Your bone density is the amount of bone mineral in your bone tissue. It is measured by the amount of mineral mass per volume of bone. In the clinical setting, it is measured according to optical mass or density per one square centimeter on the surface of a bone when imaged. When having a bone density test, it will provide a picture or snapshot of your bone's health.
Why is a Bone Density Exam Necessary for Bone Density Management?
The only way for your doctor to determine if you have osteoporosis is to perform a bone density test. The test will estimate your bone density and your chances of breaking bones. The NOF (National Osteoporosis Foundation) recommends a bone density test of the spine and hip with the use of a dual-energy x-ray absorptiometry machine.
- DEXA- Dual-energy x-ray absorptiometry machine uses a small dose of ionizing radiation, which can produce images of the inside of your body so the doctor can measure bone loss. The machine is mainly used to diagnose osteoporosis. It will also assess a person’s risk of developing fractures related to osteoporosis. The test is quick, noninvasive, and simple. It is considered the most standard method used to diagnose osteoporosis.
There is little preparation for taking this test. Tell your doctor or the technologist if there is any possibility you could be pregnant or if you've recently had a barium exam. They will need to know if you have had an injection of contrast material for a CT scan.
Leave your jewelry at home and wear comfortable, loose clothing. For most types of bone density testing, you are able to remain fully clothed. You will need to make sure there are no buttons or zippers in the area you will be having scanned. The test should take about fifteen minutes and will not include any form of needles or instruments being used on your body or skin.
A DEXA test uses very little radiation. The standard x-ray is not able to be used when testing for bone density. Conventional x-rays do not show osteoporosis until it has advanced into a severe case. An x-ray may be used in conjunction with the DEXA if it is necessary to find broken bones in your spine or anywhere else in your body.
Do not take a calcium supplement for at least twenty-four hours before having the test.
The bone density test can advise you whether or not you are at risk with your bones or if you have osteoporosis. Another name for a bone density test is a bone mass measurement test. This test will estimate how much bone you have in your spine, hip, and sometimes other bones. With the results from this test, your doctor at All Women's Care can help you create a prevention or treatment plan to protect your bone's health.
The results of the bone density test will let your doctor know if you have a healthy bone density or if it is low. The test is the only way your doctor can determine if you have osteoporosis. The lower the density of your bones, the higher the risk you are at for breaking a bone.
Osteoporosis is not something a person can see coming; it is a debilitating disease and sneaks up on people. This disease is often referred to as the silent killer as there are few warning signs, and the symptoms that do appear are easy to overlook.
Unfortunately, without a bone density test, a person does not find out they have osteoporosis until they have broken a bone. Statistics show that more than ten percent of people who fracture their hip will die within six months. Those numbers go up within two years of a hip fracture to more than twenty percent of the patients dying.
Osteopenia is the early stages of the disease, and there are few symptoms. The ones you may experience are often just considered part of getting older. As osteoporosis progresses, the symptoms become much more severe. When the disease begins weakening your bones, you may start to experience back pain which has been caused by a collapsed or fractured vertebra. Over time you will notice a loss of height or stooped posture. Your bones will also begin to break much easier.
When osteoporosis is caught early, it can be treated to prevent some of the more severe consequences such as the breaking of bones or loss of height.
Screening Tests for Bone Density Management
There are also screening tests done, which allows your doctor to measure bone density in your heel, fingers, wrist, and lower arm. These screening tests are called peripheral tests and include:
- Peripheral Quantitative Computed Tomography (pQCT)
- Peripheral Dual Energy X-Ray Absorptiometry (pDXA)
- Quantitative Ultrasound (QUS)
These tests are able to identify those who are likely to benefit from more extensive bone density testing. They are useful when you have to have a DXA, but the machinery is not available. Screening tests are often performed at health fairs or in some medical facilities. They offer people the opportunity to discover if they are at risk for osteoporosis and if they should seek further medical testing. A screening test is not able to accurately diagnosis osteoporosis. The screening also cannot tell a patient if their osteoporosis medication is working.
Anytime you have a peripheral or screening test done; you should follow up with your physician at All Women's Care. Discuss with them any further testing that may be necessary.
People who are considered large in size may not be able to have a test performed with the DEXA machine. Someone weighing more than 300 pounds will not be able to have their hips or spine measured by these machines as most will not accommodate their size. There are a few machines capable of measuring someone up to 400 pounds, but these are not widely available.
If the hips and spine cannot be measured with the DEXA machine, your physician at All Women’s Care may recommend a central DEXA test of your radius bone in your forearm along with a peripheral bone density test of either your heel or some other bone. The results from both of these tests will give the doctor complete information on your condition and determine your need for treatments or preventive measures.
What You Can Learn From a Bone Density Test
You and your doctor can learn several things from a bone density test, including:
- Your doctor will be able to predict your chances of breaking a bone in the future
- You can determine if your bones are weak or if you have the disease osteoporosis before you break a bone
- Discover if your osteoporosis treatment is working if you have already been diagnosed and are being treated
- Check the density of your bones to determine if they are staying the same; the condition is worsening or improving
- Determine whether or not you have osteoporosis
Risk factors include:
Sex- females are more at risk than males for developing osteoporosis
Age- the older a person gets, the higher the risk
Race- Asian and white descent has a higher risk of developing osteoporosis
Family history- if you have a family member, parent or sibling, who has developed osteoporosis, your chances are higher for developing it as well
Body size- females or males who have small body frames tend to be a higher risk for osteoporosis. These body frames have less bone mass to draw from as they get older
Hormones- people who have lower sex hormone levels tend to have weak bones. This weakness is caused by the reduction of estrogen levels in females during their menopause. During the menopause process, females become more at risk for osteoporosis. The testosterone levels in males graduals reduce as they age. Treatments for prostate cancer that lower testosterone levels and treatments for women with breast cancer, which reduce estrogen levels can also accelerate bone loss.
Thyroid problems- if a person has too much of the thyroid hormone, it can cause them to lose bone. This loss happens if your thyroid is overactive. It can also occur if you take too much of your thyroid hormone medicine as a treatment for an underactive thyroid.
Low calcium intake-those who have a lifelong lack of calcium intake are at risk for developing osteoporosis. A lack of calcium contributes to diminished bone density, increased risk of fractures, and early bone loss.
Eating disorders- when one severely restricts their food intake, which causes them to be severely underweight, it weakens bones. This weakening can occur in both males and females.
Gastrointestinal surgery- gastrointestinal surgery used to reduce the size of one’s stomach or to remove part of the intestine will limit the amount of surface area available on the bones. Without this surface area, the bone cannot absorb nutrients, including calcium, the bones need to survive. This condition can result in osteoporosis developing.
Medication and Steroid use- when a person uses steroids or takes oral and injected medications; such as cortisone and prednisone, it will interfere with their bone-rebuilding process. Other medicines used as prevention or treatment for cancer, transplant rejection, seizures, or gastric reflux can put a person at risk for osteoporosis.
Medical conditions- there are certain medical conditions that put a person at a higher risk for osteoporosis. These conditions include inflammatory bowel disease, celiac disease, lupus, rheumatoid arthritis, multiple myeloma, kidney or liver disease.
Lifestyle choices- some people make bad lifestyle choices that put them at risk for developing osteoporosis. Sitting for long periods during the day puts a person at a higher risk than those who enjoy a more active life. There are some activities such as jumping, dancing, walking, running, dancing, and weightlifting, which are particularly helpful in fending off osteoporosis.
Regularly consuming two or more alcoholic beverages a day puts a person at risk of osteoporosis as well as the use of tobacco.
Who Should Have a Bone Density Test?
The National Osteoporosis Foundation (NOF) suggests that you have a bone density test if:
- You are a male age 70 or older
- You are a female age 65 or older
- You are a postmenopausal female under the age of 65 with risk factors
- You are a menopausal aged female with risk factors
- You are a man between the ages of 50-69 with risk factors
Strong bones are essential for your overall good health. A BMD (bone mineral density) test will compare your bone density to that of a healthy person. It compares to the same sex and age as you to show whether or not you have osteoporosis. It will also show if you are at risk of breaking your bones, or if your treatment for pre-existing osteoporosis disease is working.
Low bone mass is an indication of osteoporosis, but not everyone with low bone mass will get the disease, they are just at a higher risk. There are ways for you to slow down bone loss if you get a diagnosis early. Eating foods rich in vitamin D and calcium, as well as performing the weight-bearing exercises, will help you maintain your bone mass. Your doctor at All Women's Care may be able to prescribe certain medicines to help you slow down the process as well.
If you are taking an osteoporosis medication, you should repeat a bone density test by using the DEXA machine every one to two years. Most healthcare providers will ask that you repeat the testing after the first year of taking your medication. Talk with your doctor at All Women’s Care to set up a schedule for your testing.
What do the Numbers Mean in Bone Mass Measurement?
The BMD test results will be compared to the readings of a healthy young adult and are given in what is called a ‘T-score.’ If your results show a score of 0, this means your BMD is equivalent to that of an average, young, healthy adult.
The difference between your BMD score and that of a young, healthy adult are measured in units called SDs (standard deviations). Standard deviations below the 0 score are indicated as negative numbers and show a lower BMD, which means you are at a higher risk of bone fractures.
If you have a T-score between +1 and -1, you are considered to be in the normal, healthy range. If you receive a T-score between -1 and -2.5, it indicates you have a low bone mass but are not low enough to be diagnosed with osteoporosis. Test results showing a T-score of -2.5 or lower is an indication, you have osteoporosis. The higher the negative number of your BMD test indicates how severe your osteoporosis is.
The numbers from this test will allow your doctor at All Women’s Care to determine a treatment or prevention options. Should your test indicate a low bone mass, but not low enough for a diagnosis of osteoporosis, a prevention plan can be developed to prevent you from getting osteoporosis.
You and your doctor can discuss healthier eating habits such as including foods rich in Vitamin D and calcium in your diet. There are exercises you can begin, such as jogging, dancing, walking, or other weight-bearing activities to slow down the progression or prevent the onset of osteoporosis.
Vitamin D, Calcium and Fracture Prevention
Calcium and Vitamin D are essential nutrients to maintain your overall health. Vitamin D will allow your body to absorb calcium from the supplements and foods you consume. This vitamin plays a huge role in helping your muscles, immune system, and nerves work properly. Your body needs calcium needs to keep your teeth and bones strong. Your body needs calcium in order for your muscles, blood vessels, and nerves to work correctly as well. It will also allow for the release of enzymes and hormones that your body needs to function.
Your bones are made up of a dense web of calcium and protein fibers. If this web becomes less dense, your bones become fragile and will break easily. The bones most affected by this are your wrists, spine, and hips. These types of fractures are often painful, and lead to a disability, make a person less independent, and reduce your quality of life. Fractures of the hip have also been linked to an increased risk of death. These conditions make it vital to your health to maintain a proper intake of both Vitamin D and calcium.
Exercise and Bone Health
Exercise is essential for preventing and treating osteoporosis. Doing proper exercises will not only improve your bones, but it will also increase your muscle strength, improve your coordination and balance. Exercise will generally improve your overall health.
Just as your muscles are living tissue, so are your bones, and they respond to exercise by becoming stronger. Studies show that young men and women who exercise regularly achieve a more significant peak bone mass as compared to those who do not.
A person's bone mass typically peaks during their third decade of life. After this time, a person begins to lose bone. Men and women older than the age of twenty are able to prevent bone loss by exercising regularly. Exercise will help maintain coordination, balance, and muscles, which in turn helps to prevent falls and related fractures from those falls.
Resistance and weight-bearing exercises have been proven to be the best type of exercise for keeping bones healthy. Weight-bearing exercises make you work against gravity and include hiking, jogging, playing tennis, climbing stairs, walking, and dancing. Resistance exercises strengthen your bones and involve lifting weights. Other beneficial activities include bicycling and swimming to maintain excellent cardiovascular benefits and keep your muscles healthy.
Check with your doctor at All Women’s Care if you suffer from heart trouble, obesity, diabetes, or high blood pressure to discuss the best exercise program for you. The Surgeon General recommends an optimal goal is to reach is performing at least thirty minutes of physical activity a day. Your doctor can discuss which exercises you should complete and what a healthy goal is for your needs.
When you begin an exercise routine, you should always listen to your body. You may experience some discomfort and muscle soreness when you start, but this should not be painful for more than two days. If you feel pain for more than two days, consult with your doctor at All Women’s Care as you may need to ease up on your level of exercise.
If you have been diagnosed with osteoporosis, your doctor at All Women’s Care will discuss with you which exercises are safe. If you have tested for low bone mass, it is recommended that you protect your spine by not performing tasks that include flexing, bending, or twisting. You will also want to stay away from exercises that include high-impact activities to avoid breaking any bones. Your doctor will want to discuss how to stretch and strengthen your muscles safely, and how to correct any poor posture habits you may have.
Bone Density Management when Density is Low
If your testing shows you have low bone density, it does not mean you will definitely develop osteoporosis. You do have a higher risk of developing the disease should your bone loss continues. There is a fracture risk assessment tool known as FRAX that will enable your healthcare provider to know when you should be treated for low bone density.
The FRAX assessment is a tool that will calculate your absolute fracture risk and provide an estimate on your chances of breaking a bone in the next ten years. This assessment can identify those who are a higher risk of breaking bones, as well as identifies those who would benefit from starting an osteoporosis medication. Talk with your doctor at All Women's Care about the possibility of this assessment benefiting your needs.
Learn More About Bone Density Management Near Me
If you are concerned about osteoporosis or have a family member you are worried about bone density management, call All Women's Care at 213-250-9461. Treatments and prevention of this disease are possible through proper testing and screening. Call today and discuss your options to find the best possible solution for your bone density management.