Bone & Joint Pain Check
Updated 10 September 2026Aching bones. A back that hurts by the middle of the day. Knees that complain on the stairs, or a big toe that swelled up overnight and made even a bedsheet unbearable. These are different problems with different answers, and the usual response, a calcium tablet or a painkiller, treats neither of them. This check measures the nine things that decide whether your bones are being quietly stripped and whether uric acid is behind the joint attacks, from one blood sample taken at your home in Lahore, read by a doctor afterwards.
Most of the nine work together on one question: is your body taking calcium out of your bones to keep the level in your blood normal? Vitamin D is where that starts, because without it you absorb very little of the calcium you eat. When it runs low the parathyroid glands step up and pull calcium out of the skeleton instead, which is why iPTH is here alongside calcium, phosphate and alkaline phosphatase. Low vitamin D with a high PTH is the pattern worth catching, because it is common in Pakistan, it causes real bone loss, and it is treatable. Magnesium sits alongside them because the body cannot use vitamin D properly without it. Uric acid answers the separate question: gout, which causes sudden, severe attacks in one joint rather than a general ache.
Your report is usually ready the same day. A PMC verified General Physician then reads all nine together, online or at a clinic, and refers you on to an endocrinologist or a rheumatologist if the results call for one. One thing to be clear about before you book: this panel finds the causes of bone loss, it does not measure bone density. Osteoporosis itself is diagnosed on a DEXA scan, not on a blood test, and your doctor will tell you if you need one.
ہڈیوں اور جوڑوں کا درد، کمر کا درد، یا اچانک کسی ایک جوڑ کا سوج جانا، ان سب کی وجوہات الگ الگ ہوتی ہیں اور صرف کیلشیم کی گولی یا درد کش دوا ان کا علاج نہیں۔ اس چیک اپ میں وٹامن ڈی، کیلشیم، فاسفیٹ، الکلائن فاسفیٹیز، پیراتھائیرائیڈ ہارمون اور میگنیشیم دیکھے جاتے ہیں، جن سے پتہ چلتا ہے کہ جسم ہڈیوں سے کیلشیم تو نہیں نکال رہا، اور ساتھ یورک ایسڈ بھی، جو گاؤٹ کی وجہ بنتا ہے۔ نمونہ لاہور میں گھر بیٹھے لیا جاتا ہے اور مرہم کا ڈاکٹر آن لائن یا کلینک پر رپورٹ سمجھاتا ہے۔ یاد رکھیں کہ ہڈیوں کی مضبوطی ناپنے کے لیے DEXA سکین ہوتا ہے، خون کا ٹیسٹ نہیں۔
Tests included
25-OH Vitamin - D3
Alkaline Phosphatase
Calcium (Ca) (Serum)
Corrected Calcium
Intact Parathyroid Hormone (iPTH)
Ionized Calcium
Magnesium (Serum)
Phosphate (PO4) (Serum)
Uric Acid (Serum)
What's included
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.
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.
How it works
Book the package
Confirm the patient’s details and pick a home-collection slot, then pay online or have our team call to confirm.
Home sample collection
A Marham Lab phlebotomist collects the sample from your home in Lahore.
Get your reports
Your reports are delivered through Marham once the lab has processed them.
Doctor consultation
Our team calls to arrange your included consultation once your reports are ready.
Frequently asked questions
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
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
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Rs. 9,200
Rs. 14,00034% offTests
9
General Physician
Online or In Clinic Consultation
Sample collection
At home · Lahore