Got my results today, (apologies if this post is a bit long). The Summary letter says:
RESULTS:
With the lowest T-score of 1.5 in the Neck of Femur and Lumbar Spine (L1-L4) this examination confirms the diagnosis of Normal BMD as per WHO classification including ISCD recommendations.
RECOMMENDATIONS:
Clinical decision regarding management of patients with confirmed bone loss conditions should be made following the NICE, NOGG and other relevant guidelines. Life style advice aimed at preserving bone health and minimising the risk of falls should be provided; that includes assessment of dietary Calciumin take (700-1200mg/day) and VitaminD (400-800IU/day) with supplementation if required, maintaining physical activity adequate to patient condition ,smoking and alcohol cessation etc.
Further assessment regarding fracture risk can be done with the FRAX tool available at shef.ac.uk/FRAX.
FOLLOW-UP:
Individuals with diagnosed cases of osteoporosis or a thigh risk for fracture should have regular bone mineral density tests. Intervals between BMD testing will be determined according to each patient' s clinical status. If the original calculated risk was in the region of the intervention threshold for a proposed treatment a repeat scan should be considered only after a minimum of 2 years, or when there has been a change in the person's risk factors (see Nice CG146).
My spine readings:
BMD (g/cm2) YA T-score AM Z-score
L1 1.250 0.9 1.1
L2 1.308 0.8 1.0
L3 1.372 1.2 1.4
L4 1.553 2.6 2.8
L1-L2 1.279 0.9 1.1
L1-L3 1.313 1.1 1.2
L1-L4 1.386 1.5 1.7
L2-L3 1.341 1.0 1.2
L2-L4 1.424 1.7 1.8
L3-L4 1.471 2.0 2.2
My femur readings:
Neck 1.241 1.5 2.5
Total 1.254 2.0 2.1
My Frax 10 year probability of hip fracture:
Major osteoporotic fracture - 3.2%
Hip fracture - 0.1%
Now I don't know what all the figures mean but I think the overall means that I am OK'ish with regard to bone density??? The Recommendations and Follow Up section seem to be a bit generic and I don't know whether I should be taking any further meds. I am currently on 27.5 mg Pred having just started tapering and have been on Pred since the end of May (commencing at 15 mg and increasing to 30 mg). GP and I have been waiting for these results to see if I should take Calcium, Vit D and AA. I have never had a calcium rich diet, but since PMR have been taking Pred with yoghurt and milk. Generally think I get enough sunshine (as much as you can in the UK) as I was walking round a golf course three times a week before PMR. Don't fancy taking the AA unless necessary (having read possible effects).
Any help and advice would be gratefully received (as usual)
Regards
LBM1953
Written by
LBM1953
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Your results are normal, being on pred means that vit D supplementation and good calcium intake is adequate - THERE IS NO REASON AT ALL TO START BISPHOSPHONATES!!! You have one slightly didgy vertebra, that isn't unusual for some reason but even it isn't osteoporosis.
Sunshine is NOT enough - in the UK it is only useful between 11am and 3pm from May to September! And at 60 we produce about a quarter of what we did at 20! You really need a vit D blood test to find out your status and work from there! I have not taken AA, but I do take 4000 IU vit D per day, summer and winter. Without it my vit D level falls steadily. You MAY be replete - but you can't assume that whatever your lifestyle. I live close enough to the equator for vit D production to be possible almost all year round. The local population - very keen on outdoor sport or working outdoors - has one of the highest rates of melanoma in Europe but something like 80% of them are vit D deficient.
I'd also have a look at how much calcium you are getting - I'm sure there is an app for that You may not need a calcium supplement - I did because i didn't have that much dairy in my diet - but maybe some extra. The dietician wanted me to stop ALL dairy to get the cholesterol level down - but it made no differenece. Then she panicked about the calcium. They want it all ways ...
Calcium is also in lots of other foods too. Fatty fish and fish with bones in such as sardines/mackerel and tinned salmon. Many vegetables and fruits contain calcium too.
Around 9 months into the journey and still on 40mg, way over the amount for PMR. aches and pains appeared.
GP did full spectrum blood test, result Vit D deficiency
The deficiency causes aches and pains just like PMR. It is an exclusion test in the diagnosis of PMR.
40,000 units per day for four weeks, another test, result still not up to speed, 20,000 units for two weeks, another test and bingo.
I still take, just like PMRpro, 4000 IU vit D per day, summer and winter and have done for the last 7 years. If I did not take it, levels would drop quickly.
A Radio 4 programme talked about the use of slip, slap and slop as a contributing factor.
Your results look pretty impressive to me. On the other hand my GP would still say you need AA even if your bones were like girders. A lot of doctors seem to have read that anyone on long term steroids should take a bisphosphonate irrespective of the Dexascan result. Hopefully your doctor is not so pedantic.
I've just had my appointment dexa scan end of Aug, if that what my results are going to look like I'm still not going to have a clue, what they mean, what they should be etc. Even what to expect from the scan itself
Hi. The scan itself is nothing. Fully clothed, lie on bed, machine goes over the top and takes the pictures. Over in 5 -10 minutes. No dietary restrictions.
Hi All. A follow up post. Couldn't get my Vit D level checked because GP said that it wasn't possible without telling a white lie. Didn't understand this but she has prescribed 400U Colecalciferol daily (800IU, not sure what the difference is between U and IU?) Started these today. Has anyone else had difficulty in getting a Vit D test and can they be done privately easily?
done by an NHS lab in the Midlands. Get together with friends and the price per test is lower.
IU is International Units - just the way it is measured.
400 IU in the calcium supplements is next to useless. I take 4000 IU all year round and that just keeps me at a good level. I buy a decent vit D supplement from the chemist. The assumption is made that we get a lot from sun - in your dreams in the UK! It is only possible between 11 and 3 from May to September - and there is next to none in food except wild salmon and some (though not a lot) in eggs and mushrooms - you could get what you need in a day from a 17 egg mushroom omelette
I (think) I have found out why my GP found it difficult to get me a Vit D test. Essentially it is because there was such a demand for them and drain on resources that the NHS decided that "......only in those patients who present with symptoms such as bone pain, muscle weakness, symptoms suggestive of rickets, or those patients who have low serum calcium levels. Public Health of England advises everyone not just “at risk” groups to take 10 micrograms (400 international unit) of vitamin D daily.” Hey Ho, I'm sending off for my own test (many thanks PMRPRO)....
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You may not need a calcium supplement - I did because i didn't have that much dairy in my diet - but maybe some extra. The dietician wanted me to stop ALL dairy to get the cholesterol level down - but it made no differenece. Then she panicked about the calcium. They want it all ways ...
BONE DENSITY BETTER. same machine. Yippee Skippy.
Please share experience or advice re Risedronic acid and zoledronic acid use for low T score/ osteoporosis in GCA/PMR.
DEXA Scan Results
Dexa scan results
