dexa scan results advice please : I just got my... - Bone Health

Bone Health

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dexa scan results advice please

MrsClanger profile image

I just got my gp to send me the full dexa scan report. Can anyone advise how ' bad ' my bone situation is.

Ive recently been diagnosed with osteoarthritis in my left hand and forearm aswell.

my info -

age 53, post menopause ( had early menopause at 37-40 years old )

i have autoimmune thyroid disease and am on levothyroxine, and top up with self sourced t3 . My endo wont prescribe the T3 on the nhs because he says theres a risk with having surpressed tsh and oesteoperosis, or osteopenia , even tho he recognises it works and that im feeling better in regards to the thyroid condition by taking the T3,

I would appreciate advice on just how bad my bones are ?

I am taking calcium, vit d, vit k2 mk-7, aswell as zinc mangnesium, b vits and iron, ( all in easy to absorb formulas )

heres what the dexa says ( done 3 march 2020 )

T score total spine -1.4 Z score total spine -0.5

T score total hip -1.7 Z score total hip -1.2

T score NOF -1.8 Z score NOF -0.9

Comment - There is evidence of oesteopenia within the spine and also at the hip .

Protective bone management and ongoing follow up are indicated.

.....................

21 Replies

I am no expert at all but if I had those results from a DEXA scan report I would be doing a happy dance! :)

I would read as much as you can about bone health start with the ROS website - they have lots of good leaflets but there are loads of good books about osteoporosis and osteopenia.Start eating the right sort of diet - look at the ROS bone friendly diet sheets - loads of dark green leafy veg etc, cut out rubbish / fast foods that don’t do your body any good, cut out fizzy drinks etc.

Make sure you get the vitamins and minerals you need for healthy bones and get good regular weight bearing exercise, I like the Margaret Martin book about Exercise for Better Bones book but again there is lots of information out there.

Like I’ve said somewhere else - I’d love to have your T scores.

Thank you, i eat tons of green stuff, as i only eat veg and nuts. I feel relieved as the endocrinologist said it was very bad and made it sound like my bones were disintegrating. I am going to register a formal complaint against him, as he clearly doesnt know how to interpret the tests.

Deb_Mc profile image
Deb_Mc in reply to MrsClanger

Couple of things.....if your endo isn't working with you on T3 AND he's communicating that your DXA scores are "very bad", it might be time to search for a new doc. Yes, your scores are lower than women your own age & ethnicity (that's what the Z Score reflects), but "very bad" is high drama and inaccurate.

Also, if you're a vegetarian/vegan, your primary challenge will be getting sufficient protein to support/protect bone health. Insufficiency in this critical macronutrient is SO common. .545 grams of protein per lb of body weight is recommended. Protein/collagen is a fundamental building block of both bone & muscle. If you're lacking in this area, you will lose bone (and muscle) at a faster rate.

And....we lose bone rapidly in the 5 years that follow the onset of menopause. Are you doing HRT in any shape or form? Estrogen slows bone breakdown & helps mitigate loss during this challenging period.

MrsClanger profile image
MrsClanger in reply to Deb_Mc

Hi Deb, thank you , ive just added up all the protein in my diet.. i think its looking ok.i will pop it below .. im post menopause, never done any hrt at all. is it worth doing when so far gone past menopause ? im 53 now and started menopause age 37, been at last 12 years since i had any hot flushes , my last random period was about 9 years ago after 3 years of having none.

here is what i eat .. pretty much the same every day since april, sometimes i just have the morning smoothie then eat bananas dates and almonds all day, and sometimes have roast parsnips with mango chutney for dinner, or those glucomannan diet noodles instead of the sweet potato. But return to the plan below most days.

30g Hemp protein powder 20g protein

1 large banana 1.5 g

1 teaspoon cocoa + 8 or more tspns a day as drink = 3.2g

( + water + stevia as a smoothie)

( cals 111 +120 +4 +32 =267)

1 tablespoon Tahini 2.6 g

Half an avocado 2 g

100g raw beet 1.6g

100g raw fennel 1.2g

100g raw carrot 0.9g

50g lettuce 0.7g

( cals 89 +161 +43 + 14 +41+8 = 356)

3 brazil nuts 2.1g

3 dates 0.6g

(cals 99+60=159)

250 g sweet potato 4 g

120g ( min ) broccoli 3g

100g mushrooms 3 g

One onion 1.2g

30 g Nutritional yeast flakes 16g

1 tspn olive oil 0g

( cals 215 +41+22+44+120+40= 482 )

Total .. 63.6g protein

Calories 1264

I weigh 120 pounds , so i Need 65 g of protein daily .. nearly there.. !

I would be ecstatic with those results. Make sure you read as much as possible about looking after your bones and not just from ROS and also weight bearing exercise regimes walking ,yoga ,dancing , pirates etc. X

You are at the better end of osteopenia - great scores of which most others would be very envious! A T-score compares your bones to those of a healthy 30-something woman, the Z- score to those of someone your age.

Here is the range used by medical professionals to class your bones as osteopenic or osteoporotic:

T-score of -1.0 or above = normal bone density

T-score between -1.0 and -2.5 = low bone density, or osteopenia

T-score of -2.5 or lower = osteoporosis

You are taking all the right supplements and presumably have a good diet as well. Unless something changes dramatically, I would say you are a very long way off being prescribed any drugs. A diagnosis of osteoporosis with a fragility fracture is generally the trigger but some doctors jump the gun and prescribe drugs unnecessarily to their osteopenic patients. I'm not saying that yours will, but be on the lookout for this as it can be a slippery slope, depending on what you're prescribed. The side effects of a lot of these drugs can be quite horrible, so don't start taking anything unless absolutely necessary.

You might find this of interest hindawi.com/journals/jeph/2... a study of the combination of micronutrients for bone. You are taking most of these anyway, so are obviously well informed already.

MrsClanger profile image
MrsClanger in reply to Arcadia10

Thank you, hoping to make up for years of poor diet, thanks so much for the advice and support

It's on the good side of osteopenia. While it would be better to have normal bone density, you are in pretty good shape. Most of us, myself included, would love to have those numbers. The main thing to keep it from getting worse. If your CTX is high or a follow-up DXA showed a large decline, that would be a problem.

We have a great deal in common. I went through early menopause for unknown reasons, but much early that you did (mid-20s to early 30s). I have Hashimoto's hypothyriodism (was diagnosed in 2017) and have been taking 75 mcg of levothyroxine daily since then.

Unfortunately, the doctors I've seen over the last 20 yrs failed me by never mentioning that I should get a bone density scan. So, when I had a routine DEXA scan done for the first time in 2019, at age 50, my lumbar t-score was -3.9. Note, I haven't have any fractures and I am a very active person.

So, I hope my NOT good t-scores, make you feel better :-) I would be thrilled if my numbers were as good as yours. You will definitely want to take action to prevent more bone loss and depending on what you are able to do mobility-wise, you might be able to reverse your osteopenia through natural means or at least prevent it from moving from osteopenia to osteoporosis.

My vitamin D levels were lowish and I have really brought them up. I used to wear sunscreen every day--never left the house without it--and I have stopped wearing it unless I got to the beach at noon, which I don't do. I'm slowing increasing the weights that I lift and I have added back extension exercises, and heel drops, and I stop each foot 4 times twice a day (as if I am crushing a can), etc. Additionally, I have added in vitamin K2, and I now eat 6+ prunes a day and handful of almonds.

Note, I am taking osteomeds for now but am hoping they are just a stop gap until I can get my numbers up a bit and then just work on keeping my bones healthy through natural methods. If my numbers were as good as yours, I would try natural remedies before taking drugs but that is just me, and I don't know your full medical history.

hi, thanks for the info, its so sad they didnt test you sooner, i was left for years till they tested me too, im glad my scores arnt as bad as i thought, and feel for you. I take k2 aswell, and think diet is so important and like you ive been trying to improve it, i posted what im eating to someone elses reply, albeit weird as i am trying to heal myself with a lectin free vegan diet.

As others have said, your bones are relatively in great shape.

Although the DEXA scan is still the NHS standard, some have questioned their results from scan to scan as unreliable / inconsistent. You might want to look into a REMS scan: osteoscanuk.com

as an alternative to better track your bone health as you age.

Bone thinning is a normal part of aging and can be kept in check by exercise, especially weightbearing exercise (as simple as regular walking, walking with a weighted vest, walking with Nordic poles, and other exercise like Tai Chi, dancing, etc.). You also need a healthy, balanced diet, and a few judicious supplements, possibly Vitamin D3 and Vitamin K2 would be sufficient, but these two are very important. "Osteopenia" is not a disease. Medical establishment and big pharma make it so, but it is just the way it is as we get older. The secret is to prevent bone thinning from developing into a dangerous level of osteoporosis.

If you find your next DXA scan is worse, despite doing what you can to maintain good bone nutrition and exercise, insist on a full evaluation of "secondary causes of osteoporosis". No one should ever take an osteoporosis drug unless absolutely necessary, and certainly never without full investigation of what may be causing bones to lose density.

osteoporosis.ca/medical-con...

I hope you feel reassured about your bone health, Mrs Clanger.

This article goes into the history of bone density measurement, diagnosis and treatment and how the diagnosis of osteopoenia came about. I don't want to discourage anyone from being aware of their bone health and being proactive. I'm also not trying to discourage anyone from treatment when they and their medical advisors believe it's appropriate. But it's an interesting perspective on how the diagnosis and treatment of osteopoenia evolved and whether there's some degree of 'medicalising' age-related bone thinning. That said, there's a lot we can do to look after our bone health, regardeless of a scan result. It can complicate thyroid treatment, especially getting T3 prescribed, and I hope that works out for you.

How a Bone Disease Grew to Fit the Prescription

"The question before the experts in Rome then was this: Since after the age of 30 all bones lose density, how much bone loss was normal? And, how much put women at risk and therefore should be considered a disease?"

npr.org/2009/12/21/12160981...

MrsClanger profile image
MrsClanger in reply to wellness1

Thank you, ill definitely find this interesting. i dio feel relieved and a bit daft for being scared by the silly endocrinologist. ill still argue to get T 3 prescribed as i feel better on it. My gp is now worried about a liver test being raised , alcaline phosphatase is always a bit high, so im looking into that now, but its probably nothing too !

wellness1 profile image
wellness1 in reply to MrsClanger

I hope you get reassuring news and good luck getting T3 prescribed.

I can put yours in to perspective when you see my dexa results. My spine was -5.5 and Is now - 4.3 with treatment. I think my hip score is - 3.4. I can’t remember what it was.

You have the beginnings of osteoporosis but I amagine with the right food and supplements you may be able to reverse it. I would get a professional opinion. Mine is really bad and I’ve had seven fractures in my back and one In both my foot and hand. They were all spontaneous apart from my hand which I fell on.

Your numbers are really really good! I would say keep with what you are already doing and do everything you can to stay positive and not worry.

A year after I was prescribed meds (and decided to not take them due to side effects), I had my annual with my GYN Dr and asked her what she knew about OsteoStrong. She went to her cupboard, pulled out their brochure and told me going there would help me 10x more than what she had prescribed me. You may have one near you. I would recommend checking it out. osteostrong.com (if this doesn't bring it up, google it. I'm not able to look up the exact site without losing everything I've written)

Deb_Mc profile image
Deb_Mc in reply to beckyiswell

I believe the website is actually osteostrong.me :0) AMAZING, best-ever place to naturally strengthen the musculoskelatal system!

beckyiswell profile image
beckyiswell in reply to Deb_Mc

Thanks, I meant to change the site. I'm looking forward to being able to get back to it!

Thank you, will have a read :)

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