My latest DXA and TBS report is in.  As a reminder, I was diagnosed with osteopenia in 2005 and given a script for Fosamax. I declined.  I was in my 50's. Now I'm in my 70's. My intention was to implement my 7 pillars for bone health for a better outcome: 

1. Calcium and mineral rich-foods
2. Supplements (Cal Citrate, Vit. D., Vit K2 - Mk7, Dr. McCormick's collagen and mineral whey)
3. Bioidentical hormones
4. Weight bearing exercise
5. Stress reduction
6. Sleep hygiene
7. Bringing joy to my everyday

At that time, Fosamax was a long term drug. I would have been a prolonged user. I'm grateful to the work of Dr. Schneider and who revealed her terrible story below. Due to her work Fosamax users now take a drug holiday.

Dr. Jennifer Schneider's Story

Dr. Jennifer Schneider was standing on a New York City subway train when the train jolted, and Schneider felt a snap in her right leg. It was her femur bone - the strongest bone in the body.

"I shifted to the right to keep my balance and felt a big crack. I could feel it in my thigh. There was no question in my mind I'd broken my femur," said Schneider, a semi-retired Tucson internist, whose break was in the top third section of her thigh.

"It's extremely unusual to fracture that part of the femur," she said. "It just doesn't happen like that."

Schneider's femur break occurred in October 2001, but it wasn't until 2005 that she began to suspect the cause of the strange injury: prolonged use of the drug Fosamax, which ironically is prescribed to treat and prevent the bone-thinning disease osteoporosis.

Schneider had been taking the drug since 1995, when she was diagnosed with osteopenia, a condition that many doctors consider a precursor to osteoporosis.

"The drug suppresses bone breakdown and in some people, who knows, it does a job that's too good. It oversuppresses," Schneider said.

Fosamax drugmakers from New Jersey-based Merck say there's no proof of a connection between the drug and femur fractures. But in the interest of patient safety, Merck says it voluntarily modified the Fosamax label in July 2009 to include "low energy femoral shaft and subtrochanteric fractures" in the adverse-reactions section of the label. [1]

IMPORTANT:

In January 2024 I'll be opening my:

Strong Bones - Healthy You Program
A Comprehensive Bone Health Program - The Whole Body Approach.

Click HERE to schedule a complimentary 30-minute session.

This call will determine if my program is a good fit for you.

IRMA's DXA

My ninety minute pilgrimage to Hospital of The University of Pennsylvania yielded an excellent DXA.

Below are my results

Great outcome for my hips and spine - all going in the right direction over time. 

Not so much my forearm.

Note the colors in the report. We're looking for green.

GREEN

The color chart below will help you understand the ranges.

T-score less than -1 = Normal | COLOR GREEN

T-score between -1 to -2.5 = Osteopenia | COLOR YELLOW

T-score greater than -2.5 = Osteoporosis | COLOR RED

TBS L1-L4 = 1.393 (normal is 1.35 and above)

Below is the Trabecular Bone Score or TBS report of my spine. Simply put, the TBS measures the inner bones, while DXA measures the outer bone. Color falls into the green normal area. My inner bones look good.

DXA Spine- Normal Range L1-L4 = T score 0.0

Below is my DXA for my spine. It also falls into the green (normal) section.

DXA Hip -

Femur Neck -1.8 Total Left Hip -1.1

YELLOW - Osteopenia

Also measures in the normal yellow range. Note the DOT in the yellow section.

Forearm

RED - Osteoporosis

Radius 33% = -2.7

Radius 33% is the measure used for the forearm.

Irma's Tracking Chart

Click the image for a better view.

For my readers who like to keep track of their DXA, below is my tracking chart. The chart shows the type of machine used. Each machine has a serial number. When looking at a DXA comparison, it’s essential to know the DXA machine and the serial number.  That serial number can usually be found in the lower right corner of your DXA report.  All my tests were on GE Lunar Prodigy with the same serial number.

How to get a proper DXA

Hips

Legs are rotated inward, allowing for a proper DXA reading.

Spine

The box positions my back flat on the table

Forearm

Next Steps

Tracking my yearly CMP (Comprehensive Metabolic Panel) blood test next year.  This test measures calcium levels which I track.   

Dr. McCormick uses blood work for a deeper dive into bone health.

Also, my friend, Dr. Lani Simpson, DC, CCD, who has been in the osteoporosis trenches for many decades, suggested I get and track bone markers:

• CTX (full name Carboxyterminal cross-linking telopeptide of bone collagen) is a bone resorption marker.
• My CTx was:
• 346 (10/27/22 - Lab Corp)
• 304 (2/22/22) Quest Labs (within the range offered in my Bone Marker presentation

• P1NP (full name Procollagen type 1 N propeptide) measures bone formation. If my doctor doesn’t write a script for this test, I’ll get the script through Evexia or Life Extension.
• My previous P1NP was 34

• Vitamin D: I test twice a year - after summer and after winter
• My last test showed 44.9 ng/mL

Dr. Lani Simpson suggested an x-ray of my spine as arthritis makes a DXA look better than it is. My x-ray was performed by Dr. Kim Zambito, who reported slight arthritis in my spine and wrist.  

It takes a community.

Forearm

Why is the non-dominant forearm added to the DXA/ TBS report?

The spine and hip may have arthritis yet the DXA shows up with stronger results.  The forearm may be a possible indication of parathyroid issues.

Your forearm is 80 to a 100% cortical bone. When a person has hyperparathyroidism, they have too much parathyroid hormone being pumped out. What does that degrade?

That degrades cortical bone more than trabecular bone. And that's why when you look at a person with hyperparathyroidism, oftentimes, their forearms will have low bone density.

• “Primary hyperparathyroidism: While this is a systemic disease affecting the entire skeleton, the lowest BMD is often the forearm, which may be the only site at which BMD is less than –2.5. In this case, the result should influence the decision regarding the surgical cure of primary hyperparathyroidism (PHPT).” [i]

Tests prove negative for hyperparathyroidism. Bones are complicated.

We Are All Different

Several members of my Bones Tribe are on medication as it was deemed necessary based on a full and comprehensive intake and blood work reviewed by their bone doctor. My Bones Tribe members seek other opinions before they make a decision regarding medication based on knowledge vs being scared into a decision.

TIPS

My DXA / TBS score was performed at:

The Hospital of the University of Pennsylvania

3400 Civic Center Blvd. – Ground Floor

Philadelphia, PA

phone: 215-662-3000 to book a DXA (ask for radiology to book your DXA).

My script reads:

• DXA bone density, axial CPT 77080

• DXA bone density / peripheral CPT: 77081

• Includes TBS, and peripheral forearm.

I requested a full colored copy of my reports BEFORE I left.

I’m feeling good about the results.

REMINDER:

In January 2024, I'm opening my:

Stronger Bones - Healthy You Program

My 8-week Comprehensive Bone Health Program - The Whole Body Approach promises to educate you on every aspect of bone health. From DXA/ TBS, bone markers, blood work, calcium-rich foods, exercise. You'll gail knowledge, a deep understanding of the terminology and move forward with empowerment.

Click HERE for a complimentary 30-minute consultation to confirm my program is right for you.

I hope my shared experience is helpful to you and your beautiful bones.

[1] https://www.drug-injury.com/drug_injury/2010/09/doctor-files-suit-says-bone-drug-leads-to-breaks.html

The post My 70 Year Old Bones appeared first on Food For Healthy Bones.

1. Calcium and mineral rich-foods
2. Researched supplements (I get my calcium through food)
3. Weight bearing exercise
4. Stress reduction
5. Sleep hygiene
6. Bringing joy to my everyday

I took my 90 minutes pilgrimage to Hospital of The University of Pennsylvania. DXA during Covid of course had its moments. Masks, temperature testing, hand sanitizer, distancing...we all know the necessary Covid drill.

Below I’m positioned so that my ankles are pointing inward which guarantees a proper reading of the hips. Clearly not a “glam” shot but hopefully you get the message.

Great outcome for my hips and spine all going in the right direction over time.  Note the colors in the reports....GREEN!

My Spine - TBS

Below is the Trabecular Bone Score or TBS of my spine. Simply put, the TBS measures the inner bones, while DXA measures the outer bone. Color falls into the green normal area. Inner bones look good.

My Spine - DXA

Below is my DXA for my spine measurement. It also falls into the green (normal) section.

My Hip - DXA

Also measures in the green normal range.

My Tracking Chart

The chart below shows the type of machine used. Each machine has a serial number. If you’re looking at a DXA comparison it’s important to know the DXA machine and the serial number.  That serial number can usually be found in the lower right corner of your DXA report.  The 2016 ad 2014 were on GE Lunar Prodigy but different machines as shown by the serial numbers.

Yet look at my Forearm numbers…..

Suddenly I was in the range for osteoporosis and my doctor suggested I see an endocrinologist.

My Next Steps

Dr. Keith McCormick suggested getting a follow-up CMP (Comprehensive Metabolic Panel) blood test next year.  This test measures calcium levels which I will keep track of.   

He uses blood work for a deeper dive into bone health.

Also, my trusted and generous friend, who has been in the osteoporosis trenches for many decades, suggested I get and track bone markers:

• CTX (full name Carboxyterminal cross-linking telopeptide of bone collagen) which is a bone resorption marker and
• P1NP (full name Procollagen type 1 N propeptide) which measures bone formation. If my doctor won’t write a script for this test, I’ll go to Life Extensions for the script.

Dr. Lani Simpson suggested there may be something wrong with the forearm test and suggested getting it re-analyzed.  I’m in the process of working with the technician who performed  the DXA/TBS.  The region of interest in the forearm is Radius 33% often reported at 1/3 distal radius. I also reached out to Dr. Deva Boone who specializes in parathyroid disease.

It takes a community.

Forearm

Why is the non-dominant forearm added to the DXA/ TBS report?

The spine and hip may have arthritis yet the DXA shows up with stronger results.  The forearm may be a possible indication of parathyroid issues.

• “Primary hyperparathyroidism: While this is a systemic disease affecting the entire skeleton, the lowest BMD is most often the forearm, which may be the only site at which BMD is less than –2.5. In this case, the result should influence the decision regarding surgical cure of primary hyperparathyroidism (PHPT).” [i]

The learning continues.  

TIPS

My DXA / TBS score was performed at:

The Hospital of the University of Pennsylvania

3400 Civic Center Blvd. – Ground Floor

Philadelphia, PA

phone: 215-662-5680 to book a DXA (numbers may change so ask for radiology to book your DXA.

My script reads:

• DXA bone density, axial CPT 77080

• DXA bone density / peripheral CPT: 77081

• Includes TBS, peripheral forearm.

I requested a full colored copy of my reports BEFORE I left. However Penn’s portal is fabulous and reports can be downloaded.

I’m feeling good about the results.

If you’d like to schedule a private session with me, kindly view those details HERE

You’ll gain insights, get support as we craft a bone plan, food plan and it's where your bone questions will be answered.

The cost for my discovery one-hour session is $200 and is followed-up with a full set of recommendations for the “next steps” on your bone journey.

Thank you for your time today. I hope my shared experience is helpful.

From my bones to yours,

Irma Jennings, INHC
Osteoporosis Patient Navigator

If you’re confused about how to Feed Your Glorious Bones?  My guide will help.
Click below for more details.

7 Day Meal Plan – Easy Cooking for Bone Health Guide

https://www.healio.com/news/endocrinology/20141203/forearm-dxa

The post My DXA 2020 appeared first on Food For Healthy Bones.