Laboratory testing should usually include the following: Serum calcium, magnesium, and phosphorus 25-Hydroxy vitamin D level Liver tests, including testing for a low alkaline phosphatase (hypophosphatasia) Intact PTH level (hyperparathyroidism) Serum testosterone in men (hypogonadism) 24-hour urine for calcium and creatinine (hypercalciuria) Other tests such as thyroid-stimulating hormone or free thyroxine to check for hyperthyroidism, measurements of urinary free cortisol, and blood counts and other tests to rule out cancer, especially myeloma (eg, serum protein electrophoresis, serum free light chains, urine protein electrophoresis), should be considered depending on the clinical presentation.