Question about DEXA Scan inaccuracy

I have heard that it’s best to get subsequent DEXA scans from the same machine , operated by the same technician… some magnesium does appear to help absorption of D3 and K2…we are all different, so it’s a bit of trial and error, and then we rely on scans to see how well we are doing…good luck !

I think DEXA, as vague as it can be, is all we have right now to determine bone health. Same machine, same technician is supposedly very important. Of course technicians quit, new people are hired, scan machines are replaced, and patients move across the country so then what? Track down the machine you were tested on and the technician who did the positioning? LOL! TBS, Echolight, and REMS; other ways to determine bone health - popular in other countries I believe but not so much here. My DEXA center never heard of TBS for example. It is part of a large hospital system.

I am like you as far as small build, weigh 120 lbs, with my spine at -4. I asked my endocrinologist the same question about the DEXA scan accuracy and he said it was accurate. But I do wonder since my hips are -2.7, why is my spine score so much worse? I've been told I have osteoarthritis in my spine and read that can make your DEXA look worse than it really is.

For now, I'm not taking any meds (Tymlos and Forteo are not options for me due to parathyroid issues). I am very careful with my movements and don't lift anything heavy and am starting to do some spine strengthening exercises.

Have you asked your doctor to check your parathyroid levels? Like you, my blood calcium levels were on the high end of normal, or slightly above. A 24 hour urine test showed I was excreting too much calcium. I had my PHT levels tested and they were too high. I won't go into my journey trying to fix that as it's a long story. But my PHT issues were definitely a cause of my osteoporosis.

I want to add to my earlier comment about my high parathyroid (PTH) blood levels. Those high PHT levels, along with high blood calcium levels, usually indicate a non-cancerous tumor on one of the four parathyroid glands, causing it to over-react which ends up pulling calcium out of your bones, and preventing the calcium from getting to your bones causing osteoporosis. It is usually cured by surgery to remove the gland with the adenoma (tumor). The four parathyroid glands are the size of a grain of rice, so can be hard to locate during surgery. My surgeon, who was a specialist in that type of surgery, couldn't find my "bad" parathyroid gland. Scans I had done before surgery didn't clearly show where it was. Also, I had a previous thyroid surgery so had a lot of scar tissue, making the surgery very difficult. So that surgery didn't solve my parathyroid problem.

Eventually I went to the Rochester Mayo Clinic and had more scans that located a small adenoma on a parathyroid gland but, because of my two previous neck surgeries, I can't have more neck surgeries because of scar tissue. Plus two of my parathyroid glands were possibly damaged during my surgery. My Mayo Dr is monitoring me for possible treatment by injecting an alcohol solution into the gland to get rid of the tumor. That usually takes 3 treatments over the course of 3 days. It's tricky because you must have at least one functioning parathyroid gland because they regulate calcium levels in your body along with other very important functions. You can't just take a pill, like you can if you don't have a thyroid gland (which is also the case with me).

High calcium and calcium in urine should trigger exam for hyperparathyroidism, and especially if your bones show a problem as too much parathyroid hormone will pull calcium out of bones.

@daisy17, my bone specialist ordered many tests to try to diagnose the underlying cause for the severe osteoporosis: 1) Vitamin D 1 25 Dihydroxy, 2) Celiac Disease Screen 2 Years and Over, 3) Calcium, Urine, 24 Hour, 4) Creatinine, Urine, 24 Hour, 5) Cortisol, AM, 6) Adrenocorticotr Opic Hormone, 7) Protein Electrophoresis, 8) Phosphorus, 9) Parathyroid Hormone Intact without Calcium, and 10) Comprehensive Metabolic Panel. During my appointment, my bone specialist said that she would order a lot of tests to try to determine the underlying cause for the osteoporosis, but she said that usually the root cause can't be determined. The only thing useful I got from these labs was that I was excreting too much calcium. My rheumatologist said that I already had risk factors for osteoporosis: being asian, around 100 lbs, having small bones, and menopause around 49.

one thing that can be missed is the fact that a high sodium intake increases urine sodium which increases urine calcium excretion. Use of electrolyte solutions and certain foods ( restaurants!!) can be sneaky sources of sodium.

@shorty321 Sounds like you have a great doctor. My only suggestion is to make sure you take Vitamin K2 along with your calcium supplements since it helps direct the calcium to the bones.

I used to take 45mcg Vitamin K2 with my calcium, but have increased the form and dose based on this article, and others that I've read: https://drkumardiscovery.com/posts/vitamin-k2-mk7-bone-strength-review/

I found two K2 MK7 supplements on Amazon and ordered both. Not sure which one I'll stick with, I'm alternating them now. One is Sports Research Vitamin K2 MK7 180mcg with Coconut Oil. It sources its K2 as Menaquinone-7 (MK7) from fermented chickpeas rather than from MenaQ7, which is a specific branded form. This is a gel capsule with liquid contents.
The other supplement is from True Vantage and contains 180mcg of that vitamin as "MenaQ7".
 I read that "MenaQ7" supplements are considered superior because "they contain a highly purified form of vitamin K2 as MK-7, which has been clinically validated for its benefits in supporting bone and cardiovascular health. Their production process ensures a high concentration of the bioactive all-trans form, making them more effective than other vitamin K2 supplements." This is in a capsule form with powdered contents. The TrueVantage brand that I ordered with MenaQ7 is made in the U.S. and 3rd party tested.

Good luck.

@daisy17 my husband also excreted excessive calcium in his urine. It was checked after he had a compression fracture. Other tests were normal. He was placed on hydrochlorothiazide (a mild diuretic) and his urine calcium has normalized. Hope this may be helpful to you.

@crbarefoot this should have been in response to @shorty321