Today we have bone density tests to tell us if our bones are healthy. However, by themselves, these test results are not predictive of fracture risk. Despite this limitation, each year more than 22 million prescriptions are written to treat osteoporosis based on these tests. This month’s newsletter will help make sense of the bone density dilemma.
There are many devices on the market to evaluate bone density. The Dexa scan (Dual Energy X-ray Absorptiometry) is the most common test to evaluate spine and hip bones. Test results show bone mineral density (BMD), T scores which compare how your bones compare to someone in their 30’s, and the Z score which compares the status of your bones to others of similar age. The limitation of these tests is that they do not measure the most important bone parameter of all, the quality or integrity of bones. I have seen individuals with very poor test results, yet never a fracture, and some with pretty good results who get fractures.
To assess the quality of your bones you need to be able to answer the following health history questions:
- Parents fracture history of hip
- Alcohol intake: three or more units of alcohol a day [A unit of alcohol varies slightly from 8-10g of alcohol. This is equivalent to a standard glass of beer (285ml), a single measure of spirits (30ml), a medium-sized glass of wine (120ml), or 1 measure of an aperitif (60ml)].
- Secondary osteoporosis (these are illnesses that have high risk for associated osteoporosis including type I (insulin dependent) diabetes, osteogenesis imperfecta in adults, untreated long-standing hyperthyroidism, hypogonadism or premature menopause (<45 years), chronic malnutrition, or malabsorption and chronic liver disease)
- Femoral neck bone mineral density (gm/cm) from your bone density test
- Dexa scan make/model per test results report (for example: Norland, Hologic)
The World Health Organization has a website to help you identify your risk of bone fracture based on the above questions. http://www.shef.ac.uk/FRAX/ At this site you can enter in your answers and receive an immediate percent indicator of fracture risk based on the quality of your bones.
Taking a few moments to do this test will help end the guessing game of making prescriptive decisions based solely on bone density test findings. If your results show a greater than 20% fracture risk, you definitely should consider some form of intervention to improve the quality of your bones. For a comprehensive preventive and/or bone repair plan I suggest a consult with your favorite naturopathic doctor.
I hope you have enjoyed this month’s newsletter. As always, comments and feedback are welcome.
Jon Dunn, ND
Naturopathic Health Care, Inc.
Dr. Jon Dunn,
Licensed Naturopathic Doctor
We all want healthy bones, but how do we know if your bones are healthy? Historically, prevention was all we had to assure healthy bones; adequate weight bearing exercise, healthy diets and sun-stimulated vitamin D production.
Dr. Dunn's informative and timely book is now available. You can find it on Amazon.com
The limitation of the bone density tests is that they do not measure the most important bone parameter - the quality or integrity of bones.
Bone Density Scan - Scam?
Dr. Jon Dunn is a licensed Naturopathic Doctor (ND) with nearly 20 years of experience. He provides the professional level of care people expect from a primary physician. Dr. Dunn's unique comprehensive systems approach effectively addresses your immediate health care needs to provide long lasting results - naturally!
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