Wednesday, September 18, 2013

Good News Part 1: DXA

One of the unnecessary scares at the time of a physical exam took place in 2003, the first year I had a DXA scan to measure bone density. I went to a testing center where an MRI was administered and later interpreted by a doctor. The results revealed significant bone loss in the lumbar spine and left femur. I was horrified. My PCP wanted me to take Fosamax; I decided to get a second opinion.

I went to the radiologist who did (and still does) my mammograms. The results on his machine were significantly better than on the first test. The radiologist explained that readings can differ from one machine to another. There is also a margin of error for any machine so that small differences are not considered significant. (Since 2003 I’ve had five DXAs since then and none has ever given results as low as the first one.)  The overall picture was not too bad. The reading for the spine was definitely in osteopenia territory, those for the femurs were normal.

In the succeeding years the picture has stayed about the same: osteopenia in the spine but no worse than before, some additional bone loss in the hips but just barely out of the normal range. Last year the spine was somewhat better, the femur readings a bit worse. This year the spine was back down but the right hip (the side with the shorter leg) had increased 3.7%. So the overall picture is that the numbers bounce around a bit but not much changes. After ten years, is it really worthwhile for me to continue with these tests?

Clearly, my body can still rebuild bone. To help the process along I’ve decided to increase my calcium supplement intake by 25%. I also take vitamin D and magnesium along with the calcium. There has been a lot of talk lately about people taking too much calcium. The theory is that the excess mineral can harden the walls of the arteries and contribute to heart disease. But how can we know whether a particular person is getting more than enough without a blood test? We’re all different. In my own case, I take well over the recommended amount yet my serum level is at the low end of normal. My blood pressure is low normal and my cholesterol readings are just fine. Instead of making sweeping generalizations, I wish the experts would recommend that people get themselves tested. That is the scientific way, after all.

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