Another option is that our DEXA results are skewed to the lower density side because of our smaller bones. Maybe our osteoporosis exists but not as severe as the t-scores reflect.

I understand what you are saying and I agree with @normahorn meaning I think that the DEXA scans might be misrepresenting my BMD because I am small: 4’11”, wrists 5.5” around, and current weight, which is more than I weighed for the majority of my adult life, 108 lbs.

I do have some medical history that most likely lowered my BMD. I started my period “later” at age 14.5 and ended it much earlier than most, at age 32. I did not get HRT.

I had extremely painful periods. Back then all they did was tell you to take Motrin. I pretty much took 800 MG of Motrin once a month and slept through the pain. From my research it seems that painful periods might be caused by a magnesium deficiency.

Note, my mother made sure we had well balanced meals and we drank milk and my diet, growing up, was definitely better than the average school kid’s diet these days, but it’s possible that even though my mother didn’t let us eat sugary cereals for breakfast, for some reason I might have not gotten enough magnesium or some other nutrient.

I had ache in college. I took tetracycline for an extended period of time—I now know that long term use of antibiotics interferes with vitamin k, which as we all know is needed for good bone health.

In my early twenties, my acne was really bad—horrible painful cyst-like bumps. My dermatologist prescribed Accutane, a very controversial drug—I had to sign a waiver saying I would have an abortion if I got pregnant while taking Accutane. My skin cleared up but while researching my osteoporosis I discovered that Accutane is horrible for your bones.

My weight fluctuated. I would say my normal weight was between 98-101 lbs. but at times I weighed as little as 92 lbs. The last time I weighed 92 lbs was in 2012. In 2015, I was around 100 lbs, then in 2016 something went haywire and I weighed 110 lbs and no matter what I did I couldn’t lose the weight. My mother and all of my siblings had already been diagnosed with hypothyroidism, and in 2017, I was diagnosed with hypothyroidism too. My point w/ the history of my weight is that during my bone forming years 0 to 30, I was pretty light weight—weight impacts bone development.

By my mid-20s, I was skipping periods. I was actually happy about it. Periods were painful and a mess and tampons aren’t cheap. I had no idea that every missed period is bad for your bones. After a while they completely disappeared and I went to my doctor in my early thirties and was told I was in menopause. My late 20s were an emotional roller coaster—now I know why, I was peri menopausal and didn’t know it. At one point I was prescribed antidepressants when what I really needed was hormone therapy.

Frequently women shed a lot of bone in the years before and after menopause, for me this was during my mid to late twenties and my early to mid thirties. Most people build bone up to about age 30. Given that I was perimenopausal in
my mid twenties, I probably reached my peak bone mass much earlier than most.

I don’t think my BTMs are wrong. I think they are right. Hypothyroidism causes bone turnover to slow down and it also causes bone formation to slow down.

I think that my endocrinologist should have known this and should have ordered BTMs before pushing bisphosphonates.