Hi All,
I did a DEXA scan last year and found my Z score over my spine has improved considerably. I'm still confused if I should go for DEXA scan this year.
I did some reading and found that Procollagen Type 1 N propeptide (P1NP) test for bone formation and the C-terminal telopeptide, sCTX1 test for bone resorption are much more accurate.
Has any one of you did these blood tests before?
Z-scores compare your bone density with average for your own age, so if your bone density remains the same between scans, your z-scores will improve. Unless you're young, you should have been given t-scores too, which compare your bone density with average for a 30 year old; we all lose bone density from about age 40, so t-scores are an estimate of how much we've lost.
DEXA scans do have quite a wide margin of error, so aren't usually recommended to be done more frequently than 2 years apart, and even then, any apparent changes may be due to this margin of error rather than actual changes that may have taken place.
I found my latest DEXA scan results too good to believe. -3.9 now -1.8 with no meds and no lifestyle changes. The VA doctor said my spine looks like a bag of potato chips after seeing my x-ray. I have multiple collapsed disks thoracic and lumbar spine. My DEXA results were consistently -3.9, -1.8 I don’t believe. Is there another test available short of a mri? Since onset of osteoporosis I have lost 4 inches of height.
Is that score for your spine? If arthritis has developed, it can make your bone density appear better than it actually is. Or there may simply have been an error in the way they aligned your spine for the scan or interpreted the results. By collapsed discs, do you mean fractures or slipped discs?
yes my spine. I have discs that are 50% collapsed others that are wedges. I have some sloped discs. Some bulging discs. 21 of 24 are mentioned in my MRI.
Did they say whether some of this is due to fractures?
yes T9 thru L2
That must be horribly painful, as could slipped discs be too. All those fractures would make the DEXA scan if the spine unreliable.
thanks for your replies. Yes and my family thinks I have given up. I haven’t slept in a bed in years. I also have pulmonary hypertension >45. My son asked me how are you still able to walk. Painfully that’s how.
I appreciate your quick responses the other day. After seeing my new GP he said due to my fractures and osteoarthritis my new DEXA results are meaningless. I am thinking about getting a new MRI to try to get a clearer picture of what changes have occurred since my last one at USC. But I remember very well how painful those 45 minutes during the MRI were! I got copies of my old DEXA scans and the last one at L2 was - 4.1. What do you think is it worth 45 minutes of pain to know what changes have happened in 3 years?
I don't know where you live, but if you can access and afford a REMS scan, that would be likely to give more reliable results than DEXA. Have you been tested for underlying causes of your Osteoporosis?
I live in California. I have osteoporosis and pulmonary hypertension.
Have you been checked for hyperparathyroidism? Is pulmonary hypertension or any medication for it known to cause osteoporosis?
no thyroid problems and osteoarthritis started first but not by much.
The parathyroid glands aren't the same as thyroid and many doctors don't know it's important to check for hyperparathyroidism, as this can prevent enough calcium from reaching the bones by retaining it in the blood. Parathyroid, calcium and vitamin D levels need to be tested from the same blood draw
I'm having that test done because I'm on teriparatide injections to build my bone.
ok beckyiswell . My question is that can we rely only on the DEXA scan or should we go for other tests that I mentioned.
I would go for other tests and not rely only on the Dexa Scan
If you are in the UK Doc Nick Birch at Osteoscan will measure your bone density AND strength with a REMS machine (Ultrasound). All the info on the web site. He is a wonderful source of diet and exercise advice too. He is an advocate of only using meds when absolutely necessary and in his opinion they shouldn't be the first resource osteoscanuk.com/about-us
Not sure if this is available in India but
"REMS is an alternative to the DEXA Scan and appears to be a lot more reliable.
Paul Magee, who is a physio who runs profortis.co.uk which is based in Amersham, Bucks, tel. 01494 840432.
He charges £135 for the REMS scan with the results. He has been fully trained by Echolight and has two years experience in scanning with the Echolight, also a sports therapist and Pain Management specialist with 25 years experience as a therapist. He doesn't offer a bone consultation just simple exercise and nutritional advice for those who are not osteoporotic but are osteopenic.
For those who are osteoporotic and need greater nutritional, hormonal or pharmaceutical interventions, he refers them to the relevant medical expert to carry out that consultation. The system is very reliable and will not give a result if there is user error. profortis.co.uk/ "
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