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Osteoporosis and Petite Women

Osteoporosis & Bone Health | Last Active: May 13 3:38pm | Replies (76)

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@hopefullibrarian

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

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Replies to "My size is almost identical to yours, and I'm trying to get tests to narrow down..."

Thanks so much @hopefullibrarian! The video was very helpful and I
appreciate your description of TBS and CXT. It looks like I should ask for
TBS with my DEXA and get Dr McCormick book.

I just plowed through the endocrinologist report dated 2015 and posted on mayoclinic.org that hopefullibrarian linked to. It is very technical but worth reading.

I am providing a direct quote from that report addressing a topic that all of us smaller women discuss. That is, whether our size affects our DEXA score.
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"Likewise, standard DXA imaging has its own limitations, due to its measurement of bone mineral content over a projected bone area to provide an areal BMD. These limitations stem from the inability of DXA imaging to differentiate cortical from trabecular bone, its provision of a 2-D (areal) measurement of a 3-D structure, Likewise, standard DXA imaging has its own limitations, due to its measurement of bone mineral content over a projected bone area to provide an areal BMD. These limitations stem from the inability of DXA imaging to differentiate cortical from trabecular bone, its provision of a 2-D (areal) measurement of a 3-D structure, and its tendency to underestimate BMD of smaller bones and overestimate BMD of larger bones."
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I would bold the text of the final clause if I could figure out how to do that on my bloody iPad.