Posts Tagged ‘TSH’
So how do you find out what aspects of your bone health are pretty good already, what will be easy to fix, and what will take some real work? Start with a Complete Bone Health Evaluation.
DXA is about 1/3 of the story and should include both hips and spine. When you are as old as I am, the spine probably is too arthritic to be really accurate, but helps complete the picture. If you have had a total hip replacement, you should use the non-dominant forearm.
VFA will pick up many persons at increased fracture risk who are missed by DXA alone. You should ask for VFA, especially if you or a parent have kyphosis (humpback) or have lost height.
The FRAX calculation picks up different individuals at high fracture risk.
Blood tests should include CBC, CMP, TSH, PTH, and 25-hydroxy Vitamin D as a start. Further testing may be needed.
A medical history and examination focused on bone issues is a critical part of the full consultation. We allot a minimum of 30 minutes for discussion. Often a follow-up visit is needed to be sure both we and our patients are clear on the whole picture.
DXA alone misses over half of the individuals who need to improve their bone health. Get a Complete Bone Health Evaluation.
Jay Ginther, MD
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.
TSH is Thyroid Stimulating Hormone. This is the common screen for thyroid function. Thyroid function decreases with age, often suddenly. In women this often happens between 40 and 70. “Low thyroid”(hypothyroidism) is the most common unrecognized hormone deficiency contributing to osteoporosis in women, and in some men too.
The thyroid gland is shaped like a butterfly and sits in the neck just below the adam’s apple (larynx). Hypothyroidism causes fatigue, temperature sensitivity, weight gain – already common in middle aged women and men. Once it is recognized, hypothyroidism is routinely treated with synthetic human thyroid hormone.
Patients often ask “What’s that for?” when I order blood tests. They understand that DXA is for Bone Mineral Density (BMD). They understand Vertebral Fracture Assessment (VFA) when I show the lateral Spine image to them on the screen. Blood tests are a bit more challenging.
Osteoporosis is often caused or made worse by other diseases and conditions. We screen for the common diseases and conditions. Some of them are easily corrected. Easy or hard, they must be identified and corrected to maximize bone health and minimize fracture risk. For this we need blood tests.