Bone Health Program

Strong bones,
smart care

Osteoporosis assessment, DEXA review, fracture risk evaluation — and the right treatment plan for your stage of bone health.

Book a Consultation How It Works

Within 1–2 weeksEndocrinologist-ledDEXA-guided plans

50%Fracture risk reduction with optimised therapy

Endocrinologist-Led

Specialist bone disease care

≈ 1–2 Weeks

Typical first appointment

DEXA Interpretation

Real fracture risk calculation

Modern Therapies

Prolia, Forteo, Evenity available

100% Virtual

No travel for assessment

About This Program

Bone health is preventive medicine

Bone health assessment and management — osteoporosis, osteopenia, fracture risk evaluation, DEXA scan interpretation, and treatment optimisation including bisphosphonates and newer agents like Prolia and Forteo.

A hip fracture in your 70s is not "just bad luck" — it is the result of years of unaddressed bone loss. The same is true of vertebral fractures. With proper screening and treatment, most osteoporotic fractures can be prevented.

Osteoporosis is silent until it is not — fractures of the hip, spine, or wrist often happen without warning. The good news: with a proper DEXA scan, fracture risk calculation, and the right medication, most osteoporotic fractures can be prevented.

Conditions Treated

Who we help

Our bone health program supports patients with:

Osteoporosis (post-menopausal & male)

Osteopenia

Fragility fractures (hip, spine, wrist)

Steroid-induced bone loss

Vitamin D deficiency

Calcium / parathyroid disorders

DEXA scan review

Bone loss in chronic disease

Cancer treatment-related bone loss

Hyperparathyroidism

Idiopathic osteoporosis in younger adults

Pre-treatment counselling for bisphosphonates

Treatment Options

Modern osteoporosis therapies

Following DEXA review and fracture risk calculation, your specialist may recommend:

First-Line

Alendronate / Risedronate

Oral Bisphosphonate

First-line therapy for most osteoporosis. Once-weekly oral dosing, generic, well-studied. Reduces hip and vertebral fracture risk.

Oral Bisphosphonate

Zoledronic Acid

IV Bisphosphonate

Once-yearly IV infusion. Excellent option for patients who cannot tolerate oral bisphosphonates or who have very high fracture risk.

Annual IV Therapy

Prolia® (Denosumab)

Twice-Yearly Injection

RANK-L inhibitor. Subcutaneous injection every 6 months. Strong fracture reduction. Important: cannot be stopped abruptly without transition therapy.

Biologic Therapy

Forteo / Evenity

Anabolic / Bone-Building

Bone-building therapies for severe osteoporosis or recent fractures. Daily injection (Forteo) or monthly (Evenity) for 12–18 months, then transition to a bisphosphonate.

Anabolic Therapy

Our Process

How your program works

A clear pathway from screening to fracture prevention.

Initial Intake & Records Review

Send your DEXA scan results (or recent imaging), fracture history, family history, and current medications. Our team reviews within one business day.

Lab Work & DEXA if Needed

Calcium, vitamin D, parathyroid, kidney function, and (if no recent DEXA) a referral for one. DEXA is OHIP-covered for screening at appropriate intervals.

Specialist Consultation

A virtual consult to review DEXA, calculate FRAX (fracture risk score), and design treatment plan. This includes calcium/vitamin D, weight-bearing exercise, fall prevention.

Therapy Selection & Start

Right medication for your situation — oral, IV, or injectable. Coordination with pharmacy or infusion clinic as needed.

Ongoing Monitoring

Annual review with bone turnover markers, periodic re-DEXA (typically every 2 years), and assessment for side effects. Therapy adjusted based on response.

Eligibility

Is this program right for you?

Our bone health program is open to most adults at risk of or with bone loss.

You may be a good candidate if you:

Have a DEXA scan showing osteopenia or osteoporosis

Have had a fragility fracture (hip, spine, wrist)

Are on long-term steroids or other bone-thinning medications

Have a strong family history of osteoporosis

Are post-menopausal and want bone health screening

Are an Ontario resident with a valid health card

This program may not be suitable if you:

Have an acute fracture needing emergency care

Have severe hypocalcemia (urgent in-person evaluation)

Are pregnant (most osteoporosis therapies contraindicated)

Program Physician

Program Lead

Dr. Umer Mustansir Bhatty

MRCP, FRCP, CCT

Internal Medicine, Diabetes, Endocrinology, and Weight Management specialist trained in the UK with sub-specialty fellowship.

Internal Medicine, Diabetes, Endocrinology, Weight Management

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Strong bones for the long haul

Specialist bone health care — typically within 1–2 weeks. DEXA-guided, evidence-based, and integrated with your overall medical care.

Book as a Patient

Self-refer via our secure online booking system

Refer a Patient

Physician referral form with fax & secure intake

Frequently Asked Questions

Bone health FAQ

Common questions about specialist bone care.

When should I get a DEXA scan?

Standard recommendations: women age 65+, men age 70+, anyone with prior fragility fractures, and earlier for those on long-term steroids or with strong family history. OHIP covers DEXA at appropriate screening intervals (typically every 2–3 years).

My DEXA shows osteopenia — do I need treatment?

Osteopenia (T-score -1.0 to -2.5) is a wide range. Whether to treat depends on your full FRAX score (which includes age, sex, fracture history, family history, and other risk factors). Many patients with osteopenia do NOT need medication; some do. Your specialist will calculate this for you.

I heard bisphosphonates can cause jaw problems — is that real?

Osteonecrosis of the jaw (ONJ) is a real but very rare side effect — about 1 in 100,000 patients on standard oral bisphosphonates. The risk is much higher in cancer patients on high-dose IV therapy. For typical osteoporosis patients, the fracture-prevention benefits dramatically outweigh this small risk.

Can I just take calcium and vitamin D instead of medication?

Calcium and vitamin D are foundational and necessary — but for established osteoporosis, they alone do NOT reduce fractures meaningfully. Pharmacological therapy is what reduces fractures.

I am on Prolia — can I just stop it?

No — never stop Prolia abruptly. Stopping Prolia without transitioning to a bisphosphonate causes a "rebound" effect with rapid bone loss and risk of multiple vertebral fractures. If you are on Prolia and considering stopping, please consult with us BEFORE stopping.

How often should my DEXA be repeated?

Typically every 2 years on therapy to monitor response. Untreated patients with osteopenia may have DEXA every 3–5 years to detect progression.

Strong bones, smart care