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Should I pursue a TBS score?
Hi all: my first post, although been lurking a while. What a terrific forum and kind group of people! I've read a few articles touting the growing value of TBS as a complementary tool to DXA, given its ability to measure bone strength. Wondering if anyone here had it done and if it yielded insightful results?
My first baseline DXA this past spring yielded -3.0 (back). Tymlos was recommended since I have major dental issues. I am 55, extremely fit with 35+ years of daily weight training and fairly high protein/clean eating - but am small framed. Could my bones be low density but stronger than avg thru decades of weight bearing exercise? Perhaps if my bones WERE stronger, even though less dense, I could maybe stall starting on these pharma solutions for a year or two?
I asked my PCP: he never heard of TBS. My rheumotologist dismissed it: didn't feel it would change his recommendations. Neither seems to want to write an RX for another DXA.
The facility for my 1st DXA can't do TBS or I'd just have them add it. No one will add a TBS score to an existing DXA unless it was done at their facility- and I need an RX to get a new DXA.
I was slated to start Tymlos this month. Do you think it's better to pause, find a new doc willing to write a DXA RX and see what the TBS reveals, before committing to a lifetime regimen of drug therapy (I have no clue what I'll be able to take after Tymlos, given my dental problems, which worries me.)
Any opinions most welcome! 🙂
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Thanks Sheilad1. My endo appt is August. All endo's in my area are backlogged. I'm concerned waiting until then and this endo doesn't work with me I've lost so much time. Maybe I can get my PCP to help. He wasn't helpful thus the referral to an endo. Will try.
I pay out of pocket for every DXA because the only facilities with TBS capabilities are out of network and not covered.
I think you might be pleasantly surprised at the reasonable cost (compared to mammos and ultrasounds that can run 200-500+). My last DXA with TBS was $125 as a cash/walk-in patient - no insurance.) Ask for the cash rate. You do need the RX though...no facility will do one without it.
I could get free DXAs thru insurance, but I'd rather have one w/TBS scoring for not much more than the cost of a night or two out.
Mikah Yu MD is a lifestyle rheumotologist in California and a osteoperosis expert. He lead a large study. Check him out. He sees people online and he's great. He takes Medicare so presumably other I sirance as well. I also consult with Keith McCormick who helped me reverse my osteoperosis without drugs.
I am sort of in the same boat as you and a prior member. Small stature, but fit--lost 1/2 in last two years, but at 67, I wasn't surprised. The surprise of OP (-4.9 L4 L1-4 -4.4). I've read about nixing the crunches, twists, etc. Alas, they were my faves. My endo appt. is a life-time away (it seems -- 5 months--I'm shopping for another), so I got a referral for PT to coach me on exercise that will not threaten to land me HELL. Does anyone if the TBS does more than the pelvis? We have it in my state--whether I can get my GP to refer it--is another thing. I am especially concerned about my distal radii--no one seems to scan more than the upper femur and the Lumbar. When I asked my GP for a more thorough scan, she said, she would expect the rest of my bones to be different. Like which ones? my Lumbar region or my Pelvis?
I asked AI to find the best explanation of TBS and it came back with a link to an article on the Algaecal website. It puts it into layman's terms: https://blog.algaecal.com/everything-you-need-to-know-about-trabecular-bone-score-tbs/