Just DXA is Not Enough

January 4, 2014 @ 3:09 pm
posted by Dr Ginther

DXA identifies only 15% of persons with increased Fracture Risk.  Are you in the other 85%?  To find out, you should get a Complete Bone Health Evaluation.  And that is…….

First and foremost, it is an entire office visit devoted to bone health.  That gives you and your doc enough time to fully discuss bone health issues.  Next there is the full panel of tests: DXA, VFA, CBC, CMP, TSH, PTH, and 25-hydroxy Vit D level.  Finally, there is FRAX.

DXA is best read by someone who has taken the ISCD course and passed the CCD exam.  The computerized reading relies on 20 year old software and is often wrong.  It needs human oversight and correction.

VFA is lateral spine to identify Vertebrae which have “crumbled” or “crunched”.  In over 1/3 of my 941 patients studied, DXA alone missed increased Fracture Risk.

25-hydroxy Vit D should be 40ng/ml or higher for optimal bone health.  In 2013, I found only 2 patients who did not need at least 1000 units of D3 daily and most needed 2-4000 units total daily.

PTH is high in persons not absorbing enough calcium from diet and supplements.  HyperParathyroidism steals calcium from your bones to keep blood levels of calcium normal.  Not good for the bones!

TSH screens for thyroid function, which often drops as a person becomes older – often in their 50s or 60s or 70s.

CBC and CMP are often part of an annual blood screen.  Some parts of CBC and CMP are important indicators of bone health.

Finally, the FRAX calculation helps account for all risk factors.  Discuss this with your doc.

Especially if you have had a fracture, Take Control of your Bone Health future.  Get a Complete Bone Health Evaluation.

Jay Ginther, MD

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