DEXA results- 29 yo female

[Ms28]

Hi everyone

I posted on here recently regrading a recent osteoporosis diagnosis. I’ve just received my results and wondered if anyone can help interpret them? Are they really that bad?

I’m a 29 year old female.

[Ms28]

Hip DEXA

DEXA hip

[Met00 in reply to Ms28]

Osteoporosis is diagnosed when your t-scores are -2.5 or lower (-2.6 is lower than -2.5), and/or when you've had a fragility fracture. You don't have osteoporosis according to your t-scores - your total spine is -1.5 (osteopenia), and your total hip is -2.1 (osteopenia). Only your neck of femur is on the cusp of osteoporosis at -2.5, but there's such a big difference between that and your spine score, that it's possible that an error was made. At 29 it isn't too late to do something to improve your bone health, unless you have other underlying health conditions that make this impossible. I'm wondering why you were sent for a DEXA scan at such a young age?

[Ms28 in reply to Met00]

Hi Met,

I was sent for one as I fractured my toe but didn’t know how. When I went for an x Ray, I was told the bone density of my foot looked quite low and to follow up with my GP which I did. She then sent for a DEXA.

[Ms28 in reply to Ms28]

I’m wondering why the doc has said I have osteoporosis? And also why it says classification osteoporosis and my fracture risk is high?

I’m glad it’s not as bad as she was making out. She was saying if I was 70 she would understand but that this is very bad for my age etc.

[FearFracture in reply to Ms28]

Your doctor is correct in saying it is not good for your age. 25-30 is considered peak bone mass, so your bone density is supposed to be at its "best" right now, since you are 29.

[Met00 in reply to Ms28]

Which toe did you fracture? I was sent for a DEXA for the same reason (possible low bone density on x-ray), but was told that a baby toe fracture doesn't count as a fragility fracture.

[Louie_2 in reply to Ms28]

At your age it is uncommon to be losing bone. You need to see a specialist to find out if there are underlying conditions causing this. They will do a bunch of blood work and a 24 hour urine test. They should rule out celiac or problems with the parathyroid gland before recommending any treatment. If there is an underlying condition that needs to be addressed.

[Ms28 in reply to Louie_2]

I’ve not been able to get an appointment in any hospital in London atm. There’s literally not even one, so I’m a bit stuck as to what to do. I don’t want to just go on alendronic acid when I don’t know what’s going on.

[FearFracture in reply to Ms28]

You are correct. You should not start meds until they rule out secondary causes for your bone loss. betterbones.com/testing/wha...

Are you a vegan or vegetarian?

[Ms28 in reply to FearFracture]

No, I eat most foods although I would say mostly fish and chicken as opposed to red meat (due to endometriosis)

[FearFracture in reply to Ms28]

Good. Protein is super important as is calcium and it is very hard to get the needed amounts on a vegan diet. I'm not saying it's not doable but it takes a lot of effort. Your doctor probably already told you this but you need to make sure that you are getting enough calcium and vitamin D3.

[dog45678]

Hello, it is possible to have a significant difference in BMD results areas scanned. This is not as uncommon as people believe. Do you have other health issues?

[Ms28 in reply to dog45678]

So I have endometriosis and adenomyosis, but my joints are always cracking and clicking and my body aches a lot.

[NewBloom]

Hi, Your scores are good and young enough to improve your bones.

My hip femur neck is -2.5 and my other two scores are similar to yours. I've been diagnosed with Osteopenia and at the hip neck Osteoporosis. I also have a bone marrow medication condition and why they're placing me on medication.I already have a good diet and exercise.

[FearFracture]

The pictures you posted shows t-scores for L1 - L4 (lumbar spine) and the total t-score for your lumbar spine is -1.5, your femoral neck is -2.5 and your total femur is -2.1.

Osteoporosis is defined as a t-score of -2.5 or lower. ONLY your femoral neck (-2.5) meets that criterion. Additionally, there is what I call "wiggle room" in DEXA scans and t-score numbers. What I mean by that is that you could have two DEXA scans on the same exact day, on the same exact machine, performed by the same exact technician and get different results, meaning the numbers could go up or down a little, and if your femoral neck went up even a hair, it would not be considered osteoporotic.

Now, when you ask "are they really that bad" if you were 70, I would say no but for someone who is 29, you are hoping for another 50-70 years on this planet so you want your bones to last a long time. Note, I am 53 and I was diagnosed with osteoporosis at age 50 and I am concerned about my bones because I am hoping for another 20-40 years.

Why did you get a DEXA scan at age 29? Generally, ppl don't get them until they are 50+ or if they are having bone related issues such as fragility fractures. Do you have any fractures? And if yes, what caused the fractures? High impact injuries, such as jumping off a two story building and breaking an ankle, are not fragility fractures; however, if you fall from standing height onto the grass and break a wrist, that could be a fragility fracture.

Assuming no fragility fractures, had I been given your numbers (t-scores) at age 29, I would have avoided meds and attempted to reverse my bone loss on my own.

Also note, you've only had one DEXA scan and one DEXA scan can not tell you if you have on going bone loss, meaning there is a chance that your numbers are "stable".

You should start by trying to identify why you have osteopenia at age 29. If you go to betterbones.com/testing/wha... there is a list of tests that you should print out and discuss with your doctor. Note, if you have something like undiagnosed Celiac, parathyroid gland issues, thyroid issues, etc. osteo-meds will NOT help! And you do NOT want to take anything until your rule out other causes for your bone loss. Taking osteo-meds can skew test results.

I experienced premature menopause (was in my early 30s) and did not have HRT (hormone replacement therapy). If you are having any issues with your cycle (skipping periods, etc), make sure to discuss those issues with your doctor. Skipping periods can be a sign that you are perimenopausal so don't ignore it. Most women go through menopause around 50 and once it occurs bone density tends to decrease.

You might also want to check out caltonnutrition.com/meet-th... Mira Calton was diagnosed with osteoporosis in her 30s and she tweaked her diet and exercise program and was eventually able to reverse her bone loss.

[Ms28 in reply to FearFracture]

So I broke my toe but literally have no idea how. That’s why I was sent for a DEXA Because the x Ray showed low bone density and because i didn’t know how I’d done it. I had no injuries etc. This was around 9 weeks ago and the same fracture has not healed and is painful to walk on.

I have endometriosis and adenomyosis and my periods have been shorter and lighter recently but I’m assuming that’s due to those two conditions( as I had an internal scan which shows they’re both not great atm- adhesions etc)

[FearFracture]

Oddly, I chipped a toe too. It was about 10 years ago, but I know how I did it and it wasn't considered a fragility fracture. I'm sure they are telling you to let your toe/foot rest and to give it time to heal. My chipped toe bone took a while to heal and there was nothing they could do for it. I just had to wait it out.

I did a little searching and it appears that there is a link between endometriosis and osteoporosis.

nytimes.com/1988/03/08/scie...

endometriosisnews.com/2017/...

And it seems there is a also link between endometriosis and early menopause. everydayhealth.com/endometr...

As I previously stated, I was really young when I went through menopause. Frankly, I was happy not to have to deal with having a period so I never really saw it as a bad thing until I learned that I had low bone density at age 50

When I searched " does adenomyosis cause bone loss" nothing immediately popped up, but you should definitely ask your OB/GYN about how endometriosis and adenomyosis effect bone density.

Also, there are test that can be done to see if you are perimenopausal.

healthresearchfunding.org/p...

harleystathome.com/blog/wha...

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There is another post on this website and a user posted that she was able to naturally increase her bone density, and it sounds like it might have been the HRT (hormone replacement therapy) that help her. Here the link if you want to have a look:

healthunlocked.com/american...

[skinnykangal]

Hi, I'm sorry not to have seen your post earlier but it seems like you've had plenty of good advice so far.I am reversing osteoporosis naturally using diet and exercise. If you can find my 2 posts on the website please read them for full instructions 😊- if you cannot track them down I'll send them on to you. My user name is skinnykangal. I pisted around Dec/Jan I think.

It is definitely possible to reverse this condition naturally - think of astronauts returning from space where they suffer bone loss at something like 4 times the rate of a post-menopausal female. They are given a strict regime of diet and exercise to correct the condition. NO MEDS! Good luck. Think positively and let me know if I can do anything else to help.

[jamr]

Dexa scans give you a bone mineral density score (BMD), and based upon your score you are classified as having osteoporosis if your T score is -2.5 or greater (ie. -.26, -2.7 etc). As you are 29 yrs old your T score and Z score are almost the same as T score is a comparison to a 30 yr old (considered to have peak bone mass). You also need to have experienced a fragile bone fracture for a diagnosis of osteoporosis, and perhaps your toe break was. Note that Dexa only measures bone density, not bone quality, both of which are important but measuring quality is difficult so Dexa/BMD only is used. Endocrinologists are the specialists for osteoporosis as pathological causes for osteo are usually caused by the endocrine system. Your GP needs to refer you to an endo so they can test (usually bloods and urine) your endocrine systems (parathyroid, adrenals, pituitary etc). If these tests are clear, its possible you have gut absorption, perhaps celiac or nutrient poor diet that has given you a poor nutrient uptake. Its possible that part of this is caused by low Vit D levels (act as a transport mechanism for calcium), low Vit K2 (which places the calcium in the bones). Various other minerals are required, Magnesium, Silicon etc for health bones. Note doctors often understate sufficient Vit D levels. Once you know the results from the above tests, and know if there is something that needs to be treated, you need to look at your options to improve your bone density. Either natural through diet, exercise etc, or using drugs like Prolia etc. Drug options have side effects for some people and should be considered carefully before committing to this as once using a drug like Prolia its not easy to get off it (due to possible bone fracturing) unless it gets replaced with another drug. Usually you have time to do your research before you commit to a drug treatment pathway. Its a complex condition with a lot of confusing information, so you need to break up your approach into manageable pieces and keep positive. I think the first step is referral to endo for all the endocrine tests plus Vit D etc. Once you have these your next decisions will be clearer. Everyones story here varies but many have experience and information that can be useful to you. Your health is your problem and responsibility, and not that of your doctors. You will need to manage their knowledge and skills without giving them control, and if you are not confident about their competence, I suggest you look for a GP and/or endo that you feel is competent. I was diagnosed by Dexa about 4 years ago (at 60 yrs old male), and given a Prolia prescription the same day and told 'I should just take it'. I was very afraid and refused, went to the endo who tested and cleared my system of all possible pathologies causing the osteo. I was then tested as having a parasite that was causing malabsorbtion over past 10 years. I had assumed food intolerances like gluten, lactose, fructose etc so had a very limited diet to avoid reactions. My Dexa scores are significantly better and thus far I have avoided using osteo drugs, my Vit D, K2 levels are good, I am able to exercise so muscle tone around the bones help strengthen and balance the body. I was sent for the Dexa due to a foot fracture from a bad fall (so not fragile) and the results were a big shock to me. Stay positive.