What's the goal for T scores?

Posted by sebutler @sebutler, 6 days ago

It just occurred to me: In taking drugs for osteoporosis, is the goal a perfect -1 (or higher), that of a healthy young adult? Do we stop taking meds only when we reach that number? It seems to me unrealistic to think that a 70+-year-old woman like me would ever reach that number, especially having started out with DXA scores of -3 or less.

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bswpb | @bswpb | 6 days ago

I don’t think it’s to have bones like a young adult but to have bones that are strong enough for us to not have multiple broken bones. We all lose bone as we age. Stopping meds is not recommended especially if you are on Prolia. They often change the med you take after a time but they don’t want to stop it all together!

mayblin | @mayblin | 6 days ago

There is a presentation, "Treat to Target for Osteoporosis", by Dr. Lewiecki that you might be interested in:

sebutler | @sebutler | 5 days ago

In reply to @mayblin "There is a presentation, "Treat to Target for Osteoporosis", by Dr. Lewiecki that you might be..." + (show)

@mayblin Thank you so much. I watched the presentation in its entirety -- lots of great information. It looks like the general goal is -1.5, since any lower than that and you don't get added benefit in terms of fracture risk. Still seems unattainable for someone like me. Especially since I am unwilling to be on osteoporosis meds forever. I also noticed from the presentation that if one is osteopenic, meds are not necessarily called for -- exercise, nutrition, etc are an option. As the speaker says, treatment needs to be individualized, as many factors need to be considered. Again, thank you, @maybin.

nycmusic | @nycmusic | 5 days ago

Good question, though i believe in doing whatever way we choose, to prevent fractures…as we know, most docs are big on the numbers…but we can’t ignore the changes in our bodies…just do everything we can to maintain as healthy a life as possible.

njx58 | @njx58 | 5 days ago

Anything -2.0 and better is fine with me. Bone strength is perhaps more important than bone density, so I don't get too hung up on the T-score. If it's in osteopenia range, I can work with that. I don't think it's possible to get to -1.0, anyway.

Remember that many people have osteoporosis and don't even know it. We're the lucky (?) ones who at least know what we're dealing with.

dvargo | @dvargo | 5 days ago

In reply to @bswpb "I don’t think it’s to have bones like a young adult but to have bones that..." + (show)

@bswpb the reason for that is because the studies were only for a couple years so they move you on to a different drug and then so on so on.

bswpb | @bswpb | 5 days ago

In reply to @dvargo "@bswpb the reason for that is because the studies were only for a couple years so..." + (show)

@dvargo yes I know!

njhornung | @normahorn | 5 days ago

In reply to @njx58 "Anything -2.0 and better is fine with me. Bone strength is perhaps more important than bone..." + (show)

@njx58
In that presentation, it was mentioned thar a T score of -1.5 seems to be the ideal target. Maybe I missed it but what is the likelihood of attaining that? I don't think that is a realistic goal but your -2 might be.

dvargo | @dvargo | 4 days ago

In reply to @bswpb "@dvargo yes I know!" + (show)

@bswpb because doctors only feel comfortable prescribing the drugs with the studies. It seems that you are endlessly on drugs. Perhaps in 2026 a breakthrough will be revealed.