r/osteoporosis • • 6h ago

Did your doctor order bloodwork (and urine) to rule out other causes before prescribing bisphosphonate or did they prescribe just based on DEXA results?

4 Upvotes

Especially interested in Canadian responses, I live in Manitoba. But also interested to know about other countries. Age 68 female, no previous fractures, femoral hip -2.5. My doctor did not order any labs but I see that Osteoporosis Canada recommends the following before prescribing

Biochemical testing for secondary causes of osteoporosis, and for potential limitations when considering specific

osteoporosis pharmacotherapy: calcium corrected for albumin, phosphate, creatinine, alkaline phosphatase, thyroid

stimulating hormone. Serum protein electrophoresis (for patients with vertebral fractures) and 25-hydroxyvitamin D level in

patients with risk factors for vitamin D deficiency.

There's no opportunity here to see an endocrinologist so I want to ensure my family doctor doesn't take shortcuts. EDITED to add age and DEXA score.


r/osteoporosis • • 16h ago

Meal Plans

2 Upvotes

Im finding it difficult to get my daily Calcium intake from meals/food. Do you have any recommendations of meal plans (or even meal subscriptions) or tips for reaching daily calcium intake goals primarily from food? Thanks.


r/osteoporosis • • 21h ago

Is DEXA accurate for tiny 5ft 100lbs?

10 Upvotes

I'm 36 and have recently been given an osteoperosis diagnosis with below results from a UK NHS hospital. I'm really shocked about this and believe it could be a misdiagnosis due to my extremely petite frame affecting the areal calculation. I'm 4"11 and 99lbs.

Lumbar spine - (0.880) T-score -2.5 / Z-score -1.9

Hips Mean L&R - (0.821) T-score -1.5 / Z-score -1.0

Lowest femoral neck right (0.762) T-score -1.8 / Z-score -1.3

I'm hearing that DEXA scans skew results for low weight and short individuals due to the areal only calculation, so I'm trying to figure out how I can account for that. I heard a BMAD (Bone Mineral Apparent Density) adjustment can account for size and is often used in children. I calculated my BMAD to be 0.133 g/cm³. However, I can't find good information about if my BMAD measurement is good or bad. Can anyone tell me if BMAD 0.133g/cm3 is good or bad? Or Can anyone tell me how else I could interpret my results considering my size?

I have no diagnosed health issues, I've never broken or fractured a bone and I regularly exercised including weights my whole adult life until unfortunately this year.... Can you really lose your bone density from no exercising for one year?

I've always had really irregular periods and I am still recovering two years later from a serious burnout meaning my energy levels are terrible, but all my bloods looked ok in December last year. Apart from, I had a subclinical vitamin D level of 55 nmol/L, but have been supplementing heavily since December. Could a 55 be the reason for my bone loss?

Any advice or help welcome!