T Scores
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Posted 27/07/2010 11:41:20 Post #2273

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Hi I have just been diagnosed with osteoporosis. My T score was -1.7 for femoral neck, -1.6 for the hip and -2.5 for the spine. It seems pretty borderline to me and I would prefer not to take medication. Would it be reasonable to increase my exercise and take calcium supplements and have another scan in 12months? Could the condition worsen dramatically if left without medication for a year? Is there any way my scan could have been interpreted differently with different scores by another technician - is the interpretation at all subjective or is the score very accurate and clearcut?

I don't really want to go down the path of a lifetimes medication at my age. I am very active and fit - or so I thought until I receved this diagnosis.

Thank you for any advice Liz
Posted 27/07/2010 16:48:01 Post #2278

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[this is not a response from a Helpline nurse]

Hi Liz... I also was diagnosed this year at the age of 54, with a T Score for the hip of -2.3 and the spine -2.7.  My doctor's first reaction was to prescribe Actonel and Addcal but when we talked about the situation, she understood I was reluctant to start serious medication, the effects of which would be with me for life and gave me her backing, to try exercise and calcium plus vitamin D for a year.  I know many people on this site have found a medication they are happy with, which is great and maybe I will have to do the same but it is a personal decision to give this route a try. I must say it is lovely to have a Doctor who had the time to listen and understand. Good luck with whatever you decide Liz, keep healthy!

Posted 28/07/2010 04:05:48 Post #2279

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[this is not a response from a Helpline nurse]

Hi Liz,  I understand your question.  I am 50 years old and have been told I have osteoporosis.  I had my DEXA scan on the same machine as last year.  This year my T-score was -2.8 for my lumbar spine, total right hip -1.9 and right femoral neck -2.6   Last year my T scores were -2.4 for lumbar spine, total right hip -1.4 and right femoral neck -2.4 

It was calculated from my previous dexa scans that at present the rate of BMD change =  -4.996% per year at L-spine and -7.851 per year at right hip.  Now over the last year with no drugs I had increased exercise especially weight training, walking etc and increased my calcium to 1,500 mg per day.  I was disappointed to see that I was still losing Bone Mass Density between -4% and -7% a year despite my efforts so I was referred to an endocrinologist.  He agreed I could carry on with just the supplements and exercise under the care of a physiotherapist who could teach me back strengthening exercises which I still do.  But he did give me research information on various drug treatments to read and he did blood tests that I hadn't had before including calcium, phoshorus, ESR and Vitamin D3 (25-OH) levels.  To my surprise my Vitamin D3 levels were 23.5 ng/mL for which the desirable Vit D3 level is recommended as on or above 30 ng/mL.  It is also 58.8 nmol/L for which the desirable Vit D3 level is recommended as on or above 75 nmol/L.  Vitamin D3 helps make bone - read up on it and all the latest research.  As a result I am takiing 2,000 iu of Vit D3 a day now and trying to get at least 10 minutes a day of sunshine without sun screen all over me.  I must admit that living in a hot climate that I stay in the shade and it is hard work staying in the sun to boost my D3 levels.  I am having a repeat blood test next month - the last one was 6 months ago and if it is below the desirable level for bone health low then I will increase the D3 capsules under doctors supervision.  I did decide to take Stontium Ranelate 2g per night and am now in my second month of taking it - so far okay.  I could have just tried the increased Vit D3 and waited for my dexa results next year but if you choose this option then please go to your GP or endocrinologist and have some blood tests first to make sure you don't have any underlying disorder that makes taking supplements bad for you and check to see that your calcium is within the normal range. 

I chose Strontium Ranelate as I realise that at the age of 50 that I will have to take a drug for a long time to reduce my fracture risk.  The biphosphonates have more side effects and a long half-life in your body, which means that even if you stop taking the drug it will stay in your body for quite a few years.  It is worth researching via this site and other books etc about the drugs to see whcih suits you.   

Posted 28/07/2010 12:01:09 Post #2280

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Dear Liz

Thank you for your recent post regarding your need for treatment.

Osteoporosis is a condition in which bone is fragile and at increased risk of breaking. Treatments for osteoporosis aim to reduce the risk of such fractures occurring.  Assessment of bone density provides useful information in assessing an individual’s risk of breaking a bone and a T score of -2.5 (-2.5 standard deviations below the young adult average) is the point at which osteoporosis is diagnosed.  We are aware however that there is more to our risk of breaking a bone than just low bone density and factors such as age, body size, history of broken bones etc are also very significant. The World Health Organisation has produced a tool called FRAX (Fracture Risk Assessment tool) which uses your T score along with these other factors to calculate your risk of breaking a bone in the next 10 years.  Your need for treatment at the moment can be also be assessed more accurately using this tool. The FRAX tool can be accessed at http://www.sheffield.ac.uk/FRAX/  Use of this tool will help you and your doctor establish whether you require a treatment now or can afford to wait and adopt the life style changes you suggest.

It is difficult to predict what will happen in the next 12 months, bone loss is an inevitable process and the rate at which this occurs differs throughout life. You do not mention your age, but bone loss tends to accelerate around the time of menopause. If you are guided by your FRAX score as described above, you can be reassured that treatment will only be recommended if your risk of breaking a bone is raised in the next ten years.

Bone density scanning generates quite a precise score but as with many diagnostic techniques there is margin of error. I hope you can appreciate from the information above however that the T score is most useful when used in conjunction with other factors.

I hope you will find this information useful

Best wishes

Helpline Nurses
National Osteoporosis Society

Posted 28/07/2010 14:55:22 Post #2281

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Hi all - please remember that this section of the forum is for our team of nurses to answer questions. If you have a question for our nurses then please start a new topic in this section.

Thank you.

James Hobbs
Electronic Communications Officer
National Osteoporosis Society

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