BMAD calculator / ancillary data

[FearFracture]

I have copies of my complete DEXA reports and ancillary data from all of my DEXAs. I highly recommend asking for this information because often the imaging center only gives patients a DEXA summary.

For those who aren't familiar with the BMAD (Bone Mineral Apparent Density) calculator, you can find it at courses.washington.edu/bone...

DEXAs can be wrong for people who are smaller (under 5 feet tall). I'm 4'11" and my wrists are approximately 5.5" around, which suggests smaller bones. I think 6" is the average size wrist for women.

I don't know exactly how to interpret the results from the BMAD calculator. I'm left guessing at what I think it means since I can't find medical professionals who know the answers or can explain various tests etc.

You do have to have your ancillary data to use the BMAD calculator.

Today, I did something that proved to be oddly interesting.

If you go to the BMAD calculator link listed above, in the notes below the calculator, you can read how, because DEXAs can't detect the depth of bones, they don't measure true bone density, they "measure" "areal" density.

I've had a total of 5 DEXAs. Today, I plugged my DEXA data into the BMAD calculator for each DEXA and took screenshots and compared the results side by side. Again, I have never really been able to figure out how to interpret the BMAD calculator results, but if you look below the calculator near the bottom of the gray box it states:

"The following calculations used the "block method" described by Bachrach, with a smaller database. This was the method used in the previous BMAD calculator."

If you have plugged in your ancillary data and select CLICK to calculate BMAD the calculator will return results for BMAD for spine L2-4 and Fem neck BMAD. After I plugged in my ancillary data for 5 DEXAs, 4 of the 5 returned the same Fem neck BMAD of 0.109 with the T-score of -2.3. Note three of those 4 DEXAs were done on GE Lunar scanners and 1 was done on a HOLOGIC.

When I got the results of my 2nd DEXA and read up more, I pretty much self determined that the 1st DEXA done in 2019, had incorrect DATA for my right hip, and it's my 2019 DEXA that, when the ancillary data is plugged into BMAD calculator, returned a different Fem neck BMAD # and T-score. The 2019 DEXA results show 0.12 and -1.9, but again I feel that my hip numbers for my 2019 DEXA were never correct.

My BMAD for spine L2-4 # and T-scores change when I enter the ancillary data for each year. Here's what I'm thinking. Since BMD doesn't calculate true density and someone is having to "measure" the Height and Width of my vertabrae and every year those numbers fluctuate, for example the Area (cm sq.) and my T-scores for my L4 by year (on GE LUNAR DEXAs) are

L4 2019: 8.75 cm sq T-score -4.5

L4 2021: 9.39 cm sq T-score -3.8

L4 2022: 9.03 cm sq T-score -4.1

L4 2023: 10.36 cm sq T-score -4.2

I just don't think the the area of my vertebrae is changing to that degree. I mean I can see losing bone density, like having a sponge get more holes it in, but coming up with a different area every year, that, I'm just not very sure about. Maybe it's miniscule changes but to go from 8.75 cm sq in 2019 to 10.36 cm sq in 2023, that's a 1.61 cm sq difference and I'm not buying it. 1.269 x 1.269 = 1.61.

Anyways this was just sort of an odd sort of analysis of my own data that, if I'm near the mark, seems to suggest that it's easier to measure the area of the femoral neck than it is to measure the area of vertebra, which makes since, but at the same time, leaves a lot of room for error.

If anyone is an expert at interpreting the BMAD calculator result, please let me know. I would love to get some questions answered.

[CDreamer]

I went for the new REMS scan which includes a questionnaire and analysis of your fragility score. The error margins depend upon the machine and the technician. The comparison of results between the two varied somewhat and the doctor said that in his opinion DEXA can have an error rates of around 10% and then consider the variation between assessing clinics. You are right to question but I’m no expert so consulted one as I was also suspicious. My 2 DEXA scans were something like 8 years apart and with different machines so there would obviously be a variation.

He also said that bone density alone is only an indicator and what he calls ‘the build’ is just as important - hence the fragility score is so important as even with holes, if your bones are strong then your risk of fracturing is reasonable and nutrition and exercise will help maintain strength.

After 6 months I came off AA and bought a LIV and am following the daily nutrition advice and will have another REMS bone scan in Sept 2025, no radiation exposure.

Hope that helps.

PS - My GP sent me for DEXA scans following 2 fractures - both hard impact fractures from fall - one whilst hill walking (ankle) one falling downhill onto concrete after missing my footing on a step (wrist). Both healed very well leaving absolutely no impairment.

[FearFracture in reply to CDreamer]

Happy to hear you bounced back after the falls.

I’d get a REM scan but the last time I contacted EchoLight (almost 2 yrs ago) there wasn’t an imaging center in my state offering REM. I tried to reach out to the company again earlier this week to see if it’s now available in my state, but the email address I have is no longer valid—guessing my contact is no longer w/ the company—so I’ll have to try a different avenue.

Would be interested in seeing your REM vs DEXA scores if you don’t mind sharing.

Please, after your 2025, REM scan post your results so we can see how the Marodyne LiV is working. I’ve been toying with the idea of getting one for two years. It’s a big investment when there is no guarantee that BMD will improve. I do think that the other health benefits (muscle and balance improvements etc) the Marodyne LiV provides, alone, make it worth the investment, especially as one ages, and I think that people with what is labeled age related bone loss most likely will have success with the device. My concern is, because I have hypothyroidism, that liv might not be able to improvement my BMD, which is why I hesitate in getting one for myself.

Lastly, you may already know this but just in case, a good thing to do after any type of fall is to get calcium into your system. When there is any kind of damage to bone, even if it’s not an actual break, the body sends calcium to try to repair the damage.

[Jumpey]

I agree .Unreliable. Eating well and exercising is the way to go.For everything.