I wrote a detailed long reply and the system can’t handle it (it won’t post).

Here’s the condensed version.

I had 2 DEXAs, 1 week apart, in December 2022, a DEXA w/ TBS on a Hologic scanner and a DEXA on the same GE Lunar scanner used for my previous 2 DEXAs.

My 12/2022 Hologic TBS scores showed
L1 1.278
L2 1.323
L3 1.342
L4 1.205
Total 1.287

Spine TBS L1-L4
Normal microarchitecture > 1.31
Degraded microarchitecture < or = 1.23

According to the reference range my L2 and L3 are in the normal TBS range, L1 is partially degraded and L4 is degraded.

The GE Lunar and Hologic showed very different T-scores for my L4 (-2.9 and -3.8) but they both showed my L4 as having the highest bone density in my lumbar spine. The images that came on my TBS report, show an area that looks like it was captured with my L4 that should not have been included in the calculation (stuff Lani Simpson talks about). Others, who I have chatted w/ on-line, who’ve had DEXAs w/ TBS, seem to have scores that follow a pattern, L1 has the lowest TBS, then L2, then L3, and L4 has the highest. On my report my L4 has the lowest TBS, then L1, then L2, and L3 has the highest????????????

My TBS report goes on to show:

BMD. BMD T-score
T-score adjusted*
Spine -4.0 -4.8
Femoral Neck -3.3 -3.6
Total Hip -2.6 -3.0

*Adjusted for ethnicity, gender and TBS.

What the hay does “Adjusted for ethnicity, gender and TBS” even mean?

I thought TBS was only done on the spine so how can my hips be adjusted for TBS and how can my ethnicity and gender cause my t-scores to be “adjusted” lower? People of my ethnicity and gender (fair-skinned white, females) are known to have a higher risk of osteoporosis.

So, yes, I’m left with lots of questions.

I know that Dr. Simpson will review results for a fee. If I find a pot of gold I’ll gladly pay for her evaluation. My potential future bone health spending includes 1. Hiring a personal trainer 2. Traveling out of state to get an REM scan w/ consultation 3. purchasing a Marodyne LiV.

I joined a gym last year and go 3 times a week and have been gradually increasing weights. I mostly use the weight machines. I’m considering hiring a personal trainer to help me properly add/do deadlifts which I currently don’t do.

I have hypothyroidism and this is also one of the reasons I question if my endocrinologist knows what he’s doing. I was aware that hyperthyroidism can cause osteoporosis due to increased bone turnover but I just recently learned that hyperthyroidism effects bones by slowing bone formation. Bisphoshonates don’t stimulate bone grow. They work by slowly resorption. Because my endocrinologist didn’t do BTM (bone turnover marker) testing prior to prescribing bisphosphonates, I don’t have baseline tests for comparison but in November 2022 (a yr after my 1 and only zoledronic acid infusion), I had BTM testing done at my request. My bone turnover markers are not high.

Last year I signed up for this on-line osteoporosis forum. It’s free, there are lots of speakers/events and they cover many topics. The link to sign up this year is https://morebonehealth.byhealthmeans.com/