1. < Osteoporosis & Bone Health

My Echolight experience

Posted by njx58 @njx58, 3 days ago

I went for a REMS Echolight scan today. It's like a sonogram: the technician has a wand, and they put gel on you and rub the wand on it. You are on your back. For your spine, they rub the wand on your stomach, which is why they tell you to fast so that there's nothing in the way. Then the machine processes the analysis and prints out a pretty report showing where you are on the T-score chart, with red/orange/green bands so that you can see what zone you're in. It also provides L1/L2/L3/L4 scores, and assigns a five-year fragility risk.

I'm not sure what to make of the results. In January, my L1-thru-L4 T-scores were -3.2,-2.8,-2.8,-3.4. After eight months of Tymlos, this scan shows -2.3,-2.6,-1.7,-1.7. They said the scores tend to be a little better with Echolight since it assesses quality as well as density. So, I'm hoping I made some progress. I have another DEXA scheduled in January (same doctor, same machine.) We'll see what it says.

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closetmonster93 | @closetmonster93 | 19 hours ago
In reply to @awfultruth "@njx58 Glad you started this discussion. I've just had my first Echolight scan also but I..." + (show)
@awfultruth

@njx58 Glad you started this discussion. I've just had my first Echolight scan also but I got the opposite of what is so commonly reported. My bone density / t-scores were much worse than my DXA scans.
Each vertebrae ranged from .8 to 1.2 t-score points less. So L1 went from -1.4 to a -2.6 t-score. And of course the actual density numbers were much worse also.
Paradoxically my fragility score for my spine was better than my TBS score from my DXA.
My femur neck was also worse but pretty close.

I find it very difficult to know what to think from this one Echolight test. More than one standard deviation off between the Echolight and DXA in my T-score is a lot of deviation.
With the DXAs I have 7 scans over 5-6 years. The scans were consistent overall. My scores didn't stay the same but each DXA showed further loss than the previous one up until I did Evenity and I had two after Evenity and they both were close. I had TBS 3-4 times and those were consistent to and I also had TBS improvement from the Evenity. If I was rich I'd go have another Echolight right away to see if the results of that were consistent.

The only reason for such a variance I can think of is that I have slight to moderate scoliosis. Could scoliosis make my DXA t-scores higher? Echolight claims scoliosis and arthritis do not effect the Echolight reading? But why would my L4 at the base of my spine before the scoliosis curve starts have the same variance as the other 3 vertebrae that are more in the scoliosis curve?

It's quite frustrating. I'll try to research beyond the marketing materials when I have more time. For now I'm going to base my decisions on my DXA scores which I have proven are consistent. I wish an objective third party would do a good comparison of these two approaches. I'm interested to see what else gets posted in this discussion.

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How much do the Echolight scans cost? Do insurance cover these? Also, what is Evenity?

REPLY
closetmonster93 | @closetmonster93 | 19 hours ago
In reply to @kegu "Many doctors aren’t receptive to this. Mine isn’t. I went on my own and then shared..." + (show)
@kegu

Many doctors aren’t receptive to this. Mine isn’t. I went on my own and then shared results.

Where do you live? Maybe I can help you find a place.

Jump to this post

Idaho.

REPLY
patjack2 | @patjack2 | 12 hours ago

Thanks everyone for your comments. I had my first Echolight and my results were worse than my Dexa scores. After I started Osteostrong I had a Dexa scan after about 6 months and my numbers had really improved. Then Osteostrong offered an Echolight and I tried it. I was so disappointed with the numbers. So in a few months I’ll have another Echolight and see what the changes are. I had read that Echolight is supposed to be so much more accurate. We’ll see

REPLY
stuffy | @stuffy | 11 hours ago
In reply to @awfultruth "@njx58 Glad you started this discussion. I've just had my first Echolight scan also but I..." + (show)
@awfultruth

@njx58 Glad you started this discussion. I've just had my first Echolight scan also but I got the opposite of what is so commonly reported. My bone density / t-scores were much worse than my DXA scans.
Each vertebrae ranged from .8 to 1.2 t-score points less. So L1 went from -1.4 to a -2.6 t-score. And of course the actual density numbers were much worse also.
Paradoxically my fragility score for my spine was better than my TBS score from my DXA.
My femur neck was also worse but pretty close.

I find it very difficult to know what to think from this one Echolight test. More than one standard deviation off between the Echolight and DXA in my T-score is a lot of deviation.
With the DXAs I have 7 scans over 5-6 years. The scans were consistent overall. My scores didn't stay the same but each DXA showed further loss than the previous one up until I did Evenity and I had two after Evenity and they both were close. I had TBS 3-4 times and those were consistent to and I also had TBS improvement from the Evenity. If I was rich I'd go have another Echolight right away to see if the results of that were consistent.

The only reason for such a variance I can think of is that I have slight to moderate scoliosis. Could scoliosis make my DXA t-scores higher? Echolight claims scoliosis and arthritis do not effect the Echolight reading? But why would my L4 at the base of my spine before the scoliosis curve starts have the same variance as the other 3 vertebrae that are more in the scoliosis curve?

It's quite frustrating. I'll try to research beyond the marketing materials when I have more time. For now I'm going to base my decisions on my DXA scores which I have proven are consistent. I wish an objective third party would do a good comparison of these two approaches. I'm interested to see what else gets posted in this discussion.

Jump to this post

It's all so confusing! I had a Zoom with my new endo this week and requested a TBS - but she says she can't just order that up, usually the radiologist does it only in severe cases where they need more info. I had read that the patient has to pay for the TBS which is just an add-on program to the DXA, so I don't know why there would be a problem. I am especially interested in the quality of the bone, which presumably the TBS would be the major resource to gain.
I'm happy to get an Echolight, however, which you also have to pay for, $280. I especially like the 5-year risk of fracture feature, since I'm 86. She at first seemed baffled by the Echolight mention, but then said she remembered hearing about it. I can get all the scans I want, she says, but the fact is that I fractured my femur, the heaviest strongest bone in my body, in falling over a case of wine while moving quite fast. It seemed like a good argument for medication, but I don't want to take any if I don't absolutely have to. I also have hematology issues, Factor 5 and MGUS, which argues against Prolix, etc. She suggested Reclast, yearly infusion. I hate infusions; my veins are tiny, wiggly and they collapse in infusions. After reading some of the reactions here, I seriously don't want to take it. Getting a second DXA soon and we'll see where calcium, D with MK-7, weigh-lifting and exercise have gotten me.
Plan C is a consult with Keith McCormick of GREAT BONES.

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