Trabecular Bone Score

Posted by ChristyJ @christyj, Feb 10, 2023

I tried to post this yesterday but don’t see so I apologize if this is a duplicate.

I’d like to get a Trabecular Bone Score with my next DEXA Scan. My endocrinologist says no diagnostic labs offer this here in Tucson but Mayo Clinic in Phoenix might. I tried various ways of contacting them but could not find a definitive answer. Does anyone know if they offer TBS at Mayo in Phoenix? Thanks!

Interested in more discussions like this? Go to the Osteoporosis & Bone Health Support Group.

@tmbdefazio

Hi, I wish I had an answer for you but I opened your question because I have the exact one.
I am also from Tucson and can't find one. Infact just finding an endo here is difficult!
Would you please let me know what you find out. I don't know how to follow you??
Thanks so very much.
Barb

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Hi Barb,
Do you know about the Bone Girls group in Tucson? We meet regularly as a group to discuss osteoporosis options, doctors, etc. and the leader is very knowledgeable. I'll send you a private message so we can connect.
Christy

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@tmbdefazio

Hi, I wish I had an answer for you but I opened your question because I have the exact one.
I am also from Tucson and can't find one. Infact just finding an endo here is difficult!
Would you please let me know what you find out. I don't know how to follow you??
Thanks so very much.
Barb

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@tmbdefazio did you contact medimaps? Email them and ask what centers are near support@medimapsgroup.com

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In reply to ChristyJ. I tried getting TBS test with December DXA through Mayo Clinic Phoenix Endocrinology Dept. and was told that it was not available at Mayo Clinic. I checked at SMIL Phoenix and they also do not offer it. Disappointing.

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@kolika Thank you so much for this, I'm glad to hear from someone with direct experience although I feel for you regarding your disappointment.

@sheilad1 Interestingly, the Medimaps Group "contact" email never responded but the "support" one did, thank you for posting about it again!

To anyone following this, I'm attaching the list of four places Medimaps have on record as having TBS. Note: if you click on the image, it expands to show the full name and address of the locations.

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@christyj

@kolika Thank you so much for this, I'm glad to hear from someone with direct experience although I feel for you regarding your disappointment.

@sheilad1 Interestingly, the Medimaps Group "contact" email never responded but the "support" one did, thank you for posting about it again!

To anyone following this, I'm attaching the list of four places Medimaps have on record as having TBS. Note: if you click on the image, it expands to show the full name and address of the locations.

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I found an imaging center with DEXA w/ TBS capabilities via medimaps. I had to drive 5 hours 1 way to get it done and the whole process was fraught with challenges but I got it done, had the scan, in December 2022. The good news is my L1-L4 TBS are not in the highly degraded range. The unfortunate part is I’m questioning the results and I’m still trying to find someone, a doctor, who can interpret the data.

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@fearfracture Well done on committing to your health!!

Why are you questioning the results? I wonder if Medimaps might be able to help you find a doctor to interpret your results. Also, although she is a chiropractor and not an M.D., Dr. Lani Simpson, a certified clinical densometrist, does consult with people concerning their bone data. https://lanisimpson.com/pages/about-dr-lani-simpson

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@christyj

@fearfracture Well done on committing to your health!!

Why are you questioning the results? I wonder if Medimaps might be able to help you find a doctor to interpret your results. Also, although she is a chiropractor and not an M.D., Dr. Lani Simpson, a certified clinical densometrist, does consult with people concerning their bone data. https://lanisimpson.com/pages/about-dr-lani-simpson

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I wrote a detailed long reply and the system can’t handle it (it won’t post).

Here’s the condensed version.

I had 2 DEXAs, 1 week apart, in December 2022, a DEXA w/ TBS on a Hologic scanner and a DEXA on the same GE Lunar scanner used for my previous 2 DEXAs.

My 12/2022 Hologic TBS scores showed
L1 1.278
L2 1.323
L3 1.342
L4 1.205
Total 1.287

Spine TBS L1-L4
Normal microarchitecture > 1.31
Degraded microarchitecture < or = 1.23

According to the reference range my L2 and L3 are in the normal TBS range, L1 is partially degraded and L4 is degraded.

The GE Lunar and Hologic showed very different T-scores for my L4 (-2.9 and -3.8) but they both showed my L4 as having the highest bone density in my lumbar spine. The images that came on my TBS report, show an area that looks like it was captured with my L4 that should not have been included in the calculation (stuff Lani Simpson talks about). Others, who I have chatted w/ on-line, who’ve had DEXAs w/ TBS, seem to have scores that follow a pattern, L1 has the lowest TBS, then L2, then L3, and L4 has the highest. On my report my L4 has the lowest TBS, then L1, then L2, and L3 has the highest????????????

My TBS report goes on to show:

BMD. BMD T-score
T-score adjusted*
Spine -4.0 -4.8
Femoral Neck -3.3 -3.6
Total Hip -2.6 -3.0

*Adjusted for ethnicity, gender and TBS.

What the hay does “Adjusted for ethnicity, gender and TBS” even mean?

I thought TBS was only done on the spine so how can my hips be adjusted for TBS and how can my ethnicity and gender cause my t-scores to be “adjusted” lower? People of my ethnicity and gender (fair-skinned white, females) are known to have a higher risk of osteoporosis.

So, yes, I’m left with lots of questions.

I know that Dr. Simpson will review results for a fee. If I find a pot of gold I’ll gladly pay for her evaluation. My potential future bone health spending includes 1. Hiring a personal trainer 2. Traveling out of state to get an REM scan w/ consultation 3. purchasing a Marodyne LiV.

I joined a gym last year and go 3 times a week and have been gradually increasing weights. I mostly use the weight machines. I’m considering hiring a personal trainer to help me properly add/do deadlifts which I currently don’t do.

I have hypothyroidism and this is also one of the reasons I question if my endocrinologist knows what he’s doing. I was aware that hyperthyroidism can cause osteoporosis due to increased bone turnover but I just recently learned that hyperthyroidism effects bones by slowing bone formation. Bisphoshonates don’t stimulate bone grow. They work by slowly resorption. Because my endocrinologist didn’t do BTM (bone turnover marker) testing prior to prescribing bisphosphonates, I don’t have baseline tests for comparison but in November 2022 (a yr after my 1 and only zoledronic acid infusion), I had BTM testing done at my request. My bone turnover markers are not high.

REPLY
@fearfracture

I wrote a detailed long reply and the system can’t handle it (it won’t post).

Here’s the condensed version.

I had 2 DEXAs, 1 week apart, in December 2022, a DEXA w/ TBS on a Hologic scanner and a DEXA on the same GE Lunar scanner used for my previous 2 DEXAs.

My 12/2022 Hologic TBS scores showed
L1 1.278
L2 1.323
L3 1.342
L4 1.205
Total 1.287

Spine TBS L1-L4
Normal microarchitecture > 1.31
Degraded microarchitecture < or = 1.23

According to the reference range my L2 and L3 are in the normal TBS range, L1 is partially degraded and L4 is degraded.

The GE Lunar and Hologic showed very different T-scores for my L4 (-2.9 and -3.8) but they both showed my L4 as having the highest bone density in my lumbar spine. The images that came on my TBS report, show an area that looks like it was captured with my L4 that should not have been included in the calculation (stuff Lani Simpson talks about). Others, who I have chatted w/ on-line, who’ve had DEXAs w/ TBS, seem to have scores that follow a pattern, L1 has the lowest TBS, then L2, then L3, and L4 has the highest. On my report my L4 has the lowest TBS, then L1, then L2, and L3 has the highest????????????

My TBS report goes on to show:

BMD. BMD T-score
T-score adjusted*
Spine -4.0 -4.8
Femoral Neck -3.3 -3.6
Total Hip -2.6 -3.0

*Adjusted for ethnicity, gender and TBS.

What the hay does “Adjusted for ethnicity, gender and TBS” even mean?

I thought TBS was only done on the spine so how can my hips be adjusted for TBS and how can my ethnicity and gender cause my t-scores to be “adjusted” lower? People of my ethnicity and gender (fair-skinned white, females) are known to have a higher risk of osteoporosis.

So, yes, I’m left with lots of questions.

I know that Dr. Simpson will review results for a fee. If I find a pot of gold I’ll gladly pay for her evaluation. My potential future bone health spending includes 1. Hiring a personal trainer 2. Traveling out of state to get an REM scan w/ consultation 3. purchasing a Marodyne LiV.

I joined a gym last year and go 3 times a week and have been gradually increasing weights. I mostly use the weight machines. I’m considering hiring a personal trainer to help me properly add/do deadlifts which I currently don’t do.

I have hypothyroidism and this is also one of the reasons I question if my endocrinologist knows what he’s doing. I was aware that hyperthyroidism can cause osteoporosis due to increased bone turnover but I just recently learned that hyperthyroidism effects bones by slowing bone formation. Bisphoshonates don’t stimulate bone grow. They work by slowly resorption. Because my endocrinologist didn’t do BTM (bone turnover marker) testing prior to prescribing bisphosphonates, I don’t have baseline tests for comparison but in November 2022 (a yr after my 1 and only zoledronic acid infusion), I had BTM testing done at my request. My bone turnover markers are not high.

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There is an error in my last post. I meant to write “ I was aware that hyperthyroidism can cause osteoporosis due to increased bone turnover but I just recently learned that HYPOTHYROIDISM affects bones by slowing bone formation.”

REPLY
@fearfracture

I wrote a detailed long reply and the system can’t handle it (it won’t post).

Here’s the condensed version.

I had 2 DEXAs, 1 week apart, in December 2022, a DEXA w/ TBS on a Hologic scanner and a DEXA on the same GE Lunar scanner used for my previous 2 DEXAs.

My 12/2022 Hologic TBS scores showed
L1 1.278
L2 1.323
L3 1.342
L4 1.205
Total 1.287

Spine TBS L1-L4
Normal microarchitecture > 1.31
Degraded microarchitecture < or = 1.23

According to the reference range my L2 and L3 are in the normal TBS range, L1 is partially degraded and L4 is degraded.

The GE Lunar and Hologic showed very different T-scores for my L4 (-2.9 and -3.8) but they both showed my L4 as having the highest bone density in my lumbar spine. The images that came on my TBS report, show an area that looks like it was captured with my L4 that should not have been included in the calculation (stuff Lani Simpson talks about). Others, who I have chatted w/ on-line, who’ve had DEXAs w/ TBS, seem to have scores that follow a pattern, L1 has the lowest TBS, then L2, then L3, and L4 has the highest. On my report my L4 has the lowest TBS, then L1, then L2, and L3 has the highest????????????

My TBS report goes on to show:

BMD. BMD T-score
T-score adjusted*
Spine -4.0 -4.8
Femoral Neck -3.3 -3.6
Total Hip -2.6 -3.0

*Adjusted for ethnicity, gender and TBS.

What the hay does “Adjusted for ethnicity, gender and TBS” even mean?

I thought TBS was only done on the spine so how can my hips be adjusted for TBS and how can my ethnicity and gender cause my t-scores to be “adjusted” lower? People of my ethnicity and gender (fair-skinned white, females) are known to have a higher risk of osteoporosis.

So, yes, I’m left with lots of questions.

I know that Dr. Simpson will review results for a fee. If I find a pot of gold I’ll gladly pay for her evaluation. My potential future bone health spending includes 1. Hiring a personal trainer 2. Traveling out of state to get an REM scan w/ consultation 3. purchasing a Marodyne LiV.

I joined a gym last year and go 3 times a week and have been gradually increasing weights. I mostly use the weight machines. I’m considering hiring a personal trainer to help me properly add/do deadlifts which I currently don’t do.

I have hypothyroidism and this is also one of the reasons I question if my endocrinologist knows what he’s doing. I was aware that hyperthyroidism can cause osteoporosis due to increased bone turnover but I just recently learned that hyperthyroidism effects bones by slowing bone formation. Bisphoshonates don’t stimulate bone grow. They work by slowly resorption. Because my endocrinologist didn’t do BTM (bone turnover marker) testing prior to prescribing bisphosphonates, I don’t have baseline tests for comparison but in November 2022 (a yr after my 1 and only zoledronic acid infusion), I had BTM testing done at my request. My bone turnover markers are not high.

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Mikah Yu MD is a plant based endocronologist who is a bone density expert having lead a study. He accepts insurance and does zoom visits. Check him out at http://www.drlifestyle.org

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@sheilad1

Mikah Yu MD is a plant based endocronologist who is a bone density expert having lead a study. He accepts insurance and does zoom visits. Check him out at http://www.drlifestyle.org

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Thank you. Unfortunately, according to the website, they currently don’t treat patients in my state.

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