Osteoporosis and Petite Women

That whole idea of being lower in weight and how the DEXA is taken and the results interpreted , if it needs to be, is an interesting concept. I would love to hear more on that if anyone knows!!

Interesting comment about weight. I weigh less than 100 lb and small bone. I’ll ask technician this question when I’m at my next dexta scan next year.

I would be interested in any information. I am small and have osteoporosis and told that it’s common for we small women unfortunately!

This link should take you to whar I assume might have info of true interest. Some of the comments had me laughing.
https://www.inspire.com/groups/bone-health-and-osteoporosis/discussion/significance-of-weight-under-127lb/

Regarding your comment, “There is less bone for the xrays to penetrate which could be interpreted as the bone being less dense,” bone density tests don’t truly measure bone density.

“The DEXA technique analyzes the attenuation of xrays as they pass through an area of the body. The method cannot detect the depth of the bone which is being measured, and thus is actually an "areal" density in g/cm2 rather than a "volumetric" or Archimedean density in g/cm3.” Source: https://courses.washington.edu/bonephys/opBMAD.html. That is also the link to Dr. Susan Ott’s BMAD calculator, which you might find interesting.

You might also want to look up Dr. Lani Simpson, https://lanisimpson.com/ She talks a lot about inaccuracies with DEXA scans.

It’s good that you are trying to gather more info and not letting a doctor push you on to osteoporosis meds.

Here are a few more informative links
https://www.betterbones.com/fractures-and-healing/bone-quality-thinner-women/
And the link below lists tests you should have before going on osteo-meds https://www.betterbones.com/testing/whats-the-cause-of-your-osteoporosis/

BTM (bone turnover marker) tests can tell you if you are losing a lot of bone right now. One DEXA scan is just a snapshot in time. It doesn’t tell you if you are actively losing a lot of bone. BTM tests can.

And this website can help you find an imaging center in your state that has DEXA with TBS capabilities. https://www.medimapsgroup.com/

TBS (trabecular bone score) is a much better indication of bone health/strength than T scores are. According to BetterBones.com “various studies document that well over half of those who suffer a low-trauma “osteoporotic” fracture do not have an osteoporotic bone density. Rather they have “osteopenia,” or even normal bone density.”

Just have to share this experience I had the other day. After knowing how the TBS along with the DEXA gives you a much better understanding of your situation I went to a listing I found of all the places in NY state that had the test. Cause it’s not easy to find that being offered. To my surprise there were 2 very close to me, but when I called the one they said they had it but don’t use it. That was in a like a drs office. The other which was a well respected hospital and they also indicated that . I was totally purplexed.!!!! So I pressed because I was speaking with one of the technicians, and she made it sound like the people in charge( ?? Drs or who I don’t know ) have decided that. I asked for the reasoning and she didn’t know . I asked her to please ask those questions and get back to me. So far after 2-3 weeks no response!!! I did tell her what I knew and hoped maybe she would share that with her team . So all of this was quite an eye opener for me !!

My physician cousin commented to me a couple of decades ago that small, fine boned, petite women are at higher risk for osteoporosis. Due to some health issues, however, I went from 110 to 155 pounds and sometime spike up to an even higher weight.

Though I prefer my former slim size my doctor told me that by carrying around more weight I am less likely to suffer bone loss because carrying extra weight is equivalent to doing weight bearing exercise.

This was the case till I was forced into a lengthy period of inactivity from a failed spinal surgery. Now I have to find a bone loss treatment I can tolerate, so weight is only one factor.

Weight is a factor, but Activity levels, weight bearing exercise and other factors also come into play. Good luck with your bone health. If your dexa scan indicates bone loss get on something like Fosamax right away.

Did you try this website to find a dexa scan facility?? They list quite a few New York State locations. Of course NYC has a lot of options but you may not live near the metro area.
https://www.nyuhs.org/care-treatment/womens/breast-health/bone-density-dexa-scan

If you use the link I provided in my post, you can fill out the form and they will send you a list of all the facilities in your state with DEXA w/ TBS capabilities. I recommend doing that, and then, from that list, trying to find a facility that can say w/ confidence, “Yes, we have TBS capabilities.”

I question the response you got from the hospital you contacted. There is no “special” piece of equipment that does the TBS part of the scan. All that is required is that the DEXA scanner (Hologic or GE Lunar) has the TBS software installed on the machine. Again, I would attempt to find a facility that regularly does DEXAs w/ TBS, but if the hospital is your only option, you may want to consider going over a few heads. Hospitals have a board of directors. I’m sure the board would hate to learn that their staff can’t figure out how to, literally, click on a link/button on a computer screen to provide you with a TBS.

There is absolutely nothing different in the procedure (meaning what is scanned) between a DEXA and a DEXA w/ TBS. The patient walks in, lies on the scanner, is scanned and that’s it.

I fully understand how incompetent too many of the people working with DEXAs are. It took me approximately 3 months to get my DEXA ancillary data. When I asked for it, the imaging center manager was very condescending to me and insisted that they did not have the information. Finally, I called GE and spoke to the technician who services the machine my DEXA scans were done on and he, literally, walked me through how to print the report, as in, go to this menu, click on this, then on that, and hit print. When I called the imaging center manager back and told her that they needed to talk to the technician, she was still very snippy with me, but shortly thereafter, she called me back and was just as nice and polite as she could be and I finally got the ancillary data.

Finding a facility with DEXA w/ TBS and setting up an appt and getting my trabecular bone scores was also no walk in the park. My endocrinologist didn’t know where I could get a DEXA w/ TBS, I saw another endocrinologist, who said she would help locate a facility with DEXA w/ TBS, but she never did. So I called GE again and the GE Lunar sales rep I spoke to told me about the website to help locate facilities w/ TBS capabilities. The website was awesome. I filled out the form and had a response w/i 15 minutes. Unfortunately, for my state there were only 6 facilities w/ TBS capabilities. 2 are VA related, which means they weren’t really options. 2 were at the largest university in my state and there were no phone numbers listed. The university has no medical school but it does have a huge agriculture dept so my gut feeling is those scanners are for research not for humans. Another was for a children’s hospital and luckily one was for a hospital in a wealthy, rural area of the state. I called the hospital and they had no idea what I was talking about. After several calls, they finally said yes, we have a DEXA scanner w/ TBS capabilities. The hospital is approximately 5 hrs away from my home but I was determined. I asked my endocrinologist to send a referral to the hospital but he never did and he wouldn’t get back to me, so I took the referral from a DEXA w/ TBS which he’d written for a local imaging center (which doesn’t have TBS capabilities) and scratched out the name of the local facility and faxed it to the hospital myself. I called the hospital but they said they could not get it entered into their system because for some reason it wouldn’t let them enter my endocrinologist’s name. After a few more calls, I convinced someone at the hospital to enter it under another doctor’s name (someone already in their system).

Then came the day of my scan. When I walked into the room to have the scan done, the technician said, “I know we told you we could do a DEXA w/ TBS, but we might not be able to give you that information.” Given that I’d driven approximately 5 hrs just to get a trabecular bone score, it’s amazing that I was able to remain calm. I had the scan and it took me a couple of months, and I had to threaten reporting them for HIPAA violations, to finally get my DEXA w/ TBS report.

Hope you are able to find a competent imaging facility. Oh and the reason the hospital couldn’t get my endocrinologist’s name entered into their system is because doctors have to have “rights” to a hospital, which is something my endocrinologist should have told me when I asked for the referral and something everyone who works at a hospital should know. 🙂

I am very small petite person also, around 100lb, and have had higher T scores since my 30s. I've never suffered a fracture except an elbow from a fall in my 20s. I am so scared of all the osteoporosis drugs, and each one I've tried gave me bad side effects. I was told it's not just density but structure/genetics that predict fracture risk. There are no dose adjustments on all these drugs too, which concerns me. What you give a 200lb person should not be the same as 100lb. I bet many side effects could be reduced.