My latest DXA and TBS report.  As a reminder, I was diagnosed with osteopenia in 2005 and given a script for Fosamax. I declined.  My intention was to implement my 6 pillars for bone health for a better outcome: 

1. Calcium and mineral rich-foods
2. Researched supplements (I get my calcium through food)
3. Weight bearing exercise
4. Stress reduction
5. Sleep hygiene
6. Bringing joy to my everyday

I took my 90 minutes pilgrimage to Hospital of The University of Pennsylvania. DXA during Covid of course had its moments. Masks, temperature testing, hand sanitizer, distancing...we all know the necessary Covid drill.

Below I’m positioned so that my ankles are pointing inward which guarantees a proper reading of the hips. Clearly not a “glam” shot but hopefully you get the message.

Great outcome for my hips and spine all going in the right direction over time.  Note the colors in the reports....GREEN!

My Spine - TBS

Below is the Trabecular Bone Score or TBS of my spine. Simply put, the TBS measures the inner bones, while DXA measures the outer bone. Color falls into the green normal area. Inner bones look good.

My Spine - DXA

Below is my DXA for my spine measurement. It also falls into the green (normal) section.

My Hip - DXA

Also measures in the green normal range.

My Tracking Chart

The chart below shows the type of machine used. Each machine has a serial number. If you’re looking at a DXA comparison it’s important to know the DXA machine and the serial number.  That serial number can usually be found in the lower right corner of your DXA report.  The 2016 ad 2014 were on GE Lunar Prodigy but different machines as shown by the serial numbers.

Yet look at my Forearm numbers…..

Suddenly I was in the range for osteoporosis and my doctor suggested I see an endocrinologist.

My Next Steps

Dr. Keith McCormick suggested getting a follow-up CMP (Comprehensive Metabolic Panel) blood test next year.  This test measures calcium levels which I will keep track of.   

He uses blood work for a deeper dive into bone health.

Also, my trusted and generous friend, who has been in the osteoporosis trenches for many decades, suggested I get and track bone markers:

• CTX (full name Carboxyterminal cross-linking telopeptide of bone collagen) which is a bone resorption marker and
• P1NP (full name Procollagen type 1 N propeptide) which measures bone formation. If my doctor won’t write a script for this test, I’ll go to Life Extensions for the script.

Dr. Lani Simpson suggested there may be something wrong with the forearm test and suggested getting it re-analyzed.  I’m in the process of working with the technician who performed  the DXA/TBS.  The region of interest in the forearm is Radius 33% often reported at 1/3 distal radius. I also reached out to Dr. Deva Boone who specializes in parathyroid disease.

It takes a community.

Forearm

Why is the non-dominant forearm added to the DXA/ TBS report?

The spine and hip may have arthritis yet the DXA shows up with stronger results.  The forearm may be a possible indication of parathyroid issues.

• “Primary hyperparathyroidism: While this is a systemic disease affecting the entire skeleton, the lowest BMD is most often the forearm, which may be the only site at which BMD is less than –2.5. In this case, the result should influence the decision regarding surgical cure of primary hyperparathyroidism (PHPT).” [i]

The learning continues.  

TIPS

My DXA / TBS score was performed at:

The Hospital of the University of Pennsylvania

3400 Civic Center Blvd. – Ground Floor

Philadelphia, PA

phone: 215-662-5680 to book a DXA (numbers may change so ask for radiology to book your DXA.

My script reads:

• DXA bone density, axial CPT 77080

• DXA bone density / peripheral CPT: 77081

• Includes TBS, peripheral forearm.

I requested a full colored copy of my reports BEFORE I left. However Penn’s portal is fabulous and reports can be downloaded.

I’m feeling good about the results.

If you’d like to schedule a private session with me, kindly view those details HERE

You’ll gain insights, get support as we craft a bone plan, food plan and it's where your bone questions will be answered.

The cost for my discovery one-hour session is $200 and is followed-up with a full set of recommendations for the “next steps” on your bone journey.

Thank you for your time today. I hope my shared experience is helpful.

---

If you’re confused about how to Feed Your Glorious Bones?  My guide will help.
Click below for more details.

7 Day Meal Plan – Easy Cooking for Bone Health Guide

https://www.healio.com/news/endocrinology/20141203/forearm-dxa

---