Tonic Doctor: “Do I Need A Bone Density Test?”
“I’m 48 and my doctor has suggested a bone density test. Is this a good idea?”
A bone mineral density test (also called dual-energy X-ray absorptiometry or DXA scan) uses X-rays to measure the mineralisation of bone. It’s commonly done around the time of menopause to try to estimate the future risk of osteoporosis or bone fracture. Results are expressed as a T-score, which is current bone mineral density compared to the peak bone mass of a healthy 30-year-old. For example, osteoporosis is defined as a T-score of more than -2.5 standard deviations below the bone density of a healthy 30-year-old, in combination with one or more fragility fractures.
Keep in mind that it’s normal to have less dense bones at 48 compared to 30, and if you don’t have fragility fractures or other risk factors such as smoking, then a low DXA scan may not mean very much. That’s true even for a T-score in the osteoporosis range; but it’s especially true for a T-score in the osteopenia range, which means you have only slightly lower bone density compared to a 30-year-old. Having slightly lower bone density does not mean “pre-osteoporosis” but is really just an observation of ageing, like wrinkles or grey hair. According to osteoporosis researcher Dr Steven R. Cummings, “when a clinician sees the word ‘osteopenia’ on a report, they think it’s a disease. It’s not.”
Most medical societies recommend routine DXA testing for women aged 65 and older but advise that younger women need only be tested if they have risk factors such as smoking, heavy alcohol intake, inactivity, low body weight, family history of osteoporotic fracture, or are treated with medications such as corticosteroids, selective serotonin reuptake inhibitors or chemotherapy. If your doctor suggested the test because of such a risk factor, it’s a good idea to go ahead with it. At the same time, please know that a T-score in the osteopenia range, or even the osteoporosis range, does not necessarily mean you need medication. There are lots of other ways to improve bone health and reduce your risk of fracture.
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This information is general only. Always seek advice from a medical practitioner about your personal health conditions. We do not accept any liability for any injury, loss or damage caused by use of the information provided in our website.