Just getting started on this info journey, but wanted to share a couple thoughts. Am reading Great Bones and author said there is more than a 90% error rate in DEXA tests between the tester, equipment, and radiologists. I’ve also read from an ob-gyn that there is a 2% variability in a DEXA scan, even on the same equipment by the same personnel and with the same radiologist in rapid succession. Finally, it is my understanding that DEXA scans show bone strength, which can be fooled by some bone drugs, and TEMS shows bone quality. Would love for others to chime in!

Thank you for the heads up. Wouldn't it be nice to have functional doctors who consider the whole body,nutrition, etc. , and time to treat the cause instead of just medicate?

My experience was different. Very knowledgeable and explained in detail.

@drsuefowler Quick clarification for anyone reading: REMS and DEXA are expected to disagree. DEXA over-reads after age 50 because osteoarthritis, aortic calcification, and old vertebral compressions inflate the T-score — that's documented in every ISCD position statement. REMS (FDA-cleared, Echolight) measures bone quality on top of density and its Fragility Score has been validated as a better predictor of actual fractures (Diez-Perez et al., Bone 2019). So a "worse" REMS isn't the machine being wrong — it's usually DEXA being falsely reassuring.

I've been a client of this practice since day one — back as ScreenMyBones / Strength Lab, now Halle (gethalle com) — and the current service includes REMS with serial-scan comparison, sarcopenia testing (which most U.S. providers ignore despite muscle being a major fracture predictor), and a personalized plan. They also collaborate with Dr. Doug Lucas and Dr. Vonda Wright. My experience has been consistently excellent.