Bone Density Test and Scores

[Sad Eyed Lady]

Today I stopped in at a health fair and had some free testing done. My results were good in everything, except my bone density T score was -2.1. They told me I needed to talk with my doctor and make sure he/she was aware of this result etc. The thing of it is: I am an extremely healthy person, so much so that I don't currently have a family doctor since I have not had a true illness for several years. I have had a broken bone which resulted in a visit to the ER, then to a surgeon for a cast, and that has been almost 7 years ago. Currently I am seeing a chiropractor due to a neck problem that comes and goes, but as far as day to day health I can't complain. Blood pressure runs low, cholesterol is good, blood sugar is good - all that stuff. I do not take any prescription medications. So, back to the topic at hand: I walk, do strength training, try to eat healthy and stay active. I don't want to take on a medication for this if at all possible. What else can I do, and is this score something I do need to be concerned about? The risk factors that I see for me is that my mother did have osteoporosis, and I have a small frame. I always thought my mother's osteoporosis was caused by a somewhat unhealthy lifestyle in that she smoked, did not eat healthy, and also from the fact that she had hyperthyroidism and was on medication for that for years and years. I know it wrecks bone health. Just would like some input from you if you have had a score similar to this and what you were advised to do about it. :thankyou:

[catherine]

Yes...I can offer my experience.
When I was in my mid-late 40s, I started doing a LOT of market research for the people who make Fosamax. I literally talked to thousands of women for years and learned a lot about osteoporosis.

so when I turned 50, I went for my physical and pretty much had to demand a bone density test (standard now is 65 years old). I really believed I had nothing to worry about, because like you, while my mother was a smoker and ate m&ms for breakfast, I felt I was VERY healthy in comparison.

Well, when I went in for the imaging the technician said, "Good thing you made your doctor order this test." I was shocked. Turns out I have osteopenia in two places, and a bit of osteoporosis in another place. I got a prescription for Fosamax, but to be honest, only took it for a couple of months.

I've had one bone density test since then, and I've been stable.

So, here's what I think:

--Sometimes you start with a lower baseline than everyone else. Those T-scores and Z-scores are relative--so they compare you with everyone else. If you are small boned, you may just naturally have a less bone density by comparison. So the big thing is, get a follow-up in a year or two and see where you are in comparison to baseline.

--Here is some literature: Miriam Nelson has a book out about exercises for osteoporosis. http://www.youtube.com/watch?v=4iJ-KsoPESk
I saw her at a health fair, and I bought her book as well.

--Here is evidence that certain (NOT ALL) yoga poses can be core-strengthening: This is a great pdf http://www.sciatica.org/downloads/YogaOsteoporosis_PilotStudy.pdf

As for diet, I may be an outlier, but I do believe that while taking a calcium/Vitamin D supplement may help, it may not do a whole lot either. There are studies that have shown that taking extra calcium may not be as bone-protective as people think. Also, keep in mind that I do not eat meat and I have one eye open on the whole theory that the acidity in animal protein could leach calcium from the bones. Again, controversial, unproven, but it's definitely a hypothesis out there.

OTOH, in one study, they gave resveratrol (found in red wine) to mice, and those mice had much better bone density to the control group. So, I see that as a great excuse to have a glass of red wine now and then!

Eat a lot of leafy greens and sardines: find a good chart for ensuring you're getting enough calcium and be sure you combine that with Vitamin D.

I do think you need to monitor it and read up on it (despite my market research involvement, I do NOT claim to be an expert). The worst thing I think is letting yourself get to the point of kyphosis (dowager's hump). If you have this information now, you need to act on it.

[CathyA]

I wouldn't take any med for it, without a repeat test at a reputable place.
I agree with the Vitamin D and calcium.

[JaneV2.0]

I wouldn't touch osteoporosis medication, personally. It can lead to esophageal cancer (see Ann Richards) and anomalous bone growth that is in no way health promoting (jaw spurs, anyone?). If I were concerned about weak bones (I'm not), I'd get some vitamin D-producing sunshine (along with D3 and K2), take a variety of minerals optimized for absorption, and eat plenty of protein (with adequate calcium), which has been shown in trials to aid bone growth in old women:

Conclusions: The highest quartile of protein intake (: 72 g/d) was associated with higher BMD in elderly women at baseline only when the calcium intake exceeded 408 mg/d. In the longitudinal study, no association was seen between protein intake and the rate of bone loss, perhaps because the sample size was too small or the follow-up period of 3 y was not long enough to detect changes. (American Journal of Clinical Nutrition)

And, from http://aje.oxfordjournals.org/content/155/7/636.long :
This prospective study supports the possibility of a positive role for dietary animal protein in the skeletal health of elderly women. It also provides some indication of an interaction between dietary protein and calcium in women, with increased protein consumption appearing to be most beneficial for those with low calcium intakes. This study also suggests that dietary protein may play less of a role in the skeletal health of elderly men as compared with women. These findings, along with the intriguing observation of a negative association between vegetable protein consumption and BMD, have significant implications for osteoporosis prevention strategies and warrant further investigation in elderly cohorts.

At the very least, I'd do a thorough study of the efficacy (or lack thereof) of currently-prescribed osteoporosis drugs before considering taking any. And I'd step up weight-bearing exercise, including weight training for good measure.

[Sad Eyed Lady]

Thanks everyone - I knew I could depend on you for sound advise. Like some of you have mentioned, I have no desire to take the osteoporosis medication and I do try to get my share of sunshine when possible. Also in agreement with your sage wisdom, I am going to wait a year and with the test repeated I will be able to tell if this is more "normal" for me of if I am losing bone mass at an alarming rate. I will continue with my walking, yoga stretches, healthy diet, sunshine, and when this neck problem is at least partially resolved I can go back to strength workouts with weights.

[Rosemary]

I had one of those low-cost public health screenings for osteoporosis last year. The equipment measured the bone in the heel. My score was similar to yours, if I recall correctly, which I found alarming. I did some research afterwards about the correlation of scores from this kind of test to the more accepted x-ray bone density testing, and it seemed that there was not a lot of correlation. SO if you are concerned, I would suggest talking to your M.D. about having a baseline bone density test done. That's my plan.

Also, another note - I suggest reading/asking how often "osteopenia" actually leads to osteoporosis. My grandmother is currently 84 and has been labeled as having osteopenia for years, but it has never progressed.

[Jemima]

Osteopenia is normal for aging women. Merck, the maker of Fosamax, is responsible for leading us to believe it is a disease.

There is now a lot of doubt about the results of bone density (dexi-scan) tests with regard to fractures. There are apparently other factors to be considered. I can't lay hands on the articles just now, but bone density isn't necessarily the only component of bone health.

Be leery of any test or "diagnosis" that leads back to a drug. Drug company research is notorious for misleading doctors and producing tainted results. Please avoid all osteoporosis drugs for the time being. Fosamax and similar drugs actually increase bone brittleness over the long run (more than five years) and Evista (which I took for several years) is a synthetic hormone that increases the risk of ovarian cancer.

I think that we will eventually find out that the whole osteoporosis scare is nothing but that. Keep doing what you're doing. Stay well.

[lhamo]

I also encourage caution about the anti-osteoporosis drugs. It is just anecdotal, but I have STRONG suspicions that my mom's declining heath over the past decade was largely kicked off by these drugs. I will never take them.

lhamo

[iris lily]

I have severe osteo on my mother's side off the family. When she broke her 2nd hip the Dr. told my brother that her's were the worst he'd seen lately. Her brother, my uncle, had dowager's hump. My mother exercised into her old age and did not drink or smoke.

I know that my dentist has remarked on my bone loss.

But all of that said, tra la tra, what, me worry?!!! I like what my friend's mother's Oesteo Doc said: when you carry more weight around you are in effect doing weight bearing exercise and that strengthens bones. So those extra pounds I've got is good for me in one regard. I doubt that I'll take medication.