How often should you repeat DEXA scan if you have Osteopenia?

[tnefeh]

In 2018 when I was aged 25 I had low calcium on blood tests so I was referred for a dexa scan. It found that I had slight low bone density for my age.

Spine -1.3

Hip -1.6

I was diagnosed with osteopenia and prescribed vitamin d and calcium.

I recently saw an endocrinologist about repeating the DEXA scan to see how things are now but he said they don't usually recommend them for people my age? I'm now 31. Is this correct?

I'm in the UK so should I find a place where I can pay to have one done myself or is there no need?

Any input, advice or suggestions would be appreciated! thank you!

[HeronNS]

I'm going to ramble on a bit below, so be aware that I'm not a trained medical person, just someone who has read a lot!

If you have been eating nutritious food, getting exercise which includes weightbearing (can be a simple as a walk!) and don't have any conditions nor are taking medications which might contribute to loss of bone density, you don't need a DXA scan. However, it is important to monitor that low calcium reading. What happens is the body requires calcium for more processes than bone building and when it needs more calcium it will actually take it from the bones if it has to which usually means the blood calcium level stays within normal range.

Hopefully you're absorbing the calcium supplement well. One thing you can do to help that calcium get into the bones is to take Vitamin K2 (not K1). This vitamin tends to be deficient in our modern diet because of the changes in how we raise and feed animals, so a supplement is often necessary. Vitamin D is important for us to be able to absorb calcium, but it is nutrients like Vitamin K2 and also magnesium and a few other items we get from diet, which actually send calcium to the bones.

As for your readings, they may have been below the optimum for your age at the time they were done, which is why the calcium and D were prescribed to you. In fact they are good readings and older people (past middle age) would be thrilled to have readings like that. Just check into your current calcium readings, bearing in mind that this doesn't actually reflect what's in your bones, and if it has remained low, that should be investigated.

Osteoporosis level (-2.5) is a fairly arbitrary number. The story is it was finally settled on in the middle of the night after a lengthy meeting - it doesn't bear in mind differences in body build, nor does it show how strong and flexible boes are. It's a very rough measure, using optimally healthy young adults as the baseline. There are even racial differences so a slender person from, say, the Indian subcontinent, isn't going to have the same bone density as a larger-boned individual from Northern Europe, but both can be equally healthy. So although a DXA scan is useful, in a case like yours for example pointing to the need for adjustments to diet and possibly lifestyle, it is imperfect. Another issue is that different machines and even different technicians, can give slightly different readings, so the ideal is to have subsequent scans done on the same machine and ideally with the same technician. This isn't likely to happen after a gap of several years and certainly won't if you have to go private.

Now, if you do have a medical condition or have to take any medication which contributes to bone thinning, then a DXA scan would be a good idea, but otherwise probably not necessary if you've been living healthily in the interim since the first one.

[Posy-White]

Hello tnefeh,

I was referred like you for OS monitoring at a similar age (27) and managed to keep to the osteopenia stage with 'healthy as possible' exercise and eating until 54 years old by then I had slowly 'just' reached the Osteoporosis stage.

I 've looked back and seemed to have had scans about every 10 years - one problem is you only get a 'best reading' by using the same machine (slight variations) and on two or three occasions the hospital had had an upgrade / I moved and attended a different hospital. At the time the Consultant said the Scans are just part of the picture like the blood tests to monitor Vit D , bone turn over etc. plus your health reports. Eg I had a bad cycle accident car ran into me, I was badly bruised, out cold but only had two hairline fractures in my left foot!

The thing is don't worry too much but really do the best you can re exercise and eating and making sure you don't drop off hospital lists / GP radar for monitoring. - My mother also had Osteoporosis lived without bone fractures and only at 90 had to get help to manage the garden and 93 to manage the housework! I hope I can live up to her ' keep on going' approach!

Good Luck

Posy White

[99real]

Usually people your age don't have DEXA scans. However, if you had one earlier because of deficiencies that affected your bones, I would think it reasonable to see if the remedies you undertook actually helped (either in stopping the decline in bone density or perhaps allowing you to improve). Another option would be to ask if they would do a CTX blood test. A lot of doctors don't know what that is, but it measures the activity of your osteoclasts, which break down bone. If the osteoclastic activity is too high, that means something is wrong. Another point that someone made earlier is to add Vit K2 to your diet. health.clevelandclinic.org/...

[ROSModerator Partner]

Hi tnefeh, It's great to see the discussion and support so far. If you would like to get more information about bone density scans and when repeat scans may be useful, and bone marker tests do check this section of our website theros.org.uk/information-a.... Click on the links there for detailed fact sheets on both topics, and our Bone Matters video on scans and tests. We work with experts in the field to provide up to date, evidence- based information. This can be useful to add to the support from others on this forum. If you don’t find answers on our website, or to discuss your own situation, contact our specialist nurses on 0808 800 0035 (UK).