When Ought to You Get a DEXA Scan? Specialists Say...

Bone loss begins to speed up for all ladies of their mid-30s, so in case you’re underneath 50 and assume DEXA scans and bone density issues don’t apply to you—maintain up.

That is info you’ll need underneath your belt sooner fairly than later. Let’s speak about why.

What’s a DEXA Scan?

A DEXA scan (quick for dual-energy x-ray absorptiometry) is a fast, non-invasive take a look at that measures the mineral content material of your bones to evaluate bone density and monitor adjustments over time.

Whereas it makes use of a small quantity of radiation, publicity is minimal—about one-tenth that of a chest x-ray and fewer than what you’d get from a single day of background radiation.

The scan takes about 10 minutes. You’ll lie on a desk whereas an imaging arm passes over key websites—mostly the lumbar backbone, hip, femoral neck, and wrist.

Why You Would possibly Want a DEXA Scan Sooner Than You Assume

At this 12 months’s BHOF Interdisciplinary Symposium on Osteoporosis, ladies’s well being researcher Dr. Amanda Clark stated plainly: “Ready till age 65 to judge skeletal well being is simply too late.”

Why? As a result of ladies start to lose bone quickly within the 12 months earlier than their ultimate menstrual interval (the official marker of menopause), and that elevated fee of loss continues for about two years after. On this quick window, ladies lose a median of 10% of their whole bone mass.

Because the common age of menopause is between 45 and 55, a lady could possibly be dropping bone for 10 to twenty years with none consciousness or intervention.

Bone transforming—a wholesome, lifelong course of wherein previous or broken bone is damaged down and changed by new tissue—slows over time. By our mid-30s, bone resorption begins to outpace bone formation, leading to a gradual however regular decline in bone mass.

This loss accelerates throughout the menopausal transition, when estrogen—a key driver of bone formation—declines.

Whereas the CDC and the Bone Well being & Osteoporosis Basis (BHOF) nonetheless advocate a primary DEXA scan at age 65, many consultants are calling for up to date tips that mirror rising proof: Girls profit from having a baseline scan a lot earlier. Quite a few threat elements already qualify many ladies for early screening—and insurance coverage will usually cowl the scan with a health care provider’s prescription indicating only one.

The way to Get a Baseline DEXA Sooner

Insurance coverage usually covers a DEXA scan when osteoporosis threat is medically justified. With so many threat elements—starting from physique composition to drugs—most ladies are doubtless lined for early testing.

Under is a non-exhaustive record of threat classes that will help you start a dialog along with your healthcare supplier:

Physique Composition & Demographic Threat Elements

• Low Physique Weight / Slender Construct – Much less bone mass will increase vulnerability to loss.

• Race – White and Asian ladies face a better threat of osteoporosis.

• Household Historical past – A mother or father with osteoporosis or a fragility fracture raises your threat.*

• Fall Historical past – An inclination to fall will increase fracture threat.*

Even minor falls (from standing peak or much less) that end in fractures ought to be thought-about purple flags. For instance, in case your mother broke her wrist tripping over a rug, that’s thought-about a fragility fracture—even when she wasn’t formally recognized with osteoporosis.

Hormonal & Reproductive Elements

• Menopause-Associated Hormone Decline

• Early Menopause (pure or surgical)

• Amenorrhea / Irregular Menstrual Cycles

Dietary & Consuming Habits Elements

Life-style Elements

Illness-Associated Elements

• Endocrine & Hormonal Problems (e.g., hyperthyroidism, Cushing’s)

• Gastrointestinal Illnesses (e.g., celiac, Crohn’s)

• Autoimmune Circumstances (e.g., rheumatoid arthritis)

• Most cancers

• HIV/AIDS

• Anorexia Nervosa

• Vertebral Abnormalities (e.g., scoliosis, unexplained peak loss)

Treatment-Associated Elements

• Glucocorticoids / ACTH

• Antiepileptic Medication

• Most cancers Hormonal Therapies

• Proton Pump Inhibitors (PPIs)

• SSRIs (Antidepressants)

• Thiazolidinediones (for Kind 2 Diabetes)

Along with this record, on-line instruments such because the International Osteoporosis Foundation Risk Check, FRAX Fracture Risk Assessment Tool, and Garvan Fracture Risk Calculator will help estimate your osteoporosis and fracture dangers.

Can I Get a DEXA Scan if I Don’t Have Any Threat Elements?

Sure—you possibly can nonetheless select to get one. Out-of-pocket prices usually vary from $100–$250, and you may typically use HSA/FSA funds. Whereas it’s an upfront expense, think about it an funding in prevention.

A baseline scan offers you information. And information offers you energy.

Remember to name forward—not all imaging facilities provide self-pay DEXA scans and not using a referral.

What Do My DEXA Outcomes Imply?

DEXA scan outcomes are usually reported as T-scores and Z-scores.

• The T-score compares your bone mineral density (BMD) to that of a wholesome 30-year-old grownup of the identical organic intercourse (thought-about peak bone mass).
• The Z-score compares your BMD to the typical of individuals your age and intercourse.

Osteoporosis is recognized utilizing the T-score. A decrease (extra unfavourable) rating signifies better bone loss:

Notice: Z-scores could also be extra helpful for figuring out secondary causes of bone loss in youthful ladies and premenopausal populations.

• A T-score between -1.0 and -2.5 signifies low bone mass (osteopenia).
• A T-score of -2.5 or decrease signifies osteoporosis.

Every T-score level roughly correlates with a proportion of bone loss. For instance:

• A T-score of -1.0 displays about 10% bone loss
• A T-score of -2.5 displays roughly 25% bone loss

The Backside Line

Given the wide selection of threat elements, most ladies are eligible—and smart—to get an early DEXA scan. Don’t assume your bones are wholesome simply since you really feel wholesome.

Discuss along with your physician about your private threat profile and ask for a prescription to get a baseline scan. Out of your mid-30s on, bone loss is going on whether or not you see it or not.

The excellent news? You’ll be able to sluggish it down and even construct bone by participating in confirmed, proactive methods like progressive strength training and impact training. And since peak bone mass is generally achieved by early maturity, we additionally must encourage the subsequent era—our children and youths—to have interaction in bone-building actions now, in order that they’ll have a stronger basis for many years to return.

Preserve lifting, leaping, and searching for robust bones at all ages. —Karin

References:

• Facilities for Illness Management and Prevention (CDC).(2024). DEXA Scans: Info and Stats. Retrieved from https://www.cdc.gov/radiation-health/data-research/facts-stats/dexa-scan.html
• Nationwide Institute of Arthritis and Musculoskeletal and Pores and skin Illnesses (NIAMS).(n.d.). Osteoporosis. Nationwide Institutes of Well being. Retrieved from https://www.niams.nih.gov/health-topics/osteoporosis
• Cosman, F. et al.(2024). Proceedings of the 2024 Santa Fe Bone Symposium: Replace on the Administration of Osteoporosis and Uncommon Bone Illnesses. Bone Stories. https://www.sciencedirect.com/science/article/pii/S1094695024000921
• Worldwide Osteoporosis Basis (IOF).(n.d.). Osteoporosis Sources and Threat Instruments. Retrieved from https://www.osteoporosis.foundation
• Research of Girls’s Well being Throughout the Nation (SWAN).(2023). Bone Well being Reality Sheet. Retrieved from https://www.swanstudy.org/wps/wp-content/uploads/2023/04/SWAN-Fact-Sheets-Bone.pdf
• College of Alabama at Birmingham.(n.d.). Step 2: Bone Density Testing – Value. UAB Tone Your Bones. Retrieved from https://www.uab.edu/shp/toneyourbones/step-2-bone-density-testing/cost
• Sidecar Well being.(n.d.). DEXA Scan Value: Value Lookup Device. Retrieved from https://cost.sidecarhealth.com/c/dexa-scan-cost
• Florencio-Silva, R., et al.(2015). Biology of Bone Tissue: Construction, Operate, and Elements That Affect Bone Cells. BioMed Analysis Worldwide, 2015, Article ID 421746. https://doi.org/10.1155/2015/421746
• NIH Consensus Growth Panel.(2001). Osteoporosis Prevention, Analysis, and Remedy. JAMA, 285(6), 785–795. https://doi.org/10.1001/jama.285.6.785
• Nieves, J. W.(2005). Skeletal Results of Vitamins and Nutraceuticals, Past Calcium and Vitamin D. Osteoporosis Worldwide, 16(7), 773–782. https://doi.org/10.1007/s00198-005-1919-7
• Riggs, B. L., & Melton, L. J.(1986). Involutional Osteoporosis. New England Journal of Medication, 314(26), 1676–1686. https://doi.org/10.1056/NEJM198606263142605
• Krabbe, S., & Christiansen, C.(1984). Bone Turnover in Postmenopausal Girls. Journal of Scientific Endocrinology & Metabolism, 59(2), 373–379. https://doi.org/10.1210/jcem-59-2-373