Osteoporosis and Petite Women

On the surface, that's baffling. I wish you'd gotten a response.
Thanks for sharing. It's is a perfect example of why there's a need to ask questions and get confirmation. If the medical center where I'm having my next Dexa wasn't going to do the TBS, I'd just go ahead and have it done in the same place as the first one.

Unfortunately, this link will not provide you with the TBS information unless you provide them with a valid email address.

To me, this suggests that I will be inundated by marketing efforts or even that my email address will be sold. So I avoid interacting with such sites; looking for another way to find the TBS info.

I recently had a DEXA scan with TBS and found out the hard way that the TBS must be indicated on your doctor's order. The software is not permanently loaded on the DEXA. Advance notice is required for the technician to do so. Insist that you doctor specifically prescribes it in the order. I hope this helps all of you having issues with this matter.

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.

Take a sheet of 20 lb paper and hold your phone flashlight behind it. The light in partially blocked the same way that the x-rays are blocked by a bone. Now do that but using 2 sheets of the same thickness and quality paper. The light is further reduced. The quality of the paper has not changed but will appear to have based on the light transmitted. This is an oversimplification but demonstrates the affect the depth of the bone being measured can have. Fine boned people have less depth of bone blocking the x-rays (between the source and the measuring device.)

This conversation has perfect timing for me. I recently had my 1yr follow-up due to my diagnosis of osteoporosis back in Dec of 22, at age 67.

So during this time, Dec 22-Jan 24, I've tried to do all things possible. My recent NTX shows I' m losing bone above normal. Personally, I don't think I'll ever be able to do enough to stop the process without RX , just hoping to slow it down a bit. I don't want to fracture, but I'm also thinking about the reliability of a simple DEXA to make this decision for me. My Dr strongly feels I need to take action, so I initiated the conversation of an anabolic first. She came around and agreed to prescribe in that order (after reciting the scary rat story😉) in which I was able to counter with the facts (humans vs rats, etc) all b/c of this site and follow-up research. That alone was an accomplishment and now changing facilities. I new I wanted a TBS along with a 1yr DEXA, another hurdle. I Just didn't have the strength to defend another point of changing facilities that offer both, so I didn't, it did come up to stay at the same. I do understand for comparison purposes the necessity. It's not easy convincing Dr's to break with the so calked, Standard of Care, yet it's all so important for my peace of mind. I am making my appt at Vero Beach Fl, 45 mins from home, thru the very same information, "Medimaps Group" that @hopefullibrarian spoke of. Will be calling her office to please add TBS to the script and will call the facility ahead as also mentioned above. Tysm!

I've spent the year trying to research what's best for me. I'll probably schedule with Dr McCormick, DC for reassurance before I do anything. I'm taking baby steps. Most importantly for me to say, is, this site with EVERYONE of you, EVERYDAY...encourages me to keep going, no matter how discouraged, fearful, broken, and alone I may feel at times. I'm also not as frightened with the medications, as I once was. A very heartfelt thank you to all!

p.s. I also fall into petite so we're still on topic.

You don't have to let that stop you getting a list from Medimaps. When there is information that I really need, I circumvent the fear of my email address being sold by using an anonymous one which helps me identify who has sold my information. In fact, I created my Mayo Clinic Connect account using one of these.
If I want to, I can turn that anonymous one off, and stop receiving all mail that is sent to it. The service I use to do this is SimpleLogin. They have both a free and a paid account option. With the free account you can have up to 10 anonymous email addresses at any given time. Each can be turned off and on at will.
It's is owned by a highly secure Swiss-based encrypted email provider called Protonmail, with whom I have my true email account. The two can be used independent of one another, so you don't have to have a Proton account to be able to use the anonymous email service.
Signing up does require that you supply your real email address, because they have to know where to forward the mail that is being sent to your anonymous addresses.
Ever since I started using the service, I haven't received any spam emails that I couldn't trace and turn off.
It's easy to sign-up, and easy to use. Just so you know, I don't work for them, and have nothing to gain by sharing this information with you. I myself, use only the free options for both services, SimpleLogin, and Protonmail.

About SimpleLogin and Proton: https://simplelogin.io/about/

PC magazine review of SimpleLogin: https://www.pcmag.com/reviews/simplelogin

SimpleLogin account registration: https://simplelogin.io/docs/getting-started/register-account/

Protonmail encrypted email service: https://proton.me/

Helari,

Thanks for reaching out. I feel like I'm in a bit of a unique situation with my bones and it's sort of a long winded story. In a nutshell, early menopause (last period at 32), diagnosed with hypothyroidism around age 48 and two years later, at age 50, diagnosed with osteoporosis.

The DEXA results that I posted (in the post you responded to) were from a Hologic scanner with TBS capabilities. If you want more info about what that is let me know.

My DEXA results for July 2019, December 2021, December 2022, December 2023 all done on a GE Lunar scanners are below. Note, my 2019, 2021, and 2022 scans were done on the same exact GE Lunar scanner but the machine broke LOL so my December 2023 scan had to be done on a different GE Lunar scanner.

LUMBAR SPINE
L1 -4.5 -3.8 -4.1 -4.2
L2 -4.3 -4.2 -4.2 -4.4
L3 -3.7 -3.3 -3.5 -3.3
L4 -3.4 -3.5 -2.9 -3.1
Total L Spine -3.9 -3.7 -3.6 -3.8
RIGHT HIP
Right Neck -2.7 -3.1 -2.9 -2.8
Total Right Femur -3.0 -3.0 -2.8 -2.6
LEFT HIP
Left Neck -3.3 -3.2 -3.1 -2.8
Total Left Femur -3.4 -2.9 -3.0 -3.0

At my endocrinologist's urging, I took osteo-meds, alendronate from January 2020 - July 2021, it caused gastrointestinal tract issues so I took a 4 month bisphosphonate holiday, and in November 2021, I had my first and only zoledronic acid infusion. My endocrinologist ordered another zoledronic acid infusion for November 2022, but I decided against it.

I can't give a good answer to your question about if my bones have improved since I started lifting weights but I do feel confident in saying that I'm not losing bone. If you compare my July 2019 T-scores and my December 2023 T-scores (remember those weren't done on the same scanner), all of my T-Scores seem to have gone up slightly, except for my L2 which went from -4.3 in 2019 to -4.4 in 2023 and my right femoral neck which went from -2.7 in 2019 to -2.8 in 2023. DEXA aren't very accurate so a .1 increase or decrease doesn't mean much.

Hypothyroidism slows down bone growth and bisphosphonates interfere with new bone formation--something my endocrinologist didn't tell me prior to prescribing bisphosphonates. I do NOT think that the bisphosphonates improved my bones and there is a chance that the bisphosphonates interfered with my efforts at the gym. I'm hoping that now that it's been more than 2 years since I've taken bisphosphonates that I might get a better idea in the coming years of whether or not my gym efforts can help my BMD.

You said you've gone from osteopenia to osteoporosis, but how big is the change and was it all over or just one vertabra? Also how old are you and are you post-menopausal and if yes, are you on HRT? Are you familiar with BTM testing and have you had it done? Have you had a full thyroid panel (testing just your TSH doesn't give a full picture)? Have you been tested for Celiac?

Get back to me and I will send you some information that might be useful.

Well I am exhausted just trying to understand this...fairly illiterate about the cyber world; have had my personal info hacked too many times (from legitimate sites like the IRS, Blue Cross, OPM) so I am super careful in my own ignorant way.

I already have a Proton account but did not know about the option you discuss. Exactly how do you 'trace and turn off' spam in these anonymous email accounts? Sound like a lot of work just keeping track of different accounts....perhaps you have tips on managing this as well.

I already 'block contacts' that arrive on a Yahoo email account on my ipad....fairly easy to identify suspicious emails and confirm this by revealing their real email address and then block that contact. Works well but the amount of diligence and time it takes each and every day is tiresome; once your email has been sold on the dark web the spam traffic is overwhelming.

Thank you so much for sharing your knowledge.

I drew up some instructions (with images) for creating anonymous email addresses with SimpleLogin. Just click on the link below to view them. I hope it's helpful.