1. < Osteoporosis & Bone Health

Osteoporosis and Petite Women

Posted by njhornung @normahorn, May 16, 2023

The form I completed before going to an osteoporosis clinic asked if I weigh less than 127 pounds. That magic figure supposedly puts one at greater risk. The Endocrinologist I saw commented on how petite I am and asked if I have always been petite. While for a few years my weight was a little higher I am now back to around 100 lbs. Can't get back to my 21" waist, though.

Searching the literature, it seems that being petite is associated with higher T scores and not just post menopausal
Supposedly DEXA takes this into account when height and weight are entered into the software. However, one could be short and have heavy bones or be small boned. The old weight charts at doctor's offices used to take that into consideration. Does anyone have knowledge that DEXA truly adjusts for structure and the high scores are not an artifact of the technique? There is less bone for the xrays to penetrate which could be interpreted as the bone being less dense. Does density determine quality?

I am at the point of not pursuing treatment until I get a better handle on what my risk truly is. My only fractures were a clean break to an ankle when I slipped on ice and a finger playing touch football. Both were many years ago.

Any insight to offer?

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1956slk | @1956slk | May 28, 2023

Yes, that has always been my concern too with all medications. I am so little, I should be given child's doses. These doctors I've seen so far have been horrid. Pain Management is who I have seen for my scoliosis and some fractures in the spine. He just suggests everything under the sun for my back, including a brace. Orthopedic surgeon stated that would not be good for me. Orthopedic is a surgeon and can do nothing for me because of the scoliosis. Physical Therapist stated that you would rely on the brace instead of making your muscles stronger with exercise. My insurance only covers the cheap osteoporosis tablets to take. No Prolia or Evenity. So I will have to figure out what to do myself. I think exercise and good food. These doctors I see are horrid. My insurance AARP Medicare Advantage through United Healthcare stating that, although had a referral and authorization, that the cost of Physical Therapy is no guarantee it will be covered??? This is what I have to put up with. One more detail a provider, Banner University, located in Tucson, AZ is billing me for an X-ray they never performed. Told me it had to be investigated and have to call back in 2 weeks. This is what I put up with. Medical care is horrid.

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3 replies
njhornung | @normahorn | May 28, 2023

Six times this three day weekend I have participated in coursing ability runs with my dog. This is a sport where the dog chases plastic bags for third of a mile ending where it started so the handler only has a short path. My 20 pound dog, with 4 paw drive, was almost pulling me off my feet in anticipation of her runs. It took major effort on my part to stay standing. I doubt if anyone I have seen about my osteoporosis would approve but my arms are still in their sockets and no fractures

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babychung22 | @babychung22 | May 29, 2023
In reply to @1956slk "Yes, that has always been my concern too with all medications. I am so little, I..." + (show)
@1956slk

Yes, that has always been my concern too with all medications. I am so little, I should be given child's doses. These doctors I've seen so far have been horrid. Pain Management is who I have seen for my scoliosis and some fractures in the spine. He just suggests everything under the sun for my back, including a brace. Orthopedic surgeon stated that would not be good for me. Orthopedic is a surgeon and can do nothing for me because of the scoliosis. Physical Therapist stated that you would rely on the brace instead of making your muscles stronger with exercise. My insurance only covers the cheap osteoporosis tablets to take. No Prolia or Evenity. So I will have to figure out what to do myself. I think exercise and good food. These doctors I see are horrid. My insurance AARP Medicare Advantage through United Healthcare stating that, although had a referral and authorization, that the cost of Physical Therapy is no guarantee it will be covered??? This is what I have to put up with. One more detail a provider, Banner University, located in Tucson, AZ is billing me for an X-ray they never performed. Told me it had to be investigated and have to call back in 2 weeks. This is what I put up with. Medical care is horrid.

Jump to this post

I also have osteoporosis and I am on the injection for six months. It’s working well, but I do trains 4, 5 times a week and I find that helps with pain a great deal.
I am a petite frame.

REPLY
1 reply
ans | @ans | May 29, 2023
In reply to @1956slk "Yes, that has always been my concern too with all medications. I am so little, I..." + (show)
@1956slk

Yes, that has always been my concern too with all medications. I am so little, I should be given child's doses. These doctors I've seen so far have been horrid. Pain Management is who I have seen for my scoliosis and some fractures in the spine. He just suggests everything under the sun for my back, including a brace. Orthopedic surgeon stated that would not be good for me. Orthopedic is a surgeon and can do nothing for me because of the scoliosis. Physical Therapist stated that you would rely on the brace instead of making your muscles stronger with exercise. My insurance only covers the cheap osteoporosis tablets to take. No Prolia or Evenity. So I will have to figure out what to do myself. I think exercise and good food. These doctors I see are horrid. My insurance AARP Medicare Advantage through United Healthcare stating that, although had a referral and authorization, that the cost of Physical Therapy is no guarantee it will be covered??? This is what I have to put up with. One more detail a provider, Banner University, located in Tucson, AZ is billing me for an X-ray they never performed. Told me it had to be investigated and have to call back in 2 weeks. This is what I put up with. Medical care is horrid.

Jump to this post

To @normahorn and others - maybe you got this information already , but if not-
BONE STRENGTH =BONE DENSITY what the DEXA reveals +BONE QUALITY what the TBS (trabecular score ) would reveal.
So clearly the DEXA IS NOT THE WHOLE PICTURE!!!

And my endocrinologist, for one, and I assume many, are not that interested in pursuing the TBS test as the DEXA seems to be the standard upon which they base their decisions.
And finding a place that performs the TBS can be somewhat challenging, though I’m told it’s just another button they push when doing the DEXA if the appropriate add on to their DEXA instrumentation has occurred.
Good luck!!!

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1 reply
ans | @ans | May 29, 2023

If others have more to share on the idea of the DEXA being off due to low weight I WOULD LOVE to hear all of that. Thanks!!

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foxy23 | @foxy23 | May 29, 2023

I read that you are more likely to have osteoporosis over 5’7” and under 127 lbs. That sums it up for me.

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tkdesign | @tkdesign | May 30, 2023
In reply to @1956slk "Yes, that has always been my concern too with all medications. I am so little, I..." + (show)
@1956slk

Yes, that has always been my concern too with all medications. I am so little, I should be given child's doses. These doctors I've seen so far have been horrid. Pain Management is who I have seen for my scoliosis and some fractures in the spine. He just suggests everything under the sun for my back, including a brace. Orthopedic surgeon stated that would not be good for me. Orthopedic is a surgeon and can do nothing for me because of the scoliosis. Physical Therapist stated that you would rely on the brace instead of making your muscles stronger with exercise. My insurance only covers the cheap osteoporosis tablets to take. No Prolia or Evenity. So I will have to figure out what to do myself. I think exercise and good food. These doctors I see are horrid. My insurance AARP Medicare Advantage through United Healthcare stating that, although had a referral and authorization, that the cost of Physical Therapy is no guarantee it will be covered??? This is what I have to put up with. One more detail a provider, Banner University, located in Tucson, AZ is billing me for an X-ray they never performed. Told me it had to be investigated and have to call back in 2 weeks. This is what I put up with. Medical care is horrid.

Jump to this post

I feel for you. Doctors are horrid, and they often know little about the drugs they prescribe. They often neglect your mental health needs too. I am very small too, under 100lb, and feel the doses they prescribe as universal is just not sound science. It makes zero sense to me. Every time I get a pill prescription I need half or quarter the dose....why not injections too? Every women at the same age is not the same height, weight, body type, etc. Hopefully pain management avoids steroids (which weaken bone/tissue). I turn a lot to more natural medicine as a last resort: herbs, supplements, foods, exercise. It takes some research though, and finding a knowledgeable naturopathic doctor. DO medical doctors also sometimes have more background in natural methods than MDs. I am on standard govt. Medicare for disability, and it works great, and they rarely deny anything. It helps to have state Medicaid too, if you are lower income. I have heard, but you may wish to research yourself, that "advantage" programs are not real Medicare, but private insurance using the Medicare name...you may want to look into getting away from that back to regular Medicare, though I've heard also this is hard, because the private companies make it hard.

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1 reply
1956slk | @1956slk | May 30, 2023

Thanks for commenting your opinions and what you are doing with your body. I appreciate it.

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donnam14 | @donnam14 | May 31, 2023

Hello,
It is my understanding that one with a smaller frame is at greater risk for osteoporosis. Few of us are “textbook” cases, and we need to be sure to do what is right for ourselves.

REPLY
rjd | @rjd | Jun 1, 2023
In reply to @tkdesign "I feel for you. Doctors are horrid, and they often know little about the drugs they..." + (show)
@tkdesign

I feel for you. Doctors are horrid, and they often know little about the drugs they prescribe. They often neglect your mental health needs too. I am very small too, under 100lb, and feel the doses they prescribe as universal is just not sound science. It makes zero sense to me. Every time I get a pill prescription I need half or quarter the dose....why not injections too? Every women at the same age is not the same height, weight, body type, etc. Hopefully pain management avoids steroids (which weaken bone/tissue). I turn a lot to more natural medicine as a last resort: herbs, supplements, foods, exercise. It takes some research though, and finding a knowledgeable naturopathic doctor. DO medical doctors also sometimes have more background in natural methods than MDs. I am on standard govt. Medicare for disability, and it works great, and they rarely deny anything. It helps to have state Medicaid too, if you are lower income. I have heard, but you may wish to research yourself, that "advantage" programs are not real Medicare, but private insurance using the Medicare name...you may want to look into getting away from that back to regular Medicare, though I've heard also this is hard, because the private companies make it hard.

Jump to this post

In my opinion, the biggest problem with standard Medicare is there is no Out Of Pocket limits. Just think what this means for some very expensive essential treatments like cancer.

Medicare Advantage is suppose to cover everything available under standard Medicare. If your Advantage coverage is denying treatment, find out what Medicare would do. Then appeal the denial and perhaps make a complaint with Medicare officialdom.

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