How bad is a spine T-score of -4 ?

@maloc I have not, but I see that they are highly rated. Dr. Siris has all five-star reviews. Worth checking out!
https://www.columbiaendocrinology.com/osteoporosis

@bk1212 If you have not taken any bisphosphonates before, an anabolic bone building medication such as Forteo would be my suggestion. I was also in my 40's when they told me I had osteoporosis . My arm was first to fracture, then my spine with multiple compression fractures. Lumbar spine was T-score -4.1. From those fractures I lost 3 1/2 inches of height. Once I started fracturing, it did not stop until Forteo started working at about 3 months. The pain was very debilitating. Do see a specialist and take care of yourself!

Greetings. I am almost 70, a biomedical scientist living in the Boston area. My bones got more than a little bit scrawny from many years of misdiagnosed celiac disease. It's a known cause of OP. I'm now avoiding gluten and taking Evenity. I have some rough patches with the medicine because it's really strong, but from what I've read for some folks it can be worth it along with other lifestyle changes. I'm relieved to know there are treatments that help and that fractures can be avoided even with pretty low T scores (one of mine is -3.4). Don't give up hope! We all need support for the discouraged and struggling periods. I'm glad I found this group and have learned so much already from the people here who are so generous in posting their experiences. Thank you all! Sincerely,
Barb

@gently
Hi I have been managing BC for 1bouot 14 yrs. It was discovered to be metastatic to a vertabrae in late '23. It has been in "sleeping" mode I was told in the last yr. NO increase since the Met. diag. I take half dose of Anastrozole and have had dental surgeries to molars so have only has 2 Zomeda infusions a while back now & my diag. of Osteopenia just last mo. after a Dexa is now showing upwards of 3 to the lower spine and hips. I have another dental sugery pending...and took a NIA dance class last wk & was trying to take it easy, but have a lot of moving of boxes, and house wk from 2 pets...and next thing you know it seems like a sm fracture to a rib from 10 yrs ago flared up w/ I think "The Body keeping score" of all I did in the last 3 wks...So the thing about our bones if we do the right exercises rebuilding I am gather that what you mean by that is unfractured bone rebuilding. I am so nervous abt. this avg. pain in that rib that has been lessening since I have been trying to take it easy & do not think I will do that dance class this wk...What does anyone suggest about how to "rebuild" through exercise? a sm rib fracture that wasn't bothering me until I did this dance movement class called NIA. ? Additionally, I have a tendency for some buldging lower back disc issues if I do bending over doing to much lifting & bending over type things like yard wk .

Rococo325,
NIA started as non impact aerobics, but has evolved. The movements I've seen look like good bone building for the lower spine and hips where you have the low bone scores. And unless your disc bulges are herniated this type of exercise rehydrates the discs.
The upper body movements which make the dancing more fun aren't so advantageous for bone building, but probably aggravated scar tissue around your old fracture. Still, follow-up with your oncologist to ascertain that it isn't cancer related could be wise.
That lifting can be so hard on your discs especially if you are accomplishing something (different from lifting weights where you concentrate on form. Lifting while twisting is ill advised. And it important to lift with your legs with your back in neutral.
A lidocaine patch could ease that rib. It isn't the metastatic rib?
It is so good that either you or your medical team detected the metastasis ten or eleven years after the cancer.
Often metastasis is missed after 5 years when we feel safe.

I would appreciate knowing this as well. Is it possible to reverse or lower a T score of 3.5 to 4.0 with any vitamins or natural remedies? If so, what are they and what works the best?

@paige479 you generally need Forteo or Tymlos to build bone in spine when numbers are in that territory. I tried exercise, diet, supplements but spine got significantly worse, and I felt it in my lower back. Tymlos took me into mid osteopenia range and eliminated my lower back pain. As we age and are older, these drugs can do a whole lot more than natural approach…at least that is my experience, and I am a healthy active person.

@paige479 most experts on bone health will state that meds are needed to treat low scores. My T score in my spine was -4.6. Before diagnosis I always ate healthy and exercised weights, jogging etc. I also have taken many supplements including BHRT. I took Evenity for a year and my score after was -3.3 then took Prolia for 2 infusions and now on Reclast. I have a DEXA in August and will see what that score reads.

I'd like to know more too. I have -5 of several lumbar vertebrae and an average of -4.6 in lumbar spine - other parts of column are fine and hips are - 2.6. I have been offered, and approved for, both Tymlos or Evenity. I am 64 and tying to make a decision about either - or a natural approach that includes increasing protein in my diet, etc. I already take 2000 of Vit D3, no other meds, and am healthy and active. My FRAX Score is 12 - not too bad so should I start drugs now - or wait until later? Or is it a lost cause for the lumbar spine when so low? How low can they go...-8, -10?! There is not alot of data/information out there for those of us who have really low T scores -research seems to be geared toward those with early osteoporosis and reversal to osteopenia and pharmaceutical intervention. There is longevity in my family and I don't want to be on drugs for bones for 30 years or more. We are an organism and any drug, or supplement for that matter, effects many organ systems. I have been struggling with making a decision for several months now. I hope more people chime in about progress toward greater bone health, or not, who were diagnosed with T scores -4 or below. Hard to say which path is best; well, clearly anabolic is best to build bone quickly, and this would need to be followed by biphosphonates to lock in any gains - and at the moment we would need life-long treatment. What are the long term effect of this drugs...and the sequence of drugs for life? Do those effects outweigh the benefits? Is anyone willing to share info on their long term treatment path - pluses and minuses, etc. I am aware of risks of hypercalcemia on kidney, heart, brain...and bone. I don't believe we have enough longitudinal data - so our best resources are ourselves.

@rococo325 I had BC when 59. Had chemo and radiation but luckily had not spread. My Dena scan year later was a -3.5 then two years later after being on Actenol it was -3.7. I had to stop meds be cause of side effects. Did no other drugs but very active person. Last year had a compression fracture from lifting. My Dexa was -2.9. It had improved that much without meds in that length of time and aging. Ihsve.been prescribed Tymlos but have to take very low dose which my Endocrinologist is fine with it. Wishing you the best and know you’ll get better in time.