Osteoporosis and Petite Women

I am petite, but I consider myself strong. I am 70 years old, 5'1.5" and weigh between 108-110 pounds. I consider myself "small boned." After 5 years without a DXA, I had one last March and the numbers scared me considerably. My hips were only slightly osteoporadic, but my spine was -4.5. I then made an appointment with an osteoporosis specialist in Central Florida, who I heard did not "push" prescription medications. The first appointment was 3 1/2 months away. Although I previously had researched osteoporosis and non-medication treatments, I continued with vigor. I read in many places that women with small wrists may have inaccurate DXA scores. I believed it.

After my first appointment with the specialist, I asked her about inaccurate DXA scores for petite women. She said that was wrong. Instead, she started pushing me to start Evenity after the series of blood tests, spine Xray and cardiac screening were complete. I left her office dejected and annoyed that I think she looked at my numbers and not me.

Prior to my second appointment, I learned about Echolight REMS technology and pretty much decided that Central Carolina Othopedic would likely be the location of my second opinion. I had watched a video of a symposium on REMS where the doctor at the facility stated that DXA scores can be inaccurate for petite women (like his wife).

My osteo specialist changed her mind during our second visit and thought that Prolia may be a better choice than Evenity since my bone resorption rate was elevated. I asked her about testing my bone quality. She said that they could test for TBS but insurance may not pay since I had a DXA 5 months ago. I told her I did not care since I was prepared to travel to NC to get a REMS scan. The doctor informed me that she thinks TBS is better than REMS. (I am not sure I believe her, but will get a TBS). It so happens that the DXA in my doctor's other office has TBS software. (I am still dumbfounded that I had to ask for it and it was not offered). I had an appointment for the DXA with TBS last Friday, but it was canceled by the facility the day before "due to scheduling conflict." Hopefully, my appointment this Friday will not be canceled.

Sorry for the lengthy explanation, but I am convinced that my DXA scores are low partially because I am petite. I strength train 3x/week, walk daily, swim every other day, climb stairs daily, practice yoga daily, take supplements and eat healthy. I feel like I am strong and I think I look like I am strong.

I am still trying to read everything I can and am doing my best to avoid osteoporosis medication. In fact, Great Bones by Dr. McCormick should be delivered to me this afternoon.

I am petite, but I consider myself strong. I am 70 years old, 5'1.5" and weigh between 108-110 pounds. I consider myself "small boned." After 5 years without a DXA, I had one last March and the numbers scared me considerably. My hips were only slightly osteoporadic, but my spine was -4.5. I then made an appointment with an osteoporosis specialist in Central Florida, who I heard did not "push" prescription medications. The first appointment was 3 1/2 months away. Although I previously had researched osteoporosis and non-medication treatments, I continued with vigor. I read in many places that women with small wrists may have inaccurate DXA scores. I believed it.

After my first appointment with the specialist, I asked her about inaccurate DXA scores for petite women. She said that was wrong. Instead, she started pushing me to start Evenity after the series of blood tests, spine Xray and cardiac screening were complete. I left her office dejected and annoyed that I think she looked at my numbers and not me.

Prior to my second appointment, I learned about Echolight REMS technology and pretty much decided that Central Carolina Othopedic would likely be the location of my second opinion. I had watched a video of a symposium on REMS where the doctor at the facility stated that DXA scores can be inaccurate for petite women (like his wife).

My osteo specialist changed her mind during our second visit and thought that Prolia may be a better choice than Evenity since my bone resorption rate was elevated. I asked her about testing my bone quality. She said that they could test for TBS but insurance may not pay since I had a DXA 5 months ago. I told her I did not care since I was prepared to travel to NC to get a REMS scan. The doctor informed me that she thinks TBS is better than REMS. (I am not sure I believe her, but will get a TBS). It so happens that the DXA in my doctor's other office has TBS software. (I am still dumbfounded that I had to ask for it and it was not offered). I had an appointment for the DXA with TBS last Friday, but it was canceled by the facility the day before "due to scheduling conflict." Hopefully, my appointment this Friday will not be canceled.

Sorry for the lengthy explanation, but I am convinced that my DXA scores are low partially because I am petite. I strength train 3x/week, walk daily, swim every other day, climb stairs daily, practice yoga daily, take supplements and eat healthy. I feel like I am strong and I think I look like I am strong.

I am still trying to read everything I can and am doing my best to avoid osteoporosis medication. In fact, Great Bones by Dr. McCormick should be delivered to me this afternoon.

I hope you can stand your ground, as they use to say. Another words, trust your intuition. I have a similar situation. I'm 75 with osteroporsis diagnosis. It's probably this way since I've been taking thyroid hormone since my 30's, and at times the amount was too high. So, this is probably what caused it. Also low VitD. Have this vitamin checked. It's low in many people. It needs to be taken in combination with Vit K. (they are combined in supplement). Good luck
The meds have difficult side effects. Study the problem.

I am petite, but I consider myself strong. I am 70 years old, 5'1.5" and weigh between 108-110 pounds. I consider myself "small boned." After 5 years without a DXA, I had one last March and the numbers scared me considerably. My hips were only slightly osteoporadic, but my spine was -4.5. I then made an appointment with an osteoporosis specialist in Central Florida, who I heard did not "push" prescription medications. The first appointment was 3 1/2 months away. Although I previously had researched osteoporosis and non-medication treatments, I continued with vigor. I read in many places that women with small wrists may have inaccurate DXA scores. I believed it.

After my first appointment with the specialist, I asked her about inaccurate DXA scores for petite women. She said that was wrong. Instead, she started pushing me to start Evenity after the series of blood tests, spine Xray and cardiac screening were complete. I left her office dejected and annoyed that I think she looked at my numbers and not me.

Prior to my second appointment, I learned about Echolight REMS technology and pretty much decided that Central Carolina Othopedic would likely be the location of my second opinion. I had watched a video of a symposium on REMS where the doctor at the facility stated that DXA scores can be inaccurate for petite women (like his wife).

My osteo specialist changed her mind during our second visit and thought that Prolia may be a better choice than Evenity since my bone resorption rate was elevated. I asked her about testing my bone quality. She said that they could test for TBS but insurance may not pay since I had a DXA 5 months ago. I told her I did not care since I was prepared to travel to NC to get a REMS scan. The doctor informed me that she thinks TBS is better than REMS. (I am not sure I believe her, but will get a TBS). It so happens that the DXA in my doctor's other office has TBS software. (I am still dumbfounded that I had to ask for it and it was not offered). I had an appointment for the DXA with TBS last Friday, but it was canceled by the facility the day before "due to scheduling conflict." Hopefully, my appointment this Friday will not be canceled.

Sorry for the lengthy explanation, but I am convinced that my DXA scores are low partially because I am petite. I strength train 3x/week, walk daily, swim every other day, climb stairs daily, practice yoga daily, take supplements and eat healthy. I feel like I am strong and I think I look like I am strong.

I am still trying to read everything I can and am doing my best to avoid osteoporosis medication. In fact, Great Bones by Dr. McCormick should be delivered to me this afternoon.

Thanks Ladies for all your thoughts, experiences and thoughtful consideration of this important health issue. I’m a petite, 75 year woman who, like many of you, are attempting to tread the choppy road of refusing meds for my osteoporosis. I’m optimistic after hearing your stories. I’ll get the book, go see an Osteo doc and continue my healthy diet, exercise program. 🙏 This group gives me hope. I’m grateful.

I am also petite, 5 ft 3 inches and 107 lbs. I used to weigh less than 100 lbs before I started breaking bones and became less active. I have tried the natural way for 10 years, and was so against taking the medication. Last year I fell twice, breaking my ankle and hand. This year I fell 3 times, breaking my shoulder, ankle and suffering a concussion. I am now taking 20 mcg of Tymlos, 1/4 a dose. That is all I can tolerate, but my endocrinologist says that any amount will help. My DEXA scan is scheduled for next month. I wonder if anyone can explain what TBS and CTX mean.

My size is almost identical to yours, and I'm trying to get tests to narrow down the cause of my bone loss, as well as my true fracture risk at this point. I'm learning about these things in order to be able to have an informed discussion with my doctor on my course of treatment.
Because I'm petite, I feel that I need to be extra cautious.

Dr. Keith McCormick's book, Great Bones is the osteoporosis "Bible" which includes detailed explanations of all of the tests, how and when to use them, and why they are important.

Just last night I watched a YouTube video of an interview with Dr. McCormick hosted by Dr. Margie Bissinger titled "Bone Turnover Markers and Osteoporosis. It does a great job of explaining the various tests.
You can view it here: https://youtu.be/eZIgvcM9Ous?si=l9yyn4BhkeXPV31X.

Based on my understanding of each, I'll summerize what TBS and CTX are.
TBS (Trabicular Bone Score) is a measure of bone quality done through a software add-on used during your DEXA scan. It measures bone quality. TBS combined with your T-score provides a better indication of your fracture risk than the T-score can on its own.
CTX (C-terminal telopeptide) is a measure of how quickly your bone is breaking down (resorption/osteoclastic activity). This is helpful before treatment to narrow down the cause of bone loss, and as a measure of the effectiveness of treatment.

Here's some info on both directly from the Mayo Clinic:
TBS:https://www.mayoclinic.org/medical-professionals/endocrinology/news/new-tools-to-predict-fracture-risk/mac-20430573
CTX: https://www.mayocliniclabs.com/api/sitecore/TestCatalog/DownloadTestCatalog?testId=83175