On my report it shows my TBS results L1 - L4 = 1.287 (partially degraded microarchitecture) so that is the average of all 4 lumbar vertebrae.

Normal microarchitecture > 1.31

Degraded < or = 1.23

Given that my 1.287 is closer to 1.31 than 1.23 I took that as an awesome sign.

On page one of the report, there is an image of my L1 - L4 called TBS Mapping and the colors are green (high TBS), yellow is in the middle, and red (low TBS) so the image of my spine, or TBS Mapping, shows each vertebrae shaded in these colors to show what my trabecular bone looks like. On page two, there is a chart labeled "Detailed Spine Results" and it lists the TBS for each vertebrae.
L1 = 1.278 TBS
L2 = 1.323 TBS
L3 = 1.342 TBS
L4 = 1.205 TBS
L1 - L4 = 1.287 TBS (the average)

Note, I question the L4 TBS number. From what I have seen, generally, L1 has the lowest TBS, then L2, then L3, and L4 has the highest TBS. Not sure if you are familiar with Dr. Lani Simpson, but she talks about how, often, on DEXAs, the area captured is 'off' and that skews the data. I honestly think that might be going on with my L4.

The DEXA report itself shows:
BONE SITE BMD T-score BMD 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 exactly does that adjusted mean? Does it mean that they thought my spine t-score was -4.0 but with the TBS added in they now think my spine t-score is almost 1 standard deviation worse, which means instead of 40% less bone than the average 30 year old, they think I have 48% less bone than the average 30 y.o. I mean I really just don't buy that one bit.

I am 4'11''. I haven't had any height loss and I am fracture free. I'm 54 and for the majority of my adult life I weighted be 92 - 101 lbs. In 2016, I gained a few lbs and in 2017 was diagnosed with hypothyroidism for which I take levothyroxine daily. Note, even with the extra weight, my BMI was always w/i range, so I have never been classified as overweight. My current weight is pretty stable at 108 lbs. I joined a gym in January 2022, and I go 3 times a week and between my July 2021 DEXA and my December 2022 DEXA, I significantly increased my lean body mass (muscle).

I am more aware of my movements and shoes with good treads are a high priority for me. I practice hip hinges regularly to remind me to bend at my hips and to avoid forward flexion my spine. I have increased the weights that I use at the gym, what I consider to be a significant amount, over the 1.5+ yrs that I have been going. For ex., I started carrying two eight lb weights when I do the farmers carry (one weight in each hand) and I am up to carrying two thirty lb weights, I am up to 130 lbs on the back extension machine, and 265+ lbs on the leg press (265 lbs is around 2.45x my current weight) and periodically, to challenge my muscles, I take the leg press weights to the max the machine will allows which over 400 lbs.

Any insight you have would be appreciated. I would love to know what your TBS numbers were and if they "adjusted" your t-scores up or down.

The technician who did my scan didn't know anything about DEXA scans. Although I had called and confirmed that the imaging center had a DEXA with TBS capabilities prior to scheduling my scan, when I arrived (after driving approximately 5 hours to get there specifically to get a DEXA with TBS) the technician told me they might not be able to provide the TBS to me. I had the scan done anyway with the intention of writing to the board of directors of the hospital (the imaging center was in a hospital) if they didn't provide me with the TBS numbers. Also, while I was talking to the technician, I mentioned something about t-score of 2 or 3, to which she replied, "that's only 1 point, that's not a big difference." HELLO! That's a 10% difference. That's huge. As the technician predicted, the facility didn't send me my TBS scores after I had the scan. They only sent the standard DEXA info. I had to hound them from several months and it wasn't until I threatened to report the hospital for a HIPAA violition (refusing to provide me with my full DEXA w/ TBS and ancillary data) did I received the information they should have been able to print out and hand to me immediately after having preformed the scan.

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