Feel Sharp · Bones, joints & fitness
Bone & Joint Pain Check
Do your knees hurt on the stairs?
Do your knees hurt on the stairs? Does your back start aching halfway through the day? Or does pain in one joint suddenly make it hard to move? When it keeps happening, you want to understand what needs attention, not keep guessing.
Bone aches and sudden joint pain can need different kinds of follow-up. This check looks at blood markers related to bone and mineral health, including vitamin D and calcium, as well as uric acid. A Marham General Physician reviews your results alongside where and how you feel pain, explains what the tests show, and advises on the next step.
These blood tests cannot identify every reason for pain. They also cannot measure bone density or confirm gout from a uric acid result alone. If you need a scan or a closer joint assessment, your doctor can guide you.
Get a clearer picture of what to do next. Feel sharp. Stay sharp.
کیا سیڑھیاں چڑھتے ہوئے گھٹنوں میں درد ہوتا ہے؟ دن کے بیچ میں کمر دکھنے لگتی ہے؟ یا کسی ایک جوڑ میں اچانک اتنا درد ہوتا ہے کہ اسے ہلانا مشکل ہو جائے؟ جب درد بار بار ہو تو صرف اندازہ لگانے کے بجائے یہ سمجھنا ضروری ہے کہ اگلا قدم کیا ہونا چاہیے۔ اس چیک میں ہڈیوں اور منرلز سے متعلق خون کے ٹیسٹ، وٹامن ڈی اور یورک ایسڈ شامل ہیں۔ مرہم کا جنرل فزیشن آپ کی علامات اور رپورٹ کو ساتھ دیکھ کر سمجھاتا ہے کہ مزید جانچ کی ضرورت ہے یا نہیں۔ خون کے یہ ٹیسٹ ہڈیوں کی مضبوطی نہیں ناپتے اور نہ ہی صرف یورک ایسڈ سے گاؤٹ کی تصدیق ہوتی ہے۔
Updated 28 September 2026
What’s tested, and why
25-OH Vitamin - D3
Alkaline Phosphatase
Calcium (Ca) (Serum)
About this testCorrected Calcium
Intact Parathyroid Hormone (iPTH)
About this testIonized Calcium
Magnesium (Serum)
About this testPhosphate (PO4) (Serum)
Uric Acid (Serum)
About this test
General Physician consultation, included — Online or In Clinic Consultation
Our team calls to arrange it once your reports are ready.
Nine tests from one blood sample, plus the doctor who reads them together.
- 25-OH Vitamin D3: the starting point. Without enough vitamin D you absorb only a fraction of the calcium you eat, however many tablets you take. Deficiency affects roughly four in five women of reproductive age in Pakistan.
- Intact Parathyroid Hormone (iPTH): the alarm bell. When calcium runs short the parathyroid glands raise PTH, which pulls calcium out of the skeleton to keep the blood level normal. Low vitamin D with a raised PTH is the single most useful finding on this report, because it means bone is actively being lost and it responds to treatment.
- Calcium (Serum), Corrected Calcium and Ionized Calcium: one measurement and two refinements of it. Total calcium is the standard number; corrected calcium adjusts it for your protein level; ionized calcium is the fraction actually available to the body. They are read together, not as three separate findings.
- Phosphate (Serum): moves in the opposite direction to PTH, which helps your doctor tell a vitamin D problem from a kidney one.
- Alkaline Phosphatase: rises when bone is being remodelled faster than usual, so it supports or argues against the picture the other numbers paint.
- Magnesium (Serum): the body cannot activate vitamin D properly without it, which is why supplementing vitamin D sometimes fails until the magnesium is corrected.
- Uric Acid (Serum): the separate question. High uric acid causes gout, which is not a general ache but a sudden, severe attack in one joint, most often the big toe, and often at night.
- General Physician consultation, included: a Marham doctor reads all nine together and tells you what is actually happening and what to do about it. Online or at a clinic, whichever suits you. Part of the package, not an add on.
What this cannot do. It cannot diagnose osteoporosis or measure fracture risk. Bone density is measured by a DEXA scan and nothing in a blood tube substitutes for it. What these nine do is find the treatable causes of bone loss before the density falls, which is the more useful thing to know early. There is also no X ray and no joint fluid test here.
If something needs following up, your doctor orders only what is needed, charged separately: a DEXA scan, kidney function, thyroid function, a 24 hour urine calcium, or a rheumatology referral for the joints.
Feel Sharp. Stay Sharp.
The doctor tells you which result explains how you feel, what to take, and when to test again so you know the treatment has worked.
If everything is normal, that is useful too: it rules out the commonest causes and moves the conversation to the next question, such as sleep, blood sugar or mood.
Not just a report. An answer.
Before your test
- No fasting for the bone tests, but for the uric acid it is worth arriving sensible. Avoid red meat, liver, kidney and seafood, and skip alcohol, for 24 hours before the sample. A heavy meat meal the night before can push uric acid up on its own.
- Do not stop calcium, vitamin D or any prescribed medicine for this test. Tell the doctor what you take instead. Stopping treatment to get a cleaner number gives a result that describes nobody: not your treated state and not your untreated one.
- Take your calcium tablet after the sample rather than before, if you can, since a dose swallowed that morning briefly lifts the serum calcium.
- Say so if you have had a vitamin D injection. A high dose injection keeps the 25-OH level up for months, so the report will look healthy whether or not you were deficient before it. The date matters more than the dose.
- Tell the doctor about water tablets and low dose aspirin. Thiazide diuretics, taken for blood pressure, and aspirin both raise uric acid, and diuretics raise calcium too. Several results shift together on these.
- Timing matters for gout. Uric acid often drops during an acute attack, so a normal result taken in the middle of a flare does not rule gout out. If you are in an attack now, mention it, and your doctor will read the number with that in mind or repeat it later.
- Postpone the panel if you have a fever or an active infection.
- Mention if you are pregnant or breastfeeding, since calcium, phosphate and vitamin D targets are different then.
- Not for under 18s. For a child with bone pain or bow legs, book a Pediatrician consultation first; the workup is different.
- Have the story ready for the consultation: where the pain is, whether it is one joint or many, whether it wakes you at night, how long it lasts, and whether anything swells or goes red. The pattern separates gout from wear and tear from a calcium problem more reliably than any single number does.
Questions people ask
کیا یورک ایسڈ کی گولی خود سے شروع کی جا سکتی ہے؟
نہیں، اور یہ اہم بات ہے۔ یورک ایسڈ کم کرنے والی دوائیں لمبے عرصے کے لیے ہوتی ہیں اور ان کا مقصد آئندہ حملے روکنا ہوتا ہے، درد کے وقت فوری آرام دینا نہیں۔ اگر گاؤٹ کا حملہ چل رہا ہو اور اسی دوران یہ دوا شروع کر دی جائے تو اکثر تکلیف بڑھ جاتی ہے۔ اس کے علاوہ شروع کرنے سے پہلے یورک ایسڈ کی سطح اور گردوں کا کام دیکھنا ضروری ہوتا ہے، کیونکہ خوراک اسی حساب سے مقرر ہوتی ہے اور بعض دوائیں گردوں کے مریضوں میں محتاط استعمال چاہتی ہیں۔ سب سے اہم یہ کہ ہر جوڑ کا درد گاؤٹ نہیں ہوتا؛ ٹیسٹ کروا کے وجہ معلوم کرنا اور ڈاکٹر کے مشورے سے دوا لینا درست طریقہ ہے۔ مزید پڑھیں: گاؤٹ
کیا کیلشیم کی گولیاں کھانے سے ہڈیوں کا درد ٹھیک ہو جاتا ہے؟
اکثر نہیں، کیونکہ عام طور پر اصل مسئلہ کیلشیم کی کمی نہیں بلکہ وٹامن ڈی کی کمی ہوتی ہے۔ وٹامن ڈی کے بغیر جسم کھائے ہوئے کیلشیم کا بہت تھوڑا حصہ جذب کرتا ہے، اس لیے صرف کیلشیم کی گولیاں کھاتے رہنے سے فرق نہیں پڑتا۔ اس سے بھی اہم بات یہ ہے کہ جب وٹامن ڈی کم ہو تو جسم پیراتھائیرائیڈ ہارمون بڑھا کر ہڈیوں سے کیلشیم نکالنا شروع کر دیتا ہے، اور خون کی رپورٹ میں کیلشیم نارمل نظر آتا رہتا ہے جبکہ ہڈیاں کمزور ہو رہی ہوتی ہیں۔ اسی لیے اس چیک اپ میں کیلشیم کے ساتھ وٹامن ڈی اور PTH بھی شامل ہیں۔ دوسری بات، بغیر ٹیسٹ کے وٹامن ڈی کے بڑے انجکشن لگوانا بھی مناسب نہیں۔ مزید پڑھیں: وٹامن ڈی کی کمی
Will this tell me whether I have osteoporosis?
My uric acid came back normal, but I get gout attacks. How?
Can I just book a vitamin D test on its own?
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