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How to tell if you are losing bone without a bone density test

While most doctors tend to monitor bone density with the dual-energy x-ray absorptiomentry (DEXA) test, there is another, less expensive test helpful in determining if you are currently losing bone. This test, called the cross-linked N-teleopeptide (or NTx for short), is a simple urine or blood test known as a "marker of bone resorption." When you lose bone, small fragments of bone protein show up in the urine and blood, and measuring these bone protein fragments gives an indication of rate of bone breakdown. In most cases a high rate of bone breakdown, also known as bone resorption, indicates that there is an ongoing loss of bone mass.

The bone resorption markers most commonly used are the urine NTx osteomark marker and the urine deoxypyridinium cross-links (Dpd). Your physician can order either of these tests. Generally, a score that’s near or even a bit below the premenopausal mean for women, and one near or even a bit below the young adult mean for men, is ideal. In both tests, the higher the number, the greater the likelihood of a more rapid rate of ongoing bone loss. For more details see my articles on bone density testing and bone resorption testing.

 

We created the Osteo Blast blog as our forum to express opinions and educate the public about natural means of supporting and improving bone health and overall wellness. As part of this forum, we sometimes discuss medical issues and medications, and their effects on bone health in general. However, we cannot advise readers about specific medical issues in this forum. If you wish to obtain advice from Susan E. Brown, PhD, about your specific bone health and nutritional concerns, please visit our Consultations page. Other specific medical questions should be referred to your healthcare provider.

Comments

February 18. 2010 16:27

Dear Dr. Brown,

I have just started the Personal Program for Better Bones but am worried because my T score was -3.0 and I know that isn't very good.  They say I am at high risk for bone fracture.  I am 62 years old but look like I am 52 an I am worried beyond worry about getting worse. It feels like the beginning of the end of my life.
My doctor wanted me to take Boniva but when my insurance wouldn't cover it I started looking on-line for alternatives and found you.  MY QUESTION IS:  which tests would be good for me to check and see if what I am doing in this program is working for me.  I haven't got into exercising much -yet- but am going to check out a gym in the area.  I just don't want to wait for another Dexa scan because I had one a month ago and if I waited one or two years, depending on my insurance, it might be too late and I could have lost much more bone density.  Please reply

Thank you Debbie

Deborah Stoll

March 16. 2010 05:03

This is not the beginning of the end of your life.  It may be the beginning of a new attitude towards aging.  It's up to you.  You can decide to age well, with minimum risk.  

I have the worst family history of osteoporosis on the planet. And ... I lost 2 inches in height at age 29, after giving birth to a beautiful baby girl. Definitely not menopausal. I was treated for osteopenia, including Fosamax, for 25 years, unsuccessfully.  When my fifth DEXA was worse and starting to be alarming at age 54, I essentially fired my doctors, at least on the subject of osteoporosis.    I had already been researching the subject for decades, but now I got really serious.  And ended up with essentially the same information on this wonderful website.

Then, I put it to work and five years later I have the best bones of my lifetime and no reason not to expect continued improvement.  And I am vastly healthier and feel stronger than I have since I was 29.  Restoring my Vitamin D levels has rebuilt a good deal of muscle as well as bone.  One of Vitamin D's roles is the maintenance of muscle mass.  Can't wait to see what exercise adds to this, I was too chicken to start until my bones improved, so just adding that now.  It wasn't necessary to wait, I was just afraid.    

Don't despair ...  it's darkest just before dawn. The bones you will have at 90 will have to be built at 80-88.  Start learning how to build them well, better than you did at 20, 40, 60, etc. It's never too late.

Wendy R

March 16. 2010 16:53

So Deborah, listen to Wendy R.  (Wendy R. thanks for the thoughtful comment).  Deborah be sure to have your doctor test for hidden causes of bone loss.  I detail all of there in this site, see http://www.betterbones.com/bonehealth/medicaltestingforosteoporosis.aspx.  Also make sure you follow all the steps of our program including working with your pH balance and exercise and the 20 key bone nutrients.  If all else fails, I can help you with a personal consultation.   Go can do it--take heart and take action! Best wishes, Susan Brown

Susan Brown

July 7. 2010 16:01

Dear Dr Brown

I have been diagnosed with osteoporosis at 72.   I have always taken dairy products, done lots of exercise (walking, tennis, gym), never dieted and have kept the weight I was when young, which was slim at 64 kg and 167 cm.   I had a bone density test when I was 60 and was 100%, even though I had gone through menopause at 52, so was not worried about loss of bone, even though I had not taken HRT, which I felt I did not need as I had not menopause symptoms like depression, hot flushes, etc.   I have never had a fracture but now am worried if I play tennis that my bones will not endure the stop/start of running, although my doctor tells me tennis is one of the best sports for me.    My gynae has put me onto Fosavance which has extra Vitamin D and I have taken calcium with extra Vitamin D for many years, which has obviously not helped as the osteoporosis in in my spine and osteopenia in my hips.   What can I do to help myself at the moment.  I have been to an osteopath who tells me the measurement for bones is done on a 25 year old woman.   Obviously I am never going to be 25 again, but, although I am healthy is every respect except this, I am now frightened of fractures, especially in the spine.   I had a fusion of three vertebrae in the lower back in 1993 and wonder if this is anything to do with the bone loss.

Jill Orton

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