How Meaningful is Your DEXA Score?

. . . Bone density scores do not correlate with fracture risk

A lot of women, and some men, are scared into taking toxic medications by tests called DXA or DEXA (dual-energy x-ray absorptiometry) that measure bone density — the amount of mineral matter, like calcium, phosphorus, magnesium and others, in your bones. Your DEXA scores are compared with those of a hypothetical healthy 30-year-old woman; if they are a certain degree lower than this standard, you are told you have either pre-osteoporosis (osteopenia) or osteoporosis itself, and that you are at an increased risk of having a fracture. About 40% of all postmenopausal Caucasian women fall into the osteopenia range, and another 7% into the osteoporosis range.

Yet, according to a recent article in Scientific American, DEXA test results don’t correlate well with fracture risk. In a 2007 Canadian study, for example, data on over 16,000 postmenopausal women were analyzed. It was found that more than half of all fractures occurred in women who had normal bone density as measured by DEXA.

How can this be? Well, for one thing, the DEXA test is based on an arbitrary definition of “normal” bone density. In some other cultures, women have thinner (less dense) bones than ours, and yet fracture rates are much lower. For another, while mineralization is important, bone density is only one component of bone health. Bone health also depends on the condition of the bone matrix — the protein structure in bone that holds the minerals. Its vitality and resilience are affected by a host of different influences all having to do with general good health. As author of The Myth of Osteoporosis and critic of our preoccupation with bone density Gillian Sanson points out, disabling fractures generally only occur in the frail and sick, and various health issues and medications are involved.

Beyond Health recommends building healthy bone in the context of optimizing your overall health. It’s normal for postmenopausal women to lose some bone density, and it doesn’t mean you can’t maintain healthy fracture-free bones. For specifics on how to optimize bone health, see Raymond Francis’ article Boning Up on Osteoporosis.

Nutrition for healthy bones should include an alkaline diet along with a complete and balanced mineral formula, such as our Bone Mineral Formula, vitamin K, adequate vitamin D based on your 25(OH)D blood levels, adequate vitamin C in powdered form or in tablets, a high-quality multi-vitamin, and the right balance of essential fatty acids.

Sanson G. The osteoporosis epidemic: more about big bucks than your bones? The John R. Lee, M.D. Medical Letter.  June 2002, pp. 5-6.
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