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

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

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

What’s a DEXA Scan?

A DEXA scan (brief for dual-energy x-ray absorptiometry) is a fast, non-invasive check that measures the mineral content material of your bones to evaluate bone density and monitor modifications 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 mentioned plainly: “Ready till age 65 to guage skeletal well being is just 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 price of loss continues for about two years after. On this brief window, ladies lose a median of 10% of their complete bone mass.

Because the common age of menopause is between 45 and 55, a girl might be shedding bone for 10 to twenty years with none consciousness or intervention.

Bone transforming—a wholesome, lifelong course of during which 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 in the course of 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 specialists are calling for up to date tips that replicate rising proof: Girls profit from having a baseline scan a lot earlier. Quite a few danger elements already qualify many ladies for early screening—and insurance coverage will sometimes cowl the scan with a physician’s prescription indicating only one.

The way to Get a Baseline DEXA Sooner

Insurance coverage sometimes covers a DEXA scan when osteoporosis danger is medically justified. With so many danger elements—starting from physique composition to drugs—most girls are possible coated for early testing.

Beneath is a non-exhaustive checklist of danger classes that can assist you start a dialog along with your healthcare supplier:

Physique Composition & Demographic Threat Components

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

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

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

• Fall Historical past – A bent to fall will increase fracture danger.*

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

Hormonal & Reproductive Components

• Menopause-Associated Hormone Decline

• Early Menopause (pure or surgical)

• Amenorrhea / Irregular Menstrual Cycles

Dietary & Consuming Habits Components

Life-style Components

Illness-Associated Components

• Endocrine & Hormonal Issues (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)

Medicine-Associated Components

• Glucocorticoids / ACTH

• Antiepileptic Medication

• Most cancers Hormonal Therapies

• Proton Pump Inhibitors (PPIs)

• SSRIs (Antidepressants)

• Thiazolidinediones (for Sort 2 Diabetes)

Along with this checklist, 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 Components?

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

A baseline scan provides you data. And data provides you energy.

You should definitely name forward—not all imaging facilities supply self-pay DEXA scans and not using a referral.

What Do My DEXA Outcomes Imply?

DEXA scan outcomes are sometimes 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 of peak bone mass).
• The Z-score compares your BMD to the common of individuals your age and intercourse.

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

Be aware: 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 share 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 danger elements, most girls are eligible—and smart—to get an early DEXA scan. Don’t assume your bones are wholesome simply since you really feel wholesome.

Speak along with your physician about your private danger 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 may gradual 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 have to encourage the following technology—our children and youths—to interact in bone-building actions now, in order that they’ll have a stronger basis for many years to return.

Preserve lifting, leaping, and looking for sturdy 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 Reviews. https://www.sciencedirect.com/science/article/pii/S1094695024000921
• Worldwide Osteoporosis Basis (IOF).(n.d.). Osteoporosis Assets and Threat Instruments. Retrieved from https://www.osteoporosis.foundation
• Research of Girls’s Well being Throughout the Nation (SWAN).(2023). Bone Well being Truth 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 – Price. 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 Price: Price Lookup Software. Retrieved from https://cost.sidecarhealth.com/c/dexa-scan-cost
• Florencio-Silva, R., et al.(2015). Biology of Bone Tissue: Construction, Perform, and Components That Affect Bone Cells. BioMed Analysis Worldwide, 2015, Article ID 421746. https://doi.org/10.1155/2015/421746
• NIH Consensus Improvement 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 Medical Endocrinology & Metabolism, 59(2), 373–379. https://doi.org/10.1210/jcem-59-2-373