so I finally got a full dexa report from my Dr (which was together with summary report)
And my BMD numbers are not really bad :
the lumbar BMD:
.626
And femur neck Numbers:
Right .608
Left .569
and with these numbers, - the computer generated me as having severe osteoporosis of T - 4.7 which indicated to the dr to high pressure me for medicine or shots.
he didn’t even notice that it doesn’t make sense.
I accept my left femur neck to be -3 .1
My right femur neck to be -3.3 and my lumbar might be -3.4
I am not doing any more dexas unless I find a dexa with tbs or do the rems in 6 months to one year after weight lifting and supplements
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Raleigh59
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Compared to my DEXA results, your BMD numbers equate to -3.1 to -3.3 in your femurs, and -3.1 in your spine. This puts you in the osteoporosis range, but definitely nowhere near the dire -4.7 you were told.
I think it's appalling that your specialist didn't pick this up and instead pressurised you to take the meds.
I think so too that it’s appalling and pressured me to take medicine and shots.
He called me yesterday speaking loudly and domineeringly. He was upset bc I called an office staff asking to speak to the radiologist who wrote this up .
After I calmed him down he said there is no radiologist, the dexa computer printed out the report.
Then he started getting worried that he has many patients on medicine and shots unnecessarily. He said there could be many with this lab error and he’s worried. Apparently there could be a software problem in the dexa computer. He said he wanted to give me a free second dexa. I said no more radiation and I just want to know if the .60 numbers can equate to - 4.7 ?
Bone mineral density (BMD) is measured in g/cm2, so is a positive number. The higher it is, the denser your bones are.
The DEXA T-score results are negative as they represent standard deviations (SD) away from zero which is normal bone density, eg. -4.7 is worse than -3.1.
I have had an annual DEXA for the past 10 years and have put all my BMD and T- and Z-scores into an Excel spreadsheet for ease of comparison. You can see how I got my estimation of your T-scores, and none are anywhere near -4.7.
I called my dr office and they said I might actually have -4.7 ? I don’t understand it . They said they don’t know if I need a second dexa . I am not doing another one
It's impossible for you to have a T-score of -4.7 based on your BMD results. The T-score is calculated from the BMD figures as you can see from my spreadsheet.
If you wanted to confirm that they've made a mistake, for your own peace of mind, you could have another DEXA done elsewhere. Be aware, however, that for consistency over a period of time, each DEXA should be done on the same machine as machines can vary slightly in their results. To just double-check your results, it won't matter.
Be assured that your -4.7 result based on the BMD figures you provided is a big mistake, not a slight margin of error.
I was always weighed and measured before my DEXA, but have no idea what they did with those figures. T-score results are standardised, so possibly they plug those figures into the machine to allow for height and weight variation, but I don't know. I just turn up and they do the scan and give me the results.
Your doctor has already admitted that there could be a software or lab error problem, so he's obviously seen that there is something wrong with your results, i.e. your BMD results do not correspond to a -4.7 T-score.
Tomorrow I'll have a look online to see what the BMD for a -4.7 T-score would be. It's getting a bit late here now.
Usually we're given a t-score. A t-score of -2.5 is where they say osteoporosis starts. Minus numbers smaller than that are considered "low bone mass" or osteopenia. Medication is not usually prescribed for osteopenia but it is a sign that steps should be taken to prevent further loss, such as appropriate exercise, perhaps diet modification and a few supplements (primarily Vitamins D3 and K2, often calcium depending on dietary status). Worsening numbers indicate you should have all the appropriate tests to find out if there are "secondary causes of osteoporosis". Even osteoporosis doesn't mean medication needs to be started, particularly if there have been no true "fragility" fractures.
However I don't understand your numbers. perhaps Arcadia10 will be able to help. I assume there's no minus sign in front of any of them?
I finally went back and read the rest of this thread. There might be a chart on-line which would give you the comparisons. It certainly looks like you are fine, assuming you've simply misplaced the 0 in a couple of them! As Arcadia10 pointed out above, the bigger the BMD number, the better.
I'm not quite sure what you're trying to decode. Do you mean whether these results are good or bad? Your doctor/specialist should have given you your full DEXA report and gone through the numbers with you. Usually, based on the T-scores (rightly or wrongly), doctors decide whether to treat their patients or not, so presumably you were given your T-scores.
I'm not an expert in densitometry/DEXA results by any means. I'm merely a pateint trying to help Raleigh with her clearly erroneous T-score of -4.7 which doesn't correlate to her BMD results. Her doctor has already admitted he/his practice made an error.
I have posted a spreadsheet further up this thread which gives my BMD results and associated T-scores back 10 years. From 2015 these were done at a major teaching hospital and this is what they do all day on a Hologic machine which I was led to believe is one of the best. So I have no reason to believe that they are inaccurate. If you for some reason weren't given your T-scores and wish to get an approximation of what they are, just use my spreadsheet to find your BMDs and look at the corresponding T-score. I see looking at it myself that your T-scores would probably be around -3.1 to -3.3 which is in the osteoporosis range. There is always a margin of error in these results so the only way to get an accurate T-score if that's what you're after is to get the results from your doctor . You should have been supplied with a full report anyway. I always ask the hospital to email mine to me.
By the way, the decimal point comes after the zero, eg. 0.596 g/cm2. Look at my spreadsheet - figures taken from the reports. I'm going to upload a Snip of the actual 2022 report so you can see the figures as supplied by the hospital. It's only part of the first page. The report is 8 pages in total.
can you look at all your spine numbers and BMD numbers - it seems that BMD Numbers and t scores are not consistent like when your BMD dinners are higher are the t scores always improved .
I am just learning from your previous post that the higher BMD is better which means my left femur is my worst number and my lumbar is better than my femurs. My left leg is my longer leg, the scholiosis makes one leg longer
Yes, I saw an endocrinologist every year at the hospital. I had my DEXA and Fasting Metabolic Bone Study done the month prior to my appointment so that she could discuss with me.
I just found out that my dr approved the cancelling of the Dexa bill so either like you said the machine needed to be recalibrated and many patients could have been affected wrongly on medicine or shots or it’s my spine that screwed it up which you said it’s not my spine
Uploading the spreadsheet was a bit fiddly. You have to click on the magnifying glass to see it in its entirety.
The figures were taken directly from each annual DEXA report. I have them done at a major teaching hospital and trust that their Hologic machine is calibrated correctly. From what I understand, there is always the possibility of a small margin of error though.
The fact that your specialist seems to be doing this himself is extremely concerning, especially if he is making major mistakes which are leading to his patients being medicated unnecessarily. He could soon have a major lawsuit on his hands.
I would run for the door if I were you, and never go back!
You can see my similar BMD numbers in my spreadsheet and how they translate to T-scores. Those were calculated by the hospital where I had my DEXAs done over a period of 10 years. No mistakes. Quite consistent.The lower your bone density, the worse your T-score. A result like -4.7 is very bad. Your BMD numbers would have to be a lot lower to get a score like that.
Your doctor/his staff/machine has made a calculation error.
in the inspire forum they talked about that if you have scholiosis the dexa of spine is invalid . I have scholiosis - so maybe that’s where the problem with my results is.
That is what I was told after a dexa scan as I have scoliosis. I have had a REMS scan and got a spinal result. I am going to have another REMS scan in November which will be two years since the last one. I will not bother with a DEXA again.
how were the rem results different to the dexa results? I have not done rem yet. My dexa results were not good but the t score seemed very bad when the bmds were not as bad
They were different in that I got a spinal reading which was ok and the other readings were ok too. I do have op but he told me that I was doing ok and to continue what I was doing ie taking the supplements and walking as I had been doing before. I do not take any OP medication. So far so good. It has been suggested to me to take prolia but I refused. I am on my own with this now as I refused to take medication. I do have a repeat prescription for Vit D but that is all the help I get now from the NHS with OP. I am happy to pay out for a REMS every two years. I hope I have at least stayed the same when I attend my appointment in November.
this is what Rems echolight man said about my dexa with scholiosis : spine seems pretty high compared to femurs , echolight rem could shed light on this.
I also have scoliosis. That's not the problem. Your doctor's DDXA machine is not calibrated correctly. He's already realised/admitted that.Have another DEXA done. That will give you a definitive answer. All else is guesswork and speculation.
my dr says he’s checked it with 3 people and your spine can be much different score or equation than your femur bones.
what I don’t understand is my femur bones were worse scores than my
Lumbar but my lumbar got the much worse t score. My dr insists his machine is correctly calibrated but he is saying he cannot guarantee that the “read” or the tech did it correctly .
I called another place in town and she said when there is such a large discrepancy between the t scores of the spine to the femur bones they do the forearm as an added measurement to make sure they are getting accurate tscores
Perhaps the machine takes that into account which is possibly why we are weighed and measured beforehand, but I really don't know. The point is that the T-scores are a function of BMD, so a T-score of -4.7 could not be calculated from your BMD figures, unless they have given you incorrect BMD figures and used different ones to calculate the T-score.
I had a look on the internet but haven't been able to find a BMD to T-score of -4.7 equivalent. It doesn't really matter though, as the only accurate way of finding out what your T-score really is is redoing the DEXA scan. I think that is the best idea as it would reassure you that your bone density is not terrible, and would set a baseline for your bone density going forward. I would NOT have this done in your doctor's office. Based on your recent experience, I don't think you would be able to trust his results as he has already admitted his mistake which probably also affects a significant number of his patients..
So try not to worry too much. My scores in the spreadsheet I posted are accurate and indicate the T-score from my BMD results. Extrapolating from these, your scores should be between -3.1 and -3.3 which is still a diagnosis of osteoporosis. Whether you decide to have treatment or not is a matter for discussion with a trusted medical professional and involves you making up your own mind as to whether the potential side effects are worth the risk.
If I were you, I would get a referral from another medical professional for a DEXA to be done in a possibly larger and more reliable facility, like a hospital which has a Department of Endocrinology, or else a specialised radiological clinic. Even if you decide not to have regular DEXAs done, at least when you have the next one you will know your baseline figures from Feb/Mar 2023 which will be very useful.
In the meantime, there is another site which I am on called Inspire.com which is based in the US which has a highly knowledgeable poster called dexaguru on it who answers questions about bone densitrometry/DEXA scans: inspire.com/m/dxaguru/ You might like to join Inspire and post a question specifically aimed at dexaguru about your anomalous results. Here are some other people's posts: inspire.com/groups/bone-hea...
A Fasting Metabolic Bone Study is a series of blood/urine tests which assesses your calcium, vitamin D3, phosphate, creatinine, kidney function, parathyroid levels as well as bone formation and resorption markers. The results indicate whether your calcium, vitamin D etc. are too low/high which might be the reason for your osteoporosis and require treatment to bring them up to where they should be, and so potentially avoid treatment with osteoporosis drugs.
As a matter of interest, why did you have the DEXA in your doctor's rooms - because of your age, have you had a fracture?
My dr encouraged me to get the dexa at his office- he acted like it was convenient. His office is a building like one stop shop with everything there. At this point i am just trying to get him to approve the cancelling of my recent dexa bill to my insurance . I contacted the billing person yesterday who messaged my Dr to get this approved.
I have not had a fracture recently but I did slip on the ice and fracture in 2017.
Idk if that affected the t score.
Right now I am trying to improve my exercise, food and supplements.
I am going to look at your link of the other site and referral person
No. The Inspire.com forum is free. There are a lot of knowledgeable people on there as well as some professionals like dexaguru, it is also quite lively with lots of discussions. I’m in the UK and find it quite useful.
I saw in your profile you take strontium citrate ? There is so much negative info on these boards about strontium faking the dexa score.
I know they mean the prescription grade when they say that but still they still think strontium citrate also masks it. I bought strontium citrate but haven’t opened it bc of all the negative posts.
Inspire.com is a health support site like HealthUnlocked, and is free to join and interact. There are some incredibly knowledgeable people on the site, much like HealthUnlocked, and some people are on both sites, like me. I have got a huge amount out of being on both sites.
Why did your doctor want you to have a DEXA? Usually it's because someone has had a fragility fracture or is getting to the age where low bone density is suspected. Slipping on the ice and breaking a bone is not a fragility fracture. Falling from a standing height and breaking a bone is considered a fragility fracture - no trauma involved.
Strontium citrate does skew your bone density by 10% apparently, but an increase in BMD is still an increase. You just deduct 10% from the score. If you're interested in reading some success stories of people who have been taking strontium citrate for 14-20 years, look on the Inspire.com website at posts by BoneLady inspire.com/m/BoneLady/ and Kathleen1314 inspire.com/m/Kathleen1314/... They both went from osteoporosis to normal bone density. I have been back on it for the past few months after a nasty experience with prescription drugs for four years.
If you look at my spreadsheet again, the green rows are when I was taking strontium citrate. You can see the improvement from 2012-2015, especially in my spine. Then I stopped it and my DEXA of 2017 reflects the drop in BMD, again in my spine particularly.
The purple rows are the two years I was on Prolia and you can see a significant improvement - 15% in my hip and 8% in my spine after two years. I had a LOT of side effects on Prolia, so stopped it in March 2020. You can see the subsequent drop in my BMD in my 2022 DEXA.
I think you need to approach this methodically after your unreliable result from your doctor (who sounds downright dangerous to me!):
1. Find a clinic or hospital that does DEXAs all day and every day, and have one done. The amount of radiation is minimal, so there's no reason not to do another one apart from the cost. If your medical insurance won't reverse the payment you've made to Dr Unreliable, then is it too much to pay for yourself out of pocket? I paid for my first DEXA as there were no circumstances indicating that I should have one. It was only $100, but I did need a GP's referral. You will most likely have to find another GP, but that's probably a good thing under the circumstances.
2. While you're waiting to get in to have the DEXA, try to contact dexaguru on Inspire.com inspire.com/search/?query=d... and pose the question about your erroneous results. Start with "Question for dexaguru re incorrect T-score from BMD results" or something like that. Hopefully he'll answer quickly, as I'm sure will other people with their opinion.
3. Read as much as you can about osteoporosis, DEXA scans, medications, etc. This is NOT a path you want to go down unprepared and ill-informed - and meds may be completely unnecessary, as in my case. Some good books are:
Dr Lani Simpson's No-Nonsense Bone Health Guide lanisimpson.com/collections... Dr Simpson is a bone densitometrist so explains DEXA scans in detail, amongst other aspects of bone health.
4. In the meantime, if you want to start using supplements to improve your bones, read the COMB guide pubmed.ncbi.nlm.nih.gov/222... You can get the free full-text article by clicking on the link to the top right on that page.
Hi Donna - I found someone on HealthUnlocked with a T-score of -4.6, so very close to your erroneous one. You might like to contact her and ask her what her BMD was at that time. healthunlocked.com/boneheal....
thank you ! 🙂I wrote to her but she wrote that post about her numbers 4 years ago.
For now -
I’ve settled into a comfort zone of NOT doing any oral medications, even my dentist friend said “ the natural order of things is best” I try to walk 30 minutes + per day. I go to one zoom exercise class per day now. And I am customizing my supplements regimen though I wish I had that down to an exact schedule with times of day .
She's online regularly (I was in touch with her last year) and will get a message from HealthUnlocked regarding a new post on that thread, so I'm sure will pick up your post/question and hopefully will reply.
Did you see my long reply to you about strontium citrate, the COMB study and with the links to reading/books/articles? These threads can get messy at times and posts overlooked. Most of the supplements in the COMB study are the usual ones you can buy at any pharmacy or online (depending on where you live). Those are a good start to keep your bones healthy and strong, eg. vitamin D3, boron, magnesium, melatonin, etc.
In the meantime, educate yourself as much as possible because this is a minefield. You need to be very well informed in order to make a decision about meds if that becomes necessary. A lot of doctors seem to be trigger happy when it comes to prescribing - and not very well informed.
yes ! Love the COMB study in particular - I didn’t see dosing mgs- I wonder if I saw the whole thing. But the idea of the micronutrients as they call the supplements is really a relief and comforting that it’s recognized as a treatment plan with strong protection 🙂
I am not much of a book reader and more trying to motivate to do maybe 1.5 hours of exercise per day, one class and 30 minutes walking. I don’t know if I should do osteo strong or bio density machines.
I don’t even know if I should go see the specialist at this point. I am happy to just do my supplements and 1.5 hours of exercise per day and my weights are in the kitchen. I now use them there
You should pose the question about strontium to Kathleen1314 or BoneLady on the Inspire.com site as they are the experts, both from personal experience and doing lots of research.
I am starting to feel more in control. Thank you. With all of your support- there was so much negativity on health unlocked American community against strontium saying it fakes out the dexa , but how can it fake it out unless it’s made the bones denser. The Scan does not weigh your bones or check quality. It’s an aerial view to see how porous.
I talked to my pharmacist who had originally sent me to this dr and she too doesn’t like their dexa machine but her numbers aren’t as bad. She just waited a year and then went to Raleigh Radiology higher level place. And her insurance covers one per year.
I think if I am careful and do things in level ground even if there are hills but not too many things at weird angles and not walking on slippery leaves. I think if I don’t go to a swimming pool where I can skip on water or go where there is ice on the sidewalk. If I just carefully do things carefully and I take my supplements , do my walk, take my one exercise zoom class per day that often has weights . Basically stay active and careful . I think I can manage this disease. Yes total life style change .
The question I have now is these osteogenic loading centers - are they safe
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