A Bone Density Test Will Help You Monitor Your Treatment Program
A bone density test uses x-rays to measure the bone mineral density of the spine and hips. Vitamin D blood tests and stomach acidity tests also provide guidance when developing an osteoporosis treatment program.
It is recommended that women have a baseline bone density test when they reach perimenopause (menstrual irregularity occurring usually between 45 and 55) or earlier if they are at risk from the use of certain medications.
Men should request a bone density scan at age 70 or earlier if using corticosteroids or prostate cancer drugs.
The bone density test will provide T-scores for the spine and hips indicating the standard deviation below the mean bone mineral density (BMD) of a young adult female. The accepted guidelines for T-scores are as follows:
- Osteopenia: -1 and -2.5
- Osteoporosis: lower than -2.5
The bone density test will focus on bones that are most likely to break including:
- lower spine bones (lumbar vertebrae L1-L3)
- the narrow neck of your thigh bone (femur) that adjoins your hip
- the femur itself (thigh bone)
... and sometimes the bones in your wrist and forearm. Bone loss does not occur equally among these sites-so a doctor may prescribe osteoporosis medication that targets one area more effectively than another.
A reduced BMD is one of many factors to be taken into account when assessing the risk of fracture. The existence of previous low-impact fractures, certain medical conditions, a family history of osteoporosis and a person's risk of falling are also important considerations before designing a treatment program.
As an effective bone building program will take 1.5-2 years to improve bone density, most health insurance plans will only pay for tests every two years... and some are moving to three year intervals.
Bone Density Tests (DEXA Or DXA)
The most common bone mineral density (BMD) test is called a dual energy x-ray absorptiometry or simply a DXA or DEXA test. This test involves lying on a table for several minutes while a small x-ray detector scans your spine, one hip, or both.
The test is safe and painless and does not require any injections or any other discomfort. You receive a very small amount of radiation from a DXA test, approximately the same amount you are exposed to if you fly from coast to coast in North America.
Bone densitometers (the machines that perform the test) are available on a limited basis across Canada, and thus, individuals who are suspected to be at high risk are generally given priority for this testing.
As for any other diagnostic test, you must be referred to a diagnostic facility by a physician. If you are monitoring your bone density, try to re-test on the same BMD machine whenever possible.
Bone Turn-Over Tests
There are also blood/urine tests that that will allow you to measure how much your bone is building up and how much it is breaking down and at what speed.
These tests are covered by most medical plans in Canada and are particularly useful between DXA tests to determine if your bone-building program is working. Most provinces now cover bone density tests every two or three years.
NTX Or CTX
The NTX (n-telepeptide) and CTX (c-telopeptides) Osteomark tests measure the bone-breakdown in your urine. PYD or DPD PYD (pyridinium) and DPD (deoxypyridin) urine tests can indicate an increased or decreased rate of bone-breakdown.
Vitamin D Blood Test
Adequate vitamin D levels are essential for the absorption of calcium but research shows that over 75% of Americans and Canadians are vitamin D deficient in the winter months.
Osteoporosis Canada is now recommending up to 2,000 IU daily of vitamin D which is more than most calcium supplements contain. Many experts suggest that 5,000 IU can be taken safely... and may be necessary in northern regions.
Stomach Acid Test
Sufficient stomach acid is important for breaking down and absorbing calcium. But for most people, stomach acid decreases with age. A simple PH test strip will help you to assess and monitor your stomach acid.
Readers may also be interested in "The Myth of Osteoporosis" which argues that osteoporosis T-scores create undue alarm by ignoring bone quality and the natural aging process.