It's time to get hip to this bone density and physique composition take a look at.
Osteoporosis could look like an outdated particular person's drawback — the “silent” situation progressively reduces bone mass and density, making your interior scaffolding weaker, thinner and extra liable to fractures.
The illness is definitely turning into more and more widespread amongst youthful folks because of poor consuming habits, sure underlying well being points and medicine use.
Dr. Pooja Gidwani, a concierge doctor in L.A., is especially frightened about ladies taking GLP-1 medication like Ozempic, which might trigger a lower in bone density together with speedy weight reduction.
She recommends ladies endure a “baseline” dual-energy X-ray absorptiometry (DEXA) scan of their early to mid-30s to assist predict future well being dangers.
The take a look at measures the power and high quality of bones whereas additionally quantifying physique fats, lean mass and visceral fats.
“It's a favourite in analysis, scientific medication and elite athletic packages for that reason,” Gidwani instructed The Publish.
Right here's every little thing you should find out about this enlightening know-how.
How does a DEXA scan work?
An X-ray offers detailed photographs of bone form and construction, nevertheless it can't precisely measure bone density or forecast fracture threat.
A DEXA scan harnesses the facility of X-rays to disclose a clearer image of bone power.
The machine directs two X-ray beams, one high-energy and one low-energy, at your bones as you lie nonetheless on a padded desk.
The beams are absorbed by bone and comfortable tissue at totally different charges.
The scanner detects this distinction and calculates bone mineral density and physique composition with an error fee sometimes inside 1% to 2%.
“The scan is painless, noninvasive and normally takes lower than half-hour begin to end,” Gidwani mentioned.
“It makes use of far much less radiation than a typical X-ray and is designed to catch bone loss effectively earlier than it turns into seen or results in fractures.”
Gidwani famous that the examination doesn't contain injections or distinction dyes. She suggested getting scanned within the morning.
These exams are typically not really helpful for pregnant ladies, and calcium complement customers could must cease taking the tablets 24 hours beforehand.
What can a DEXA scan reveal?
DEXA scans are primarily used to diagnose and monitor osteoporosis and osteopenia, a milder, earlier stage of bone loss.
It could additionally detect nuanced circumstances similar to:
- Sarcopenia: low skeletal muscle mass
- Sarcopenic weight problems: low muscle and excessive fats
- Osteosarcopenic weight problems: low muscle, low bone density and excessive fats
- Irregular visceral fats distribution linked to metabolic illness
- Unexplained fractures or suspected secondary osteoporosis (because of drugs, hormonal issues, and so forth.)
“It's extra dependable than physique fats scales and extra detailed than MRI for whole-body composition,” Gidwani mentioned of DEXA.
“Its precision makes it excellent for monitoring adjustments over time, particularly throughout weight reduction, power coaching or hormone transitions like perimenopause and menopause.”
Ought to I get a DEXA scan if I'm in any other case wholesome?
Bone mass tends to peak round age 30. The bone reworking course of continues, however the breakdown of outdated bone begins to barely outpace the formation of latest bone.
Genetics and private habits similar to weight-reduction plan, train, cigarette use and alcohol consumption affect bone well being. Hormonal shifts — notably a lower in estrogen — can speed up bone breakdown.
“Estrogen ranges can start to fluctuate within the mid-to-late 30s,” Gidwani defined, “because of a variety of things, together with early or pure perimenopausal transition, continual stress, postpartum restoration, disrupted ovulatory cycles, low physique fats, overtraining or preexisting gynecological or endocrine circumstances like PCOS or hypothalamic amenorrhea.”
Girls are additionally vulnerable to early bone density decline if they've a household historical past of early osteoporosis, a scarcity of power coaching, inadequate calcium, protein or vitamin D consumption, disordered consuming, sedentary habits or speedy weight reduction.
GLP-1 medication, which suppress urge for food, may cause speedy slimdowns.
“Whereas GLP-1s may be extremely useful when achieved proper, they will additionally result in unintended losses in lean muscle and bone density if not paired with correct vitamin and resistance coaching,” mentioned Gidwani, who treats ladies on GLP-1s and focuses on hormone well being and longevity.
“In ladies of their 30s and 40s utilizing GLP-1s,” she added, “DEXA is very priceless for detecting early lack of muscle or bone, usually lengthy earlier than signs or problems come up.”
Gidwani mentioned she's seen feminine sufferers as younger as 32 present low bone density on scans.
For males, Gidwani means that these with a household historical past of osteopenia/osteoporosis, a historical past of fractures, long-term steroid use, low muscle mass, very low testosterone or long-term GLP-1 use take into account a DEXA scan sooner than the usual guideline of age 70.
The place can I get a DEXA scan?
Hospitals, diagnostic imaging facilities, ladies's well being or endocrinology clinics and more and more, wellness and health facilities supply DEXA scans.
“Firms like BodySpec and DexaFit concentrate on cellular or consumer-accessible DEXA scanning, usually used for health monitoring,” Gidwani mentioned.
“Simply remember to affirm whether or not the scan is being achieved for diagnostic functions (bone density) or wellness (physique composition).”
DEXA costs vary widely, from $40 to $300 or extra out of pocket, relying on the power, the extent of the scan and the precise cause for it.
Scans are sometimes coated by insurance coverage for ladies over the age of 65, males older than 70, postmenopausal ladies with threat elements, folks with sure medical circumstances or these taking drugs that enhance fracture threat.
“Hopefully, as consciousness round early bone loss and adjustments in physique composition will increase (particularly within the context of GLP-1 use and hormonal shifts in youthful ladies),” Gidwani mentioned, “screening pointers will start to mirror this want for earlier, proactive intervention.”
What are the therapy choices for low bone density?
If a scan reveals low bone density, step one is to determine the trigger.
Gidwani mentioned a therapy plan sometimes contains:
- Energy coaching to enhance bone and muscle
- Elevated protein consumption — goal for not less than 0.8 to 1.2 grams of protein per pound of physique weight, particularly if you happen to're on GLP-1s or dropping pounds.
- Calcium and vitamin D supplementation
- Hormone remedy, notably for perimenopausal and postpartum sufferers
- Fall prevention and steadiness coaching
- Way of life adjustments similar to lowering alcohol consumption, quitting smoking and addressing dietary deficiencies
In reasonable to extreme circumstances, drugs like bisphosphonates and denosumab sluggish bone breakdown whereas teriparatide stimulates the formation of latest bone.
“In your 30s or 40s, essentially the most impactful technique is prevention,” Gidwani mentioned, “figuring out early losses, tailoring life-style interventions and checking progress over time with repeat DEXA scans.”
