. 1 Evaluating clinical risk factors, menopause stage, and fracture history
  2. 2 Screening medication and comorbidity bone impact
  3. 3 Analyzing DEXA, lab biomarkers, and nutritional status
  4. 4 Generating personalized bone health report with AI clinical analysis

This typically takes 30 to 60 seconds.

BoneWise™ Bone Health Risk Score
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/ 100
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Low Risk Moderate High Very High
Clinical Risk
--
--
Hormonal
--
--
Medication
--
--
Nutrition
--
--
Lab/DEXA
--
--

Key Risk Factors Identified

Protective Factors

Bone Health Stage Assessment

Nutrition & Supplementation Analysis

Medication & Comorbidity Review

Screening & Monitoring Recommendations

AI-Powered Analysis • Claude by Anthropic

Personalized Bone Health Report

💾 Download Your BoneWise™ Report

Save a comprehensive PDF of your bone health risk analysis with all scores, risk factors, and recommendations.

✉ Email Your Results

Receive your full BoneWise™ analysis in your inbox.

🔒 Your email is used solely to deliver your report. No health data is stored.

Personalized Guidance

Want a Board-Certified Physician to Review Your Bone Health Results?

Schedule a private telemedicine session with Dr. Kilgore to review your BoneWise™ report, discuss your risk factors, optimize your prevention strategy, and determine if DEXA screening or pharmacotherapy is right for you.

$225
✓ Deep-dive into your BoneWise™ scores and risk profile
✓ Personalized nutrition, supplement, and exercise plan for bone health
✓ Medication review for bone-toxic drug alternatives
✓ DEXA screening timeline and lab panel recommendations
✓ Written action plan delivered within 48 hours
Book Your Bone Health Review →

🔬 Get the Lab Panel for Comprehensive Bone Assessment

For the most accurate BoneWise™ analysis, order a bone health lab panel including vitamin D, calcium, PTH, bone turnover markers (P1NP, CTX), thyroid panel, and inflammatory markers. No doctor visit needed in most states.

🔬 Order Bone Health Labs — ULTA Lab Tests

🧬 Understand Your Biological Age & Bone Aging

Your biological age directly influences bone health trajectory. TruDiagnostic’s epigenetic clock measures your pace of aging at the cellular level — providing context that connects your biological age to your bone health risk. Available through Dr. Kilgore at healthcare provider pricing.

🧬 Explore Epigenetic Testing — TruDiagnostic

Ongoing Bone Health Monitoring

For women at high or very high risk, Dr. Kilgore’s Comprehensive ($1,000/mo) and Executive ($2,000/mo) consulting tiers include regular BoneWise™ tracking, lab review, DEXA trend analysis, and full 4-layer health integration (genetics, epigenetics, biomarkers, and wearables).

View Consulting Tiers
View Scientific Sources & References →

BoneWise™ uses a multi-domain composite scoring model informed by current clinical guidelines (AACE/ACE 2020, Endocrine Society 2019, USPSTF 2025) and peer-reviewed research in bone metabolism, menopause medicine, and osteoporosis prevention.

Composite Score (0–100)

The score integrates five weighted domains. A higher score indicates lower bone health risk (more favorable status). The weights reflect evidence strength for each domain’s contribution to fracture prediction:

  • Clinical Risk (30%): Age, BMI, prior fracture, family history, smoking, alcohol, glucocorticoid use, rheumatoid arthritis, and secondary osteoporosis causes. Mirrors and extends FRAX clinical risk factors.
  • Hormonal & Reproductive (20%): Menopause timing, years since menopause, estrogen status, amenorrhea history, POI, and HRT use. Early menopause (<45) and prolonged hypoestrogenism receive highest risk weighting.
  • Medication & Comorbidity (15%): Systematic screening across 11 bone-toxic medication classes and 11 comorbidity categories. Dose-response weighting for glucocorticoids per AACE guidelines.
  • Nutrition & Lifestyle (15%): Calcium and vitamin D intake adequacy, vitamin K2, magnesium, exercise type (weight-bearing and resistance training), probiotic use, and modifiable risk factors.
  • Laboratory & DEXA (20%): Applied only when lab values are provided. Bone turnover markers (P1NP, CTX, osteocalcin), vitamin D sufficiency, PTH evaluation, inflammatory markers, and DEXA T-scores with TBS when available.

Risk Categories

  • Low Risk (80–100): No major risk factors, adequate nutrition, favorable labs. Recommendation: maintain, retest in 3–5 years.
  • Moderate Risk (60–79): One or more risk factors, suboptimal nutrition or borderline labs. Recommendation: targeted lifestyle modification, retest 1–2 years.
  • High Risk (40–59): Multiple risk factors, bone-toxic medications, or concerning biomarkers. Recommendation: physician evaluation strongly recommended.
  • Very High Risk (0–39): Prior fragility fracture, very low T-scores, or multiple converging high-risk domains. Recommendation: urgent physician evaluation.

Key Scientific References

  • USPSTF. Screening for Osteoporosis to Prevent Fractures. JAMA. 2025;333(6):498-508.
  • Camacho PM, et al. AACE/ACE CPG for Postmenopausal Osteoporosis — 2020 Update. Endocr Pract. 2020;26(Suppl 1):1-46.
  • Eastell R, et al. Pharmacological Management of Osteoporosis in Postmenopausal Women. J Clin Endocrinol Metab. 2019;104(5):1595-1622.
  • Wu Q, Jung J. Racial and genetic disparities in FRAX performance. J Bone Miner Res. 2026;41(4):424-433.
  • Qin Y, et al. Personalized reference intervals for bone turnover markers in older adults. Clin Chem Lab Med. 2026;64(5):1109-1116.
  • Yuan Y, et al. Probiotic supplementation and bone turnover markers: meta-analysis of 15 RCTs. Front Cell Infect Microbiol. 2026;15:1738378.
  • Alghadir AH, et al. HIIT and vitamin D on bone metabolism in women with osteoporosis. BMC Musculoskelet Disord. 2025;26(1):381.
  • Ali M, Camacho PM. Workup and Management of Premenopausal Osteoporosis. Endocrinol Metab Clin N Am. 2024;53(4):597-606.

AI Analysis

The personalized report is generated by Claude Opus 4.6 (Anthropic) using physician-designed prompts that incorporate evidence-based bone health principles. Dr. Paul Kilgore, MD, MPH, FACP designed and oversees all AI guardrails. Output is governed by the REGULATORY_GUARDRAILS system applied across all tools on drpaulkilgore.com.

Educational Use Only

BoneWise™ is designed for educational and informational purposes only. It does not constitute medical advice, diagnosis, or treatment. The analysis provided should not replace guidance from qualified healthcare professionals. Always consult your physician before making changes to your health regimen, medications, or supplements, especially regarding osteoporosis prevention or treatment.

AI Disclosure

This tool uses artificial intelligence (Claude Opus 4.6 by Anthropic) to generate personalized bone health analysis based on the data you provide. AI-generated content is governed by physician-designed guardrails created by Dr. Paul Kilgore, MD, MPH, FACP. Despite multi-layer verification, AI output may occasionally contain inaccuracies. View full AI Disclosure.

Not a Diagnostic Tool

BoneWise™ is a risk assessment tool, not a diagnostic instrument. It cannot diagnose osteoporosis, osteopenia, or any medical condition. Osteoporosis diagnosis requires clinical evaluation including DEXA bone density measurement interpreted by a qualified healthcare provider. A low-risk BoneWise™ score does not mean you do not have osteoporosis.

Privacy

No personal health data is stored or retained after your session. All analysis is processed in real-time and discarded. We do not share your data with third parties. If you choose to email your results, the email is sent via Resend and is not stored on our servers.

FRAX Comparison

BoneWise™ is not a replacement for FRAX or any validated fracture risk calculator. While it incorporates FRAX risk factors and extends them with additional domains (laboratory biomarkers, medication screening, nutritional assessment), it has not undergone independent prospective validation for fracture prediction. Use BoneWise™ as a complementary educational tool alongside clinical assessments.

Accessibility

This tool is designed to meet WCAG 2.2 Level AA standards. Use the accessibility icon (bottom-right corner) to adjust text size and contrast. If you experience any accessibility issues, please contact us.

Emergency

If you are experiencing a medical emergency such as a suspected fracture, severe pain, or a fall with inability to bear weight, call 911 or your local emergency number immediately. Do not use this tool for emergency medical decisions.

📚 Sources: This tool is based on peer-reviewed research and published clinical guidelines. View complete citations →