Shocking REMS score!

That is interesting. I’ve had consistent DEXA results over the years, with last one showing -3.7 in lumbar, but I’ve also had two REMS a year apart, at the same time as the DEXA. REMS shows a consistent -1.8 lumbar. Hip t-scores have been very close on both, -2. I’ve also never taken meds, but I’ve not fractured. Can’t compare the technologies with each other, so cannot state that I had any improvement. Just more confusion and hesitation. Are your T-scores you mention from the lumbar or femur? Where were the fractures? Did you incorporate any new exercises or nutrition/supplements into your routine? I don’t think you wasted your money, but you might find an expert to discuss your results. Dr. Andy Bush is extremely helpful in such an analysis.

Here is the contact info for Bush if you are interested:
https://www.boneforte.com/about

Thanks for responding.
T-scores that I referenced were for the lumbar area.
DEXA femoral neck in May '24 was -3.8; yesterday REMS result was femur -1.9
The fractures 2 yrs ago were in the thoracic area.
No new nutrition or supplements (I've eaten very clean for yrs). The only thing I did was stop my SSRI a year ago, as I read it can contribute to bone loss.

Without knowing your medical history or the extent of your fractures, you are at higher risk of future fracture simply because you have already fractured. It doesn’t really matter at this point which test you rely on or what the t-scores are or the fragility score. The goal is not to fracture again. Discontinuing the SSRI may have helped, but I would make sure you are supplementing with D, K2, Mg, Ca (if needed) if you are not already doing so and working with a doctor who can order any other diagnostic tests to make sure all issues are addressed. In addition, find a good PT who can help you strengthen your supporting muscles. These things should all be investigated whether or not you choose to take prescription meds.

I'm taking all the appropriate supplements and run my own labs including CTX & P1NP, which are good. I've had PT and walk 2-3 miles a day. DEXA scores in 2024 were an improvement from previous scan (same machine), so hopefully I'm on a trajectory of improving, but the REMS scan numbers have to be wrong. Even on an anabolic, I would not improve that much!

Why not have another DEXA, as it's been well over a year?

Yes, I will have a DEXA this fall.

That’s true, but this was your first REMS, and you can only legitimately compare it with another REMS, not the DEXA. Good to know that you had some improvement indicated on the DEXA though. You are apparently moving in the right direction, regardless of technology! After all, you are a person, not a T-score!

to midvestgirl
Your experience coincides with mine. I also made REMS this May and it showed another T-numbers (proving osteopenia, and not osteoporosis in my spine) in comparison with DEXA. The doctor told me that DEXA can have many mistakes depending from technician (e.x. a position of a body, etc.), while REMS is more precise and all is done by a machine. I believe it because I also read the same in the book by Keith McCormick "Great Bones" and I put the attachment of this page on this forum a couple of days before.

Hello all,
I’ve never heard of REMS — how can scores be SO different from DEXA?
I’m having a decision crisis and would be grateful for any thoughts or advice.
Have been on an aromatase inhibitor (post early stage breast cancer lumpectomy and radiation) for 18 months. This med is rapidly worsening my T scores (& bone quality) — started at lumbar 3.3 and o osteopenic at hip and femoral neck, now 3.9 lumbar and osteoporosis elsewhere —and my bone specialist endocrinologist is recommending 3years of Prolia while I complete the 5 year course of cancer med, then a year of Evenity. Then probably more bisphosphonates to maintain. I’m only 63 and terrified of beginning a lifelong course of potent bone meds that will stop my body’s own bone resorption/regeneration process forever. Considering going off m cancer med, which would increase my breast cancer recurrence but possibly allow me to maybe start with Reclast and stop losing bone density. I eat well, exercise, supplements for 20+ years, etc. What’s the least awful choice here..? 🙁