What is bone density testing?
Bone density tests are medical exams that measure how much minerals you have in your bones, especially calcium and collagen.
Osteoporosis is a condition characterized by weakened bones and an increased risk of fractures. In the United States, more than 40 million people either have osteoporosis or are at a higher risk of fractures due to low bone mineral density (known as osteopenia). Osteoporosis is often referred to as a “silent disease” because it typically progresses slowly and without symptoms until a fracture occurs.
Early identification of low bone density through screening allows for lifestyle changes and therapies to protect bone health and reduce the risk of fractures. That’s why the U.S. Preventive Services Task Force recommends routine bone mineral density screening for women aged 65 and older.
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Risk factors for women
Women aged 65 years and older.
Women with fractures after the age of 50. Women of 50 – 64 with risk factors.
Women with a family history of:
- Osteoporosis and/or fracture,
- vitamin D deficiency,
- Smoking,
- malabsorption,
- use of medications like prednisone,
- frequent falling.
The Importance of Bone Health
The skeletal system is very important for how we function as humans. They hold and protect our vital organs in place. They give us form, and posture, and help us move. Our bones also help store minerals for the body and release them in times of need.
Purpose of Bone Density Tests
Bone density helps diagnose osteoporosis before a fracture, it helps to estimate your chances of breaking a bone later, and it also helps monitor the effectiveness of an osteoporosis treatment if you’re having that.
Bone density tests typically involve measurement of how many grams of calcium, collagen, and other bone minerals are present in a segment of bone. The higher your bone mineral content, the denser your bones, the stronger and more healthy they are.
Usually, bones in the spine, hip, and forearm are tested.
Not to be mistaken for bone scans, bone density tests do not detect cancer, fractures, infections, and other bone ailments.
Osteoporosis which tends to affect older women more than everyone else is the major reason a doctor would recommend a bone density scan.
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Factors Influencing Bone Health
Age
For children and teenagers, bone increases in mass and size as they grow through a constant net deposition of minerals to their bones. That means there are more minerals added than taken out at those stages of development. However, after the age of 30, the bone loses materials faster than it can be deposited. Hence, the older we are the more our bones get weaker.
Menopause
While osteoporosis affects both men and women, women suffer it more due to the hormonal changes that occur after menopause. This and the fact that women generally have less bone mass than men in the first place.
Family History
Studies show that people with parents who suffered osteoporosis had a higher chance of developing it. Also, they found a relationship between the severity of their parent’s osteoporosis and the degree to which they suffered it.
Even though family history can be a risk factor, it is not a sentence to bone ailments. With proper lifestyle and diet, you can chart your own bone health course.
Recommended Bone Tests for Women
Dual-Energy X-ray Absorptiometry (DXA) Scan
Dual-energy X-ray absorptiometry (DXA) is both the most common and most versatile bone density test.
It is completely painless and non-invasive, you don’t need to undress. Just ensure you’re not wearing zippers or buttons in the areas to be tested. But be sure you tell your doctor beforehand if you recently had a barium exam or were injected with contrast material for a previous CT scan or nuclear medicine test.
Also, avoid taking calcium supplements within 24 hours of your DXA as it will misrepresent your real status.
To take the test, all you have to do is lie on the DXA table and do as the technologist instructs.
DXA can diagnose osteoporosis before you ever get a fracture, estimate your likelihood of getting one, or the effectiveness of your osteoporosis treatment.
DXA tests have a score called the T-score. The normal score is -1 and above. The lower your T-score is from -1, the weaker your bones and the higher the chance they can break. A score of -2.5 or less (e.g. -3.0) then you’re likely to have osteoporosis.
FRAX Risk Assessment Tool
FRAX is a fracture risk calculator that comes with the software of most DXA. When you input your age, bone density, sex, weight, height, and other questions. It then calculates the likelihood you’ll have different types of fractures in the next 10 years. A diagnosis of osteoporosis is made when you score 20% or more for a fracture of the shoulder, spine, or forearm. A 3% probability of hip fracture is also considered an osteoporosis diagnosis.
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Bone Health Maintenance
- Practicing lifestyles and diets that both promote healthy bones and prevent loss of density are paramount.
- Quit smoking and alcohol.
- Avoid steroid medications like prednisone that interfere with bone building.
- Eat foods rich in calcium like milk, cheese, or other dairy products, nuts, tofu, soya beans, and fish with bones you can chew like sardines and pilchards, broccoli, cabbage, but not spinach.
- Increase Vitamin D intake by sunbathing without sunscreen in summer. In winter and autumn, you can take vitamin D supplements.
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