My Dexa scores are all now below -2.5, but my End says I still have OP. I do??

I do??

[usr2022]

Just a note about DEXA scores: since we are talking about negative numbers, the closer a number is to zero the _higher_ it is.

I suspect you mean your current numbers are higher than -2.5 (are in the yellow or green range in the attached picture)?

Useful page that details both T- and Z- scores:

americanbonehealth.org/bone...

DEXA scores

[Hidden in reply to usr2022]

Thank you for the graph. My scores fall in the Osteopenia range after several rounds of PROLIA. My Endo disagrees, she insists I still have Osteoporosis. This is what confuses me!

[bellybuddie in reply to Hidden]

Unfortunately i think your endo is correct. Osteoporosis is not curable. Meds just made the Dexa reading improved a bit, usually temporarily.

[Hidden in reply to bellybuddie]

Oh I understand now, thank you. You’ve done a better job of explaining the situation I’ll accept & adjust. I appreciate your help.

[usr2022 in reply to bellybuddie]

I wouldn't say this: "Osteoporosis is not curable" but rather explain how medications that exist currently work.

Presuming the person has an ongoing bone loss (osteoclast activity is greater than osteoblast activity, leading to less bone being formed than bone being removed) and they take a medication (like bisphosphonates or Prolia) during that period of time the osteoclasts are slowed down significantly. In case of bisphosphonates (fyi), the medication stays in the body, attached to the bone, for several years after treatment is done, and continues its effects.

After medication is interrupted (or in case of bisphosphonates - several years later), you probably will create again more osteoclasts and remove more bone than you are forming via osteoblasts. So it is likely that you will lose again bone .

Prolia has a similar slowdown effect, but achieved in a different way than bisphosphonates, and needs to be followed by an anti-resorptive to avoid "a vast increase of osteoclast number and activity, which leads to a subsequent profound increase of bone turnover above pre-treatment values, a phenomenon commonly described as rebound phenomenon "

ncbi.nlm.nih.gov/pmc/articl...

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Hidden

I would also say that each OP case can have different circumstances, of why the bone loss occurred, and your endocrinologist probably believes that you will again produce excess osteoclasts that will make you lose bone over time.

Have you been checked for secondary causes of OP? Is it solely menopausal loss of estrogen?

[Hidden in reply to usr2022]

No I haven’t been tested for secondary causes….i will definitely take this up with my doctors. Thank you! (I suspect early hysterectomy/lack of estrogen therapy {breast cancer runs in my family}, pour nutrition, years of lack of vitamin D3, etc, most of all it’s ‘operator error’. I was incredibly healthy for the first 60 years of my life…I was in complete denial & over confident in my amazing body.)

I appreciate your help!! Best to you!

[yogalibrarian]

Congratulations on improving your test results.

Keep in mind that osteoporosis is a chronic medical condition not an acute illness. Even if your DXA scores have changed because of medication or lifestyle intervention, you are not "cured" of osteoporosis. You still have a chronic medical condition that requires ongoing management.

Consider the parallel with high blood pressure. If you take meds and/or manage to lower your BP with diet and lifestyle interventions, you still have high BP, but it's well managed.

[Sch614 in reply to yogalibrarian]

That’s really interesting - I didn’t previously understand that about osteoporosis (or high blood pressure!) thanks for the clarification and analogy. I’d rather it be reversible but I know now that’s not reality.

[yogalibrarian in reply to Sch614]

In general, primary osteoporosis is a condition of aging. (Secondary osteoporosis is related to medical conditions and medications.) But there are many things we can do to manage chronic conditions long term. With the help of good medical care we can now have long-term management of conditions. I have several friends who are now in their early 90s and are still very active. (Nothing will make them 50 -- or even 70 -- again.)

Ethel Siris. who was the President of National Osteoporosis Foundation (now Bone Health & Osteoporosis Foundation) said that the formula is exercise, a healthy diet (with adequate calcium and vitamin D); a healthy lifestyle (don't smoke and limit alcohol); and osteoporosis medication if needed.

[Hidden in reply to Sch614]

Perfectly said. I totally agree

[RubymyT]

I just finished reading an article that said -2.5 and over you are still in danger. Your End would know , but if you're on Prolia , don't just stop. BAD side effects if just stopping

[Hidden in reply to RubymyT]

Yes, thank you! I now understand by agreeing to PROLIA too early (& at all), I’ve obligated myself to staying on the drug or (in my case) transitioning off with RECLAST infusions. I do wish we could have a DEXA/REMS test annually vs every 2 years.

[RubymyT in reply to Hidden]

What country are you in ? I'm in Canada , high risk is allowed 1 bone density(dexa) test yearly. Low risk 3 yrs , then 5 yrs.

Have you ever had any bone breaks