This week I got a relatively new bone health test called the Echolight REMS scan. It is found to be more reliable than DEXA scans and gives information not only on bone density but also on bone quality/fragility. Unfortunately this scan is not covered by insurance and is not widely available but it may be worthwhile if you can find a place that does the test and if you can afford it. You receive a detailed printout of your results about 10 minutes after the scan is done. I got mine done in Dallas, Texas, and it cost me $150. It is recommended that you get one every year to be able to track your progress.
As I mentioned above, the scan measures not only bone density, as the DEXA does, but also bone quality/fragility. This information was very enlightening to me. Be sure to ask the technician to measure bone quality/fragility if you get a REMS scan. Most technicians should know to do so but be sure to ask.
The DEXA and the REMS bone density measures are not actually comparable. Also, the DEXA results can vary from machine to machine as well as from one technician to the next. The REMS scan is felt to avoid these 2 drawbacks. A European study cited in the video linked below found that 90% of DEXA scans had some error, and 50% of the scans had significant errors. Also in the video linked below at the time stamp of about 2:30 Dr. Brown tells the story of a woman who was "terrorized" by her DEXA results for 13 years. Then she got a REMS scan and found she had fine bone health and very little risk of fracture. This woman states that the REMS data was "life changing." At the end of the video below Dr. Brown also talks about the negative effects that stress and fear have been found to have on bone health and mentions the benefit of happiness on bone health. I love her positive, holistic approach.😄
Here's the link to the video. I enthusiastically recommend getting this scan if you can do so.
Thanks for sharing your experience. I am scheduled for a REMS test in February. I suspect (and hope) my DEXA scan was erroneous since it cited severe OP yet when I fell down four times since that test no bones broke. Or it may be that the DEXA correctly measured what it was designed to measure, but that didn't include bone strength. I will find out. Glad you had the opportunity to get the REMS, those machines are few and far between in the US.
You're welcome. I'm glad you're getting a REMS test in February and hope it gives you more positive results. Yes, I'm also suspicious about the accuracy of your severe OP diagnosis since you had no broken bones from the 4 falls. By the way, the REMS test declared that my T-score for my spine is -2.6, which is concerning. However, my fragility score for the spine is 23.2, which is in the green zone. Below is the image of my spine fragility score. I'm still going to work to reduce my T-score through weight training, diet and so on, but the fragility score is encouraging. Best wishes on your upcoming REMS results.
I recently had an Echo Light test by Dr. Andy Brown in N.C. (pictured in the video link). The Dexa scan had been inaccurate and my osteoporosis was actually worse in my spine, BUT and this is the important part.... my fragility score was good. I'm guessing that is similar to 99real. Based on DEXA, the physicians were telling me to take medication - Dr. Bush agreed that it is not needed, but I will take supplements and do strength training and exercise to nudge the score into even better territory.
The $150 is not covered by insurance but well worth it if you can afford it and can get the test. REMS has a good history in Italy as well as the U.K. and is first now starting to be more available in the states.
Gosh, I'm so glad that you got an Echo Light test and that the strong case could be made that you don't need to be on medication. I heard someone say that the DEXA test, by giving information on bone density, can tell you, to make an analogy, that your dining room table has 4 legs, when it should have 6. The Echo Light test can give you additional information about bone quality and tell you that the 4 legs of that table are made of solid wood and not cardboard. Therefore, you should have little need to be concerned that your dining room table will collapse.
Yes, I absolutely agree that the Echo Light test is well worth it if you can afford it. Hopefully, this test will gradually replace the DEXA test as the best assessment and then be covered by insurance.
This is great information I have had 3 or 4 Dexa scans with different results. All on different scaning locations, my last scan was inproved results which leads me to believe other scan results gave an inaccurate result implying worse than actual. Which this made perfect sense to me because I was not having pain or any type of fractures or breaks. But the doctor's kept double checking are you sure you haven't broken or fractured anything? Apparently on earlier results of scans would lead them to believe more bone loss thus believing should be evidence by fractures. Thankfully I've had none. And I'm also appreciating that I didn't just go ahead and take their strong suggestion treatments for more advanced osteoporosis patients.
Great. I'm glad you're looking to get a REMS test. I hope you find a place like I did which charges $150 or so. I'm so glad I got mine. The DEXA is relied on by most doctors, I think, because they feel it's the best one in existence and they don't want to recommend a test not covered by insurance. Most doctors probably don't even know about the REMS test.
Here is an analogy which might help your doctor understand why you are seeking out a REMS test. The DEXA test, by giving information on bone density, can tell you that your dining room table has 4 legs, when it should have 6. The Echo Light test can give you additional information about bone quality and tell you that the 4 legs of that table are made of solid wood and not cardboard. Therefore, you should have little need to be concerned that your dining room table will collapse.
And it is pretty well known even by traditional doctors that the DEXA test's reliability is poor. Results can vary greatly from one machine to the other and from one technician to another.
By the way, REMS tests expose you no radiation at all, unlike the DEXA test.
Hi can you possibly give the contact for the place in Dallas you went to, I know they have REMS in College Station but I drive to Dallas once a week for OsteoStrong so this may be better for me. I could do both on one trip.
To schedule an appointment for the REMS test, you can call 972-999-1765. I believe the technician at the center who does the tests is named Michelle. She was more than nice. The test is painless and takes about 30 minutes to complete. When the test is done, the technician prints out your results in a couple of minutes and gives you the copy to take with you. It is recommended that you get a REMS test once a year to assess your progress.
Also, feel free to check out the YouTube channel for Optimal Bone Health with Dr. Doug Lucas, a retired orthopedic surgeon. He advocates getting REMS tests rather than DEXAs, and he has a lot of sound advice.
Best wishes on getting this test done. I hope the test results empower you as you seek to manage your diagnosis. Feel free to ask me more info if you wish.
I had the opportunity to receive a REMS while visiting family in Dallas, and I find the results puzzling. My most recent DEXA is from two years ago, and I’m scheduled for an update in a few weeks, but I am hoping to have at least slowed the rate of decrease with two years of added supplementation and intense exercise. I have never fractured. I did expect the REMS to be in the ballpark of the DEXA, but that did not happen.
From DEXA January 2022: Lumbar T-score -3.2; Femoral necks -1.4 and -1.9; TBS -2.0; FRAX 10% major and 1.6% hip; Vertebral Fracture Analysis normal
From REMS Feb 2024: Lumbar T-score -1.8; Femoral necks -2.2 and -2.3; Fragility score for spine 31.9; Fragility score for hips 41.9
I understand the different technologies involved in how these machines measure density; however, with such striking contrasts, it’s hard to know which to believe. Seems illogical to accept REMS lumbar score and the DEXA femur score, while ignoring the REMS femur score and the DEXA lumbar score. Also, that fragility score is a bit scary. I am looking for as much information as possible to either push me to start Tymlos or justify my continued refusal of medications. For now, I will keep doing what I’ve been doing,, although my endo will likely scoff at the REMS results.
Hi, I'm sorry your DEXA and REMS scores are confusing. My DEXA and REMS scores were pretty different too. But I have much more confidence in the REMS results. Your REMS fragility scores are higher than you'd like, I know, but I still wouldn't take medication. I would keep watching your diet, using supplements and doing weight bearing exercise for the time being.
My last REMS results: Spine T-score -2.6, fragility score 23.2. My femoral hip T-score -2.7, fragility score 31.8. I'm watching my diet, taking supplements and doing weight bearing exercises and am choosing not to take medications. I've had osteoporosis for years and haven't had a fracture yet.
I found the video by Dr. Susan Brown on YouTube described below to be very helpful, and it features 2 doctors who really like the REMS test. In the video the doctors state that the DEXA and the REMS bone density measures are not actually comparable. Also, the DEXA results can vary from machine to machine as well as from one technician to the next. The REMS scan is felt to avoid these 2 drawbacks. A European study cited in the video linked below found that 90% of DEXA scans had some error, and 50% of the scans had significant errors. Also in the video linked below at the time stamp of about 2:30 Dr. Brown tells the story of a woman who was "terrorized" by her DEXA results for 13 years. Then she got a REMS scan and found she had fine bone health and very little risk of fracture. This woman states that the REMS data was "life changing." At the end of the video below Dr. Brown also talks about the negative effects that stress and fear have been found to have on bone health and mentions the benefit of happiness on bone health. I love her positive, holistic approach.😄
To get to Dr. Brown's video, enter this in the search box on YouTube, and the video should come up:
NEW OSTEOPOROSIS TECHNOLOGY: Understanding Your REMS Report for Future Stronger Bones
Also, you may want to check out Dr. Brown's website:
betterbones.com/
Also, you may want to check out Dr. Doug Lucas' great video on REMS results. He likes the REMS test and dislikes the DEXA test because of its unreliability.
Dr. Lucas has a free YouTube channel called the Dr. Doug Show that is great as well. Dr. Lucas will prescribe drugs for his osteoporosis patients only in severe cases and only when other measures have failed.
I watched and read these resources prior to having the REMS, which is why I was so enthusiastic about being able to get one. They are encouraging, as are your words. What I needed was someone else to say stay calm and carry on, so thank you.
You're welcome. I know that navigating through the health care system with osteoporosis can be like paddling through a river with treacherous rapids in a fragile canoe. I'm glad to provide some encouragement.
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The test is painless and takes about 30 minutes to complete. When the test is done, the technician prints out your results in a couple of minutes and gives you the copy to take with you. It is recommended that you get a REMS test once a year to assess your progress.
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