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

Bone loss begins to speed up for all girls of their mid-30s, so in the event you’re below 50 and suppose DEXA scans and bone density issues don’t apply to you—maintain up.

That is data you’ll need below your belt sooner fairly than later. Let’s speak about 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 May Want a DEXA Scan Sooner Than You Suppose

At this yr’s BHOF Interdisciplinary Symposium on Osteoporosis, girls’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 girls start to lose bone quickly within the yr earlier than their ultimate menstrual interval (the official marker of menopause), and that elevated charge of loss continues for about two years after. On this brief window, girls 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Bone reworking—a wholesome, lifelong course of by which outdated or broken bone is damaged down and changed by new tissue—slows over time.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 suggest a primary DEXA scan at age 65, many specialists are calling for up to date tips that replicate rising proof: Ladies 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 medicines—most ladies are seemingly coated for early testing.

Under is a non-exhaustive checklist 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 girls face the next threat of osteoporosis.

• Household Historical past – A father or mother 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 lead to fractures must be thought of purple 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 Elements

• Menopause-Associated Hormone Decline

• Early Menopause (pure or surgical)

• Amenorrhea / Irregular Menstrual Cycles

Dietary & Consuming Conduct Elements

Life-style Elements

Illness-Associated Elements

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

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

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

• Most cancers

• HIV/AIDS

• Anorexia Nervosa

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

Remedy-Associated Elements

• 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 may also help estimate your osteoporosis and fracture dangers.

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

Sure—you’ll be able to 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, take into account it an funding in prevention.

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

Make sure you name forward—not all imaging facilities provide self-pay DEXA scans with no 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 of peak bone mass).
• The Z-score compares your BMD to the typical of individuals your age and intercourse.

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

Word: Z-scores could also be extra helpful for figuring out secondary causes of bone loss in youthful girls 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 occurring whether or not you see it or not.

The excellent news? You may gradual it down and even construct bone by partaking 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 technology—our youngsters and youths—to have interaction in bone-building actions now, so 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: Details 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
• Examine 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 Software. 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 Ladies. Journal of Scientific Endocrinology & Metabolism, 59(2), 373–379. https://doi.org/10.1210/jcem-59-2-373