The first priority is to treat underlying diseases and minimise medication that may worsen the patient's osteoporosis.

Further investigations should include:

  1. Optimise calcium intake to 1220-1500 mg daily.
  2. If vitamin D levels are < 50nmol/l, a therapeutic dose of ergocalciferol (2000IU daily) for 6 months, then maintenance dose of 500 -1000IU daily
  3. Address patient's risk of falling. Assess anti-hypertensive, diuretic, sedative and anti-depressant medications.
  4. Assess musculoskeletal problems of the lower limbs. Assess hazards in the home for risk of falling.
  5. Consider possible use of HRT or more specific anti-osteoporotic medication such as the bisphosphonates or SERMs.