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

hi sophie, hope by now your bone density is good with the correct medicine, food and exercise protocol.
I'v discovered I have severe osteoporosis [3.5] and trying to understand the best medicine to take for it.
can you please tell me which tests show bone reabsorption and bone building ..the doctors don't tell u anything mostly and i'm scared to start these complicated med. blindly. thanks

This is a good overview of the medications, and what you would take based on your T-score.

Hi @lvondra! Welcome! It's great that you're here as you begin your journey with osteoporosis. To answer your question, many of us have had success with improving our scores.

My first suggestion to you would be to do a search here for "new to osteoporosis" or the like. You will find a vast amount of information, and it can feel overwhelming at first! Gradually it will come together.

Do you have a metabolic bone specialist overseeing your care? (Rheumatologist/ Endocrinologist/ Orthopedist, etc). What has been suggested to you regarding treatment?

Best of luck to you moving forward!

Hi @shail. DEXA and TBS are the imaging studies. Here's a good overview of the lab work:
https://share.google/IIztF8ekTlFpIZV5n
My suggestion is that you do a search on this site for "new to osteoporosis" or the like as that will give you a broader view of osteoporosis treatment. What has your doctor suggested for you?

Best wishes to you moving forward!

Thanks a lot for sharing this article .. it explains the Bone Marker Tests in great detail. It's good learning and much needed.
I was unaware of TBS imaging and will find out more about it - so important to know whether you are at high risk or not.
Will take up your suggestion about searching for information for people new to osteoporosis - makes sense!

wow this is exactly what I need! thankyou for sharing..it takes time & effort..I really appreciate it

my orthopedic simply prescribed Prolia for 2 years and then to do a Dexa. he replied on my query of rebound bone loss that I needed to show him literature on it. he said I could easily continue with it further. He didn't mention any bone gain locking in med like reclast post Prolia.

he didn't ask for any tests like CTx

Hi Sophie,
I had my last dexa scan in 2018.
Osteopenia in my hips improved from a few months of Osteostrong and my lumbar improved marginally from -4.5 to -4.2. I discontinued going because it was far for me to travel and quite expensive. I’ve been on estrogen, the twice a week patch for almost 5 years (I’m almost 71), trim, and physically active.
I haven’t fractured anything but now my doctor wants me to take Actonel (a bisphosphonate) and I am very reluctant to take it having read so much about the downsides and I’m very drug sensitive. I want another scan because of HRT, but my doctor said there is no point and to start the medication. Needless to say, I’m not happy.
I am however incorporating weight bearing exercises and following Dr. Lisa Moore on YouTube.

An orthopedist is maybe not the best choice to treat osteoporosis. You are better off with an endocrinologist who has experience with it. Bone marker testing (P1NP, CTX) is important. And Prolia deserves a thorough conversation.

@shail You're welcome! I'm glad you found it helpful.