DEXA scan: I’ve got my Endo appt tomorrow and I... - Thyroid UK

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DEXA scan

Wired123 profile image
21 Replies

I’ve got my Endo appt tomorrow and I’ve been reading about DEXA scans and how it’s useful to monitor bone health from time to time, especially now I’m on T3 as well as T4.

Has anyone managed to get such a scan paid for by their private medical insurance? What are the criteria/clinical indication for having this approved?

Many thanks

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Wired123 profile image
Wired123
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21 Replies
radd profile image
radd

Dk123,

I've had several DEXA scans due to osteopenia diagnosed when I about 48 years old. Amazingly medicating T3 has actually increased bone growth. It is incredible. I am also very active and do all the right things to encourage health bones.

Unfortunately the NHS is willing to provide me ongoing DEXA scans with a bit of Vit D thrown in but won't prescribe me T3!

Hope you get one paid for if you feel its needed as results are interesting.

Wired123 profile image
Wired123 in reply toradd

How did you manage to get the Dexa on the NHS? What is the clinical reason that the doctor used?

Simplyred57 profile image
Simplyred57 in reply toWired123

My nhs endocrinologist requested I had a DEXA scan as part of my routine tests .

radd profile image
radd in reply toWired123

Dk123,

Just a part of the investigations before I was diagnosed because my mother had oesteoporosis. The results horrified me and were the main reason my newly acquired private endo then prescribed me T3.

Wired123 profile image
Wired123 in reply toradd

What other things do you do to help keep your bones healthy?

radd profile image
radd in reply toWired123

Dk123,

Bone is continuously broken down & replaced by osteoclasts/osteoblasts.

Healthy bones like an optimal T4/T3 ratio so old bone can be dissolved/resorbed and new bone can be produced to replace what was resorbed.

Thyroid hormones too low and both bone resorption/production decreases (osteoporosis, osteopenia). Thyroid hormones too high & bone absorption exceeds bone production with a net loss of bone mass. Elevated SHBG is a good indicator that osteoporosis risks are being increased.

Other bone encouragers/preservers are oestrogen (estradiol). Endo suggested HRT but it took me another year to agree. Then the usual weight bearing exercise, a healthy diet including high calcium foods, optimal nutrients (especially Vit D/K but others such as magnesium).

I was due another DEXA last year but it's been postponed due to COVID. If I ever get there it will be interesting to see any further changes.

london81 profile image
london81 in reply toradd

very interesting radd thank you!i had a dexa privately this week. all fine on the bone density front

my shbg is high, fsh high and oestrogen falling, so i’m assuming i’m in peri menopaose

my ft4 is low only 4 % and ft3 56% so i’m not quite sure what’s happening! have increased ndt to 5 grains. anyway thanks for this info it’s great

wellness1 profile image
wellness1 in reply toradd

If you don't mind my asking, has your TSH remained in the reference range on T3? Or did you see improved BMD from T3 with a low or suppressed TSH?

You mentioned that you also began HRT. Was this after you already saw improvement in BMD from T3?

radd profile image
radd in reply towellness1

wellness1,

Except when I was first diagnosed with a TSH of 45.2mu/L (0.27-4.2), it has always remained well under-range in varying degrees, no matter what meds I take.

I was diagnosed osteopenic long before adding T3 to my Levo in 2015. T3 was then withdrawn in 2016 by local CCG so I switched straight to 1.25mcg grains NDT and had another DEXA in 2017 which showed remarkable improvement.

In-between time (around 2016) my endo finally persuaded me to start HRT which once on I wished I had started before. His reasons apart from deficient O&P were low mood since starting T3 and my osteopenia. It helped the low mood too.

I haven't had another DEXA since but hopefully will be called at some point. I remain on NDT & HRT. My FT3 levels have never been high.

wellness1 profile image
wellness1 in reply toradd

Thanks, radd . It sounds like it was some time between DEXA scans. (I assume you have repeat scans on the same machine) I'm glad you've sorted your thyroid treatment and have seen improved bone density as well. I hope that continues for you.

fuchsia-pink profile image
fuchsia-pink

I got one on the NHS - in the (unnecessarily large) gap between being referred to an endo and actually seeing one. Big fan: it gives you a really useful benchmark to use when under-informed docs try and tell you that raising your T3 is a one-way ticket to doom and destruction

It was before I found this forum; my blood results (no T3 and not actually given to me) showed I was "over-medicated" but the very small reduction I had made to levo (from 125 mcg x 3 days/150 mcg x 4 days to 125 mcg x 5 days and 150 mcg x 2 days) had made me feel substantially under-par but not altered my bloods and I had (very politely) declined to go lower.

The (arrogant patronising) new GP was worried that his lack of knowledge and my refusal to reduce my meds might backfire against him, so sent me for a dexa scan and a referral to someone else - simply to get me off his hands ;)

[I've since seen a MUCH better young female GP at the practice but think I'm still technically assigned to the first one - he sent me a letter the other day that was almost funny in its lazy wrongness]

nellie237 profile image
nellie237

I had a DEXA scan a couple of months ago on the NHS. I filled in the Sheffield University FRAXX tool (took about 5 mins), and sent it to my GP via e-consult. There's a traffic light score, and mine came out amber, so he couldn't refuse. Hope this helps

sheffield.ac.uk/FRAX/tool.a...

radd profile image
radd in reply tonellie237

nellie237,

Hey that good. Saves a grovelling appointment.

I haven't seen that online for patients to complete before.

nellie237 profile image
nellie237

I only waited about a month for the scan too. .....Osteopenia...so, OK.

penny profile image
penny in reply tonellie237

I haven’t got the link to hand but have posted it before that ‘osteopenia’ is a made-up condition.

helvella profile image
helvellaAdministrator in reply topenny

Osteoporosis is, as I understand, when bones break easily.

Doesn't osteopenia simply refer to states between good, healthy, strong bones and osteoporosis?

Cooper27 profile image
Cooper27 in reply tohelvella

My partner has Osteoporosis and Osteopenia.

Osteoporosis is where the bones have thinned to the point that they break easily.

Osteopenia is the bone equivalent of pre-diabetes. The bones are thin, but not quite to the point of osteoporosis. It means you need to take interventionary measures and be careful.

penny profile image
penny in reply tohelvella

...found it:

npr.org/2009/12/21/12160981...

helvella profile image
helvellaAdministrator in reply topenny

The term osteopenia itself dates from at least 1963 - thirty or so years before the period that link is referring to.

Fracture of the month. 33. Osteopenia with fractures of lumbar vertebrae

pubmed.ncbi.nlm.nih.gov/139...

Treatment of osteopenia by Fosamax is, indeed, something that needs to be looked at carefully.

penny profile image
penny in reply tohelvella

Ah, so they didn’t invent the name.

london81 profile image
london81

my dad got one at the recomendation of endocrinologist ( which was a bit ironic as i had been the one who helped him get onto ndt, did all the leg work and wrote to endo but i myself have never been offered a scan)i assume the clinical reasoning would be patient is taking a medication which can be present in cases of thinning bones ( i understand that is not actually the case that taking t3 causes it, in fact it’s hyperthyroidism that’s the cause. although many women over 50 break bones and suffer due to bad medical care and lack of hrt provision, but for the purpose of your question i’ll forget that)

i got a dexa scan this week privately it costs me £125 as they have an offer on. it’s called body scan and they are based in london- let me know if you want their email

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