How often do you need bone density testing?

If you are a woman over 50, you have probably either read about, or heard from your doctor, that you need interval bone density testing to ‘prevent osteoporosis’.   While the potential for progression toward severe bone loss and its risk for fractures should not be ignored, the majority of women do not need the most aggressive measures in follow up testing.   A New England Journal of Medicine article (1/19/2012; 366:225-233) showed that the advisable bone density screening frequency can vary dramatically. To summarize these results, it was found that in order to keep your risk of developing osteoporosis over the suggested screening interval to less than 10% odds:

If your initial result was:               Next routine screening:

Normal or mild osteopenia             15 years

Moderate osteopenia                       5 years

Advanced osteopenia                       1 year

Women with osteopenia do not face a medical emergency.   They are having a bone loss trend which should be addressed, but most often does not need the frequent screenings and drug therapy that are often advised.   Because Medicare covers bone density tests every two years, that is often the interval that doctors recommend.  And although drug therapy for mild to moderate bone loss can be expensive and side effect prone, the manufacturers press physicians to use it early and often.  Keep this in mind when you consider the advice you receive and the options from which you will choose.

For true ‘prevention’, and therapy as well, even and especially for those in the ‘advanced’ category, make sure that you integrate the ‘basic three’ of bone support:

-increase the frequency of weight bearing activity into your chores and exercise.   If you can, consider some form of core and upper body strength work as well.

-eat plenty of dietary calcium in the form of leafy greens, legumes, yogurt, or nuts…~1200 mg of calcium per day is a reasonable target for total calcium intake.

-get your Vitamin D3 level checked.   Almost everyone I see is too low for this critical nutrient.   Aim for a blood level of 50-70 (not the ‘minimum’ of 30 that some consider acceptable).   If you use supplemental D3, take it with a meal to optimize absorption.

As we learn more about individual Vit D related genetic variations, it is becoming ever more clear that some people need up to 4000-8000 IU/day to get therapeutic levels.   This is why blood testing to know where you are at is imperative.

It is never too late, or too early for that matter, to stabilize or reduce a bone loss trend, so whatever else you choose to do, get after these ‘basic three’ today!

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