When Ought to You Get a DEXA Scan? Specialists Say Sooner Than You Suppose

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

That is data you’ll need beneath your belt sooner slightly 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 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 May Want a DEXA Scan Sooner Than You Suppose

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 simply too late.”

Why? As a result of ladies start to lose bone quickly within the 12 months earlier than their closing 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 may very well be dropping bone for 10 to twenty years with none consciousness or intervention.

Bone transforming—a wholesome, lifelong course of through 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 suggest a primary DEXA scan at age 65, many consultants are calling for up to date pointers that mirror rising proof: Ladies 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.

How you can 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 doubtless lined for early testing.

Under 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 mum or dad with osteoporosis or a fragility fracture raises your danger.*

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

Even minor falls (from standing top or much less) that end in fractures ought 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 identified with osteoporosis.

Hormonal & Reproductive Components

• Menopause-Associated Hormone Decline

• Early Menopause (pure or surgical)

• Amenorrhea / Irregular Menstrual Cycles

Dietary & Consuming Conduct Components

Life-style Components

Illness-Associated Components

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

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

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

• Most cancers

• HIV/AIDS

• Anorexia Nervosa

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

Medicine-Associated Components

• Glucocorticoids / ACTH

• Antiepileptic Medicine

• 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 can assist estimate your osteoporosis and fracture dangers.

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

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

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

Remember to name forward—not all imaging facilities supply self-pay DEXA scans with out 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 identified utilizing the T-score. A decrease (extra destructive) rating signifies larger bone loss:

Word: 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 danger elements, most girls are eligible—and clever—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’ll be able to 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 usually achieved by early maturity, we additionally have to encourage the subsequent era—our children and teenagers—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: Information 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 Ailments (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 Ailments. 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 Ladies’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 Instrument. Retrieved from https://cost.sidecarhealth.com/c/dexa-scan-cost
• Florencio-Silva, R., et al.(2015). Biology of Bone Tissue: Construction, Operate, and Components 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, Prognosis, 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 Ladies. Journal of Scientific Endocrinology & Metabolism, 59(2), 373–379. https://doi.org/10.1210/jcem-59-2-373