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There are two ways to find out you have osteoporosis: breaking a bone and getting a bone density test.
Breaking a bone is painful, expensive and debilitating. Getting a bone density test is not. We hope that the information on this website will help you prevent fractures and bone loss. It is never too late to help your bones be healthier.
Just as it is important to know your blood pressure or height, it is important to know your T-score. This is the measure of your bone density test result.
For most women, the time to watch your T-score is shortly after menopause when declining estrogen levels no longer protect your bone density. While not universally agreed upon, there are also other cases when a bone density test may be appropriate. At American Bone Health, we also consider it appropriate for men 65 and older, people who have taken medications that affect bone density for prolonged periods (such as some asthma and steroid medications), and people with a history of osteoporosis or fractures in their family. Knowing your T-score and risk factors help you and your physician decide how aggressively you should address osteoporosis prevention and treatment.
Additional tests may be used to help with osteoporosis diagnosis.
If you have lost more than 1½ inches in height, your doctor may choose to order an IVA (Instant Vertebral Assessment) along with your bone density test to reduce the radiation exposure. If IVA is not available, your doctor may order an x-ray of your spine. These tests will help detect whether any of the bones in your spine (vertebrae) have broken or collapsed due to compression fractures. Please keep in mind, x-rays do not assess the density of your bones, only whether you have had a fracture.
Depending on your bone density test results, your doctor may order other tests. There are a variety of blood tests that may help with the diagnosis of osteoporosis. A standard CBC (complete blood count), chemistry panels and a thyroid test are basic. In more complicated cases, your doctor may want to run other tests including a parathyroid hormone test, a kidney function test, a measurement of male or female hormones, a measurement of calcium in the urine, or a vitamin D test.
For older people who have suffered a fracture, a vitamin D test is particularly important. Vitamin D deficiency appears to be an epidemic today and it is critical for calcium metabolism.
To determine how fast your bone is breaking down, your doctor may order a lab test of your urine or blood called bone turnover markers. These tests evaluate if your body is breaking down your bones (turning over your bone) faster than normal. If tests show a high rate of bone turnover, additional tests might be done to find the cause. For example, your doctor might look at the level of thyroid hormone in your blood to see if your thyroid is overactive.
Bone turnover markers, specifically urine tests and newer blood tests, can also be used to monitor treatment of osteoporosis. Bone density tests and bone turnover markers work together to help your doctor get an accurate picture of your fracture risk, your bone loss rate, or your response to a prevention or treatment program.