A T-score for normal bone density is -1 and above. This means your bone mineral density is average. If your bone density measurements are between -1 and -2.5 your bone density is below average, and your doctors will call this Osteopenia. Osteopenia is the stage before osteoporosis when you have lower than average bone density for your age but not low enough to be classed as osteoporosis. Osteopenia does not always lead to osteoporosis, as there are ways to keep your bones healthy.
When your T-score is -2.5 and below, you’ll likely be diagnosed with osteoporosis because your bone density is too low, and you are at a higher risk of bone fracture.
How is the T-score test performed?
Your T-score is found using a DEXA scan, sometimes known as a Bone Density scan; this does not involve the need to go into a tunnel scanner like with an MRI, any injections or medications. Bone density testing using a DEXA scan(Bone density scan) involves lying flat on your back on an open x-ray table. During the scan, a large scanning arm passes over the body to get a measurement of bone density in the centre of your skeleton. You will need to be still during the exam so the images do not blur and the machine can make an accurate measure.
Usually, a narrow beam of low-dose X-rays will be passed through the part of the body which needs to be examined, this is often skeletal sites, such as your lower spine and hip joint, to check for weak bones, but more than one part of your body may be scanned, as bone density can vary in different bones.
Bone density tests are available through an NHS referral. The scan usually takes 10 to 20 minutes, and you can go home once it’s done.
What is Osteoporosis?
Osteoporosis is a lack of bone density which weakens the bones, making them more likely to break. A diagnosis of osteoporosis is not usually made until a fall or sudden impact causes a broken bone or osteoporotic fracture and then Bone density testing is done. The most common injuries which show signs of osteoporosis are hip fracture, a break in the vertebrae(spinal bones) or broken wrists; however, breaks from osteoporosis can happen in other bones. Osteoporosis doesn’t cause unusual pain until a bone is fractured or broken. Other signs of osteoporosis can be a bent forward posture; this happens when the bones in the spine have been broken and have more trouble supporting the body’s weight.
The age of patients diagnosed with osteoporosis is generally between 50 -90. Adult women in the age bracket are more likely to be diagnosed with osteoporosis as they have lighter, thinner bones and an average longer lifespan.
Causes of Low bone density
The bones constantly renew themselves, and when you’re young your body makes new bone faster than it breaks down old bone leading to an increase in bone density mass. Once people reach their 30s they have reached peak bone density levels and bone strength, which begins to be lost faster than it’s created. The amount of bone mass you lose depends on how much you gain in your youth; often, this varies by ethnic group, gender, lifestyle choices, family history of osteoporosis, and medical conditions.
Women are, on average, more at risk of osteoporosis than men; especially postmenopausal women and women who have had their ovaries removed.
Other factors that increase the chances of developing osteoporosis include taking a high dosage of steroid tablets for more than three months, inflammatory conditions, hormone conditions, eating disorders such as Anorexia, and heavy drinking or smoking.
Treatment options for Osteoporosis
If you’ve been diagnosed with osteoporosis, your treatment plan will depend on a few different factors –
- Your age and sex
- Whether you’ve experienced a bone break
- if you’re at a high risk of future fracture
- Your predicted response to treatment
You may not need to take osteoporosis medication, however, if you do, there are a few different drugs your doctor may prescribe you.
- Bisphosphonates, slows the rate bone is broken down in the body
- Selective oestrogen receptor modulators (SERMs), which act in the same way as the hormone oestrogen – a hormone that’s essential to maintaining bone health
- Parathyroid hormone, stimulates the cells responsible for bone growth. This is usually given via injection and only used when other treatments haven’t worked.
- Calcium supplements to support your bone mineral content
How can I prevent osteoporosis?
Some people have unchangeable risk factors for osteoporosis. However, lifestyle choices can influence your bones’ health and reduce bone loss.
The World Health Organisation recommends that the average adult between the ages of 18-64 should do at least 1.25 – 5 hours of physical activity a week, and to reduce the detrimental effects of high levels of a sedentary lifestyle. All adults should aim to do more than the recommended levels of moderate to vigorous physical activity. They suggest the same for adults aged 65 years and over; however, they should also do varied activities focusing on functional balance and strength training on three or more days to enhance functional capacity and prevent likelihood of falls.
A healthy diet is vital for every aspect of our lives, including maintaining healthy bones and preventing osteoporosis.
To maintain healthy bones, an emphasis is put on consuming enough calcium. 700mg of calcium daily is recommended, which is easily achieved through a healthy diet. Calcium-rich foods include leafy greens, salmon, different types of beans, dairy products and juices such as Orange juice.
The body absorbs vitamin D from the sun, food, and supplements. Vitamin D is vital for healthy bones as it helps your body absorb calcium.
Being in the sun can trigger Vitamin D production, however, you can also consume the daily recommended ten micrograms of Vitamin D a day from food such as; oily fish (Salmon, sardines etc.), egg yolks, some breakfast cereals and red meat. If you find it challenging to get your vitamin D needs from these foods alone, you can take daily supplements of Vitamin D; however, it’s always best to seek medical advice if you’re thinking about adding supplements to your diet.
Drinking less alcohol and stopping smoking
The NHS recommendation is not to drink more than fourteen units of alcohol a week; this is important for many reasons, however, when it comes to bone health, excessive alcohol consumption can decrease the body’s absorption of calcium and vitamin D, which are vital for bone health. Smoking has also been linked to increased chances of poor bone health as it affects body weight, vitamin D levels, and many other negative health effects.
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