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

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

That is data you’ll need underneath your belt sooner reasonably 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 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 Would possibly Want a DEXA Scan Sooner Than You Assume

At this yr’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 yr earlier than their ultimate menstrual interval (the official marker of menopause), and that elevated fee of loss continues for about two years after. On this brief window, ladies lose a mean of 10% of their whole bone mass.

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

Bone reworking—a wholesome, lifelong course of during 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 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 advocate a primary DEXA scan at age 65, many consultants 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 usually cowl the scan with a physician’s prescription indicating only one.

The right way to Get a Baseline DEXA Sooner

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

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

Physique Composition & Demographic Danger Elements

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

• Race – White and Asian ladies face a better threat of osteoporosis.

• Household Historical past – A dad or mum with osteoporosis or a fragility fracture raises your threat.*

• Fall Historical past – A bent to fall will increase fracture threat.*

Even minor falls (from standing peak or much less) that lead to fractures needs to 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 recognized with osteoporosis.

Hormonal & Reproductive Elements

• Menopause-Associated Hormone Decline

• Early Menopause (pure or surgical)

• Amenorrhea / Irregular Menstrual Cycles

Dietary & Consuming Conduct Elements

Way of life Elements

Illness-Associated Elements

• Endocrine & Hormonal Problems (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 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 can assist estimate your osteoporosis and fracture dangers.

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

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

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

You should definitely 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 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-about peak bone mass).
• The Z-score compares your BMD to the common of individuals your age and intercourse.

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

Observe: 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 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 wide selection of threat components, most girls are eligible—and smart—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 occurring whether or not you see it or not.

The excellent news? You’ll be able to sluggish 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 usually achieved by early maturity, we additionally have to encourage the subsequent technology—our youngsters and teenagers—to interact in bone-building actions now, so that they’ll have a stronger basis for many years to return.

Hold lifting, leaping, and looking for sturdy 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 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 Instrument. Retrieved from https://cost.sidecarhealth.com/c/dexa-scan-cost
• Florencio-Silva, R., et al.(2015). Biology of Bone Tissue: Construction, Perform, and Elements That Affect Bone Cells. BioMed Analysis Worldwide, 2015, Article ID 421746. https://doi.org/10.1155/2015/421746
• NIH Consensus Improvement 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 Drugs, 314(26), 1676–1686. https://doi.org/10.1056/NEJM198606263142605
• Krabbe, S., & Christiansen, C.(1984). Bone Turnover in Postmenopausal Girls. Journal of Medical Endocrinology & Metabolism, 59(2), 373–379. https://doi.org/10.1210/jcem-59-2-373