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

Not a good score but a bone building medication can bring it back up substantially.

The weird thing I've noticed (and the doctor and the densitometrist commented on this also):
My bone loss progresses VERY fast, They were so perplexed that they did the scan TWICE, because they couldn't believe their eyes, My total spine has gone from -3.6 to -4.0 in 6 months time. Same machine, same doctor.
I'm devastated for having to deal with this at such a young age.

@sophie93 I don't think there is a big difference between -3.6 and -4.0 in terms of urgency. I have kept a chart of my scores since 2001 and they jump around a bit, even with the same machine. Some variation happens because of the way technicians do things. I was told only a change more than -.5 was significant. Regardless, even at -3.6, you need to do something.

How old are you? Have your hormones been tested? Parathyroid? What meds are you going on? Hoping Tymlos, Forteo or Evenity.

I had a -3.6 in spine that went to -2.5 (borderline) in 18 months on Tymlos.

I am so sorry you are dealing with this as a young person.

@windyshores

Thank you for replying.

I'm 30. The reason for me developing osteoporosis at such a young age is early menopause. I have already gone through it a couple of years ago. My mistake is that I didn't do something back then, so when I did my first dexa scan it was already established osteoporosis everywhere.
Regardless, I can't be put on HRT because of other risk factors. Parathyroid is fine, and really everything else came back fine.

I'm on oral bisphosphonates but I had only one pill since the start, so I'm aware it cannot work as quickly. This medication was prescribed already a year ago, but I postponed taking it, I wanted to go the 'natural route' which didn't do anything obviously.

so sorry that you are dealing with this at a young age. It is a scary diagnosis but the good news is you've discovered it early and can now take all steps necessary to improve. Have all causes been explored? Have you been tested for celiac? A truly accurate diagnosis can only be determined by biopsy but gluten antibodies can be tested. Your osteoporosis may be specific only to early menopause though and that would surely be reason enough.

May I ask why you cannot go on HRT? There may be specific risks in your case that preclude using hormones but I ask this because most conventional doctors will not prescribe hormones due to fear of risk factors that were misinterpreted in the flawed Women's Health Initiative study from 30 years ago. If it is something you want to explore further to get an accurate picture of actual risks, I would highly recommend seeking out a knowledgeable specialist in menopause and hormone therapy (as most gynecologists and endocrinologists are not knowledgeable in this area). One can be found through the North American Menopause Society. You can also start by listening to Dr Felice Gersh, Dr Mary Claire Haver and Dr Avrum Bluming (book-Estrogen Matters) to get a more accurate assessment of benefits vs. risks. This may not be applicable in your case but worth a really thorough exploration as hormone replacement therapy would help build and maintain bone (along with a focused diet and appropriate exercise)

@teb

Thank you for replying!
I have done all the necessary tests for secondary causes. And everything came back clear. Therefore it was concluded that the reason for the bone loss is my early menopause.

I can't go on HRT because I'm considered to have a high risk for breast cancer. It just terrifies me and I don't want to take any chance...

I understand. Good that you are on Fosamax to arrest the progression. That will buy you a little time to figure out a long term plan. Wishing you the best of luck moving forward.

Thank you. I hope that meds will stop this progression (I'm on Boniva, the monthly pill) But it is the same category as Fosamax, regardless.
I wish you the best as well 🙂

If your DEXA's are of serious concern perhaps you can convince your doc to prescribe Forteo, Tymlos or Evenity first. The better sequence is those bone builders first, then lock in gains with Reclast or other bisphosphonate like Boniva.

My sister had a hysterectomy and has used replacement hormones for decades, with no cancer. I have not used hormones after menopause but I got cancer (breast). Being low on estrogen has some health effects that may rival cancer. I am fine after my treatment (8 years out). You are probably right but I would get a second or even third opinion!

All of the doctors that are aware of my situation, have said that it is ok to try to stop the progression with a bisphosphonate.
I think they refer to my blood markers of bone turnover: The ones that reflect bone building are in the normal range, but the ones that reflect bone resorption are elevated. Hence the bisphosponate