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

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

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

What’s a DEXA Scan?

A DEXA scan (quick 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 yr’s BHOF Interdisciplinary Symposium on Osteoporosis, girls’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 girls start to lose bone quickly within the yr earlier than their remaining menstrual interval (the official marker of menopause), and that elevated charge of loss continues for about two years after. On this quick window, girls lose a mean of 10% of their complete bone mass.

For the reason that common age of menopause is between 45 and 55, a lady may very well be shedding bone for 10 to twenty years with none consciousness or intervention.

Bone transforming—a wholesome, lifelong course of during which outdated or broken bone is damaged down and changed by new tissue—slows over time.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 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 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 threat components already qualify many ladies for early screening—and insurance coverage will sometimes cowl the scan with a health care provider’s prescription indicating only one.

Methods to Get a Baseline DEXA Sooner

Insurance coverage sometimes covers a DEXA scan when osteoporosis threat is medically justified. With so many threat components—starting from physique composition to medicines—most girls are probably coated for early testing.

Under is a non-exhaustive record of threat classes that can assist you start a dialog together with your healthcare supplier:

Physique Composition & Demographic Danger Components

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

• Race – White and Asian girls 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 must be thought-about crimson 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 identified 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)

Treatment-Associated Components

• Glucocorticoids / ACTH

• Antiepileptic Medicine

• 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 may also help estimate your osteoporosis and fracture dangers.

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

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

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

Be sure you name forward—not all imaging facilities provide 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-about 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 unfavorable) rating signifies better bone loss:

Be aware: 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 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 big selection of threat components, 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 together 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 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 must encourage the subsequent era—our youngsters and teenagers—to interact in bone-building actions now, in order that they’ll have a stronger basis for many years to return.

Hold 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 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 Assets and Danger Instruments. Retrieved from https://www.osteoporosis.foundation
• Examine 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 Software. 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, 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