If you have osteoporosis, or are at high risk for the disease, your health care provider can help you plan a treatment program. They can help you decide what medications would be the best choices for you, and review the benefits, side effects, and how these medications interact with other medications you are taking for other conditions. In addition to medicine, your treatment plan should include a healthy, calcium-rich diet and regular physical activity.
Bone density DEXA scans, completed before a treatment program starts, and repeated on a regular basis, can help check whether the treatment program is effective. If you have osteoporosis, you should work with your health care provider to plan a treatment program that meets your needs. There are a variety of prescription medications available to slow bone loss and help prevent fractures caused by osteoporosis.
Understanding BMD Test Results
When you have a bone mineral density test,
it compares your bone density to a "young normal" healthy 30-year-old adult with peak bone density (also called peak bone mass). Peak bone density is the point at which a person has the greatest amount of bone that she or he will ever have.
You will get the result of your BMD test in a special number called a T-score. It stands for "standard deviations" or "SD." It indicates how much your bone density is above or below normal.
Healthcare providers use the T-score to diagnose osteoporosis. If more than one bone is tested, they use the lowest T-score to make a diagnosis of osteoporosis. The World Health Organization (WHO) has defined the T-scores and what they mean.
What your T-score means:
- A T-score between +1 and -1 is normal bone density. Examples are 0.8, 0.2 and -0.5.
- A T-score between -1 and -2.5 indicates low bone density or osteopenia. Examples are T-scores of -1.2, -1.6 and -2.1.
- A T-score of -2.5 or lower is a diagnosis of osteoporosis. Examples are T-scores of -2.8, -3.3 and -3.9.
The lower a person's T-score, the lower the bone density. A T-score of -1.0 is lower than a T-score of 0.5; a T-score of -2.0 is lower than a T-score of -1.5; and a T-score of -3.5 is lower than a T-score of -3.0.
For most BMD tests, 1 SD difference in a T-score equals a 10-15 percent decrease in bone density. For example, a person with a T-score of -2.5 has a 10-15 percent lower BMD than a person with a T-score of -1.5.
Your BMD test result also includes a Z-score that compares your bone density to what is normal in someone your age and body size. Healthcare providers do not use Z-scores to diagnose osteoporosis in postmenopausal women and men age 50 or older. Among older adults low bone mineral density is common, so Z-scores can be misleading. An older person might have a "normal" Z-score but still be at high risk for breaking a bone.
Most experts recommend using Z-scores rather than T-scores for younger men, premenopausal women and children. However, healthcare providers often use T-scores for perimenopausal women. A Z-score above -2.0 is normal according to the International Society for Clinical Densitometry (ISCD). A diagnosis of osteoporosis in younger men, premenopausal women and children should not be based on a BMD test result alone. NOF does not recommend routine BMD testing in children, adolescents, healthy young men or premenopausal women. (source National Osteoporosis Foundation, 2008)
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