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BMD Bone Mineral Density

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Old 06-20-12 | 05:43 PM
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BMD Bone Mineral Density

I'm now 57. Back in 2004 I had what I thought was a minor fall that resulted in a fractured femur neck. After that accident I thought it would be a good idea to get a bone density scan considering that osteoporosis was a problem for my mother and grandmother but my insurance company told me they wouldn't pay for it. Well I finally just paid for it myself and here is what they found: AP Spine L1-L4 1.239 g/cm^2 Young Adult T-score 0.2, age matched Z-score 0.1. Femur neck left 0.758 Young Adult T-Score -2.4, age matched Z-score -1.8. BTW, since the test found a problem the insurance company is paying for it, go figure.

A young adult T-score of <= -2.5 is considered to indicate osteoporosis making my femur neck just 0.1 standard deviations away from osteoporosis. The good news is my spine is better than average. So, the doctor told me I have osteopenia (defined as a T-score of -1 to < -2.5) and to be sure to get at least 1,200 mg of calcium a day.

My take on all this is that I'm relieved my spine is in good shape. As far as the hip is concerned my plan is to make sure I really keep up with the strength training program and try not to fall on my left hip (my right femur neck has three titanium pins so I figure it is a bit stronger than the left).

Anyway, the internet is always a good place for free and informed medical advice so I thought I'd post this Actually, this is generally a very thoughtful group so I thought I would ask what others of you with low bone density are doing and what was your experience with, or opinion of, medical interventions for this condition and/or other advice you have for dealing with this.
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Old 06-20-12 | 06:19 PM
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My son (45yo) has had osteoporosis and osteopenia for many years, discovered when he fell out of bed and broke his back several years back.

He was on Fosamax, which likely contributed to his femur breaking about 3 years ago, as it is now associated with brittle bones.

He could not stand the daily shots of Forteo, so is now on Prolea - 2 shots per year.

We will see what happens
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Old 06-20-12 | 06:45 PM
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Having had 3 significant broken bones in 2 years I thought that a bone density scan would be a good idea too. When my primary physician plugged it into his computer it came up that frequent fractures wasn't a good enough reason for Medicare to pay for it. Like you I said, "Lets do it anyway. I'll pay for it." His billing clerk, however, found a way to get the insurance to pay.
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Old 06-20-12 | 07:43 PM
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I've never had a bone density scan, but about a decade ago when I had a soccer mishap that required that my leg be screwed back together, the team orthopedists for the Sacrament Kings were running up and down the halls with my X-Rays showing off the densest shin bones they had ever seen.

Maybe all that excess bone is affecting my climbing speed.
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Old 06-20-12 | 07:53 PM
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Glad you found the problem and are on top of it.
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Old 06-21-12 | 12:54 AM
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I'm 52 & have had yearly bone scans for the past 3 years ever since my OB-gyn got a scanner. Maybe insurance is more generous checking BMDs on women than men. I turn it into my insurance & get the insured rate but my HSA deductible is so high that I end up paying the whole thing anyway.

All bones in osteopenia range:
L1-L4 .965 (worse than yours @ 1.239) This number worsened from 1.056 @ first scan
L femur .870 (better than yours @ .758) This number worsened from .910 @ first scan
R femur .851 This number worsened from .901 @ first scan

Soo . . . After the first scan, I started 1200 mg calcium daily and started walking 5 miles 3-5 times weekly. The other days are cycle days, typically a slow 50 mile ride. The bad news is,
I've read that cycling isn't necessarily any good for osteopenia, tho my doc says any exercise is good. Apparently, the sweating you do when cycling can actually make you lose more calcium - and I ride in the Arizona heat After a year of this, my spine scored a hair better and both hips a hair worse.

Then I came off the pill, bye bye estrogen - all 3 numbers worsened even tho I'd stepped up from walking to jogging. The doctor was about to put me on some kind of Fosamax type drug but I showed him the new calcium pills I'd just started, Bayer's Citrical Plus Bone Density Builder w/ Genistein. Genistein is supposed to "increase bone density by up to 5%." I also stepped the jogging up to running (six 10-minute miles). Running is supposed to be good because bang-bang-banging the ground causes microfractures which cause bones to remodel. So even tho I dislike running, I do it and we shall see in a few months if it and the Genistein have had any effect. The upside is I've gone from size 8 to the size 2 of my youth, not easy to do after 50 because the other thing that happens when estrogen leaves is you get fat
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Old 06-21-12 | 05:51 AM
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You might consider adding some weight training as well Yumadons. The jogging you are doing is a good thing as well for the reasons you mentioned. It's important for all of us "mature" cyclists to include weight bearing excercises in addition to our riding. I'm a firm believer that weights should be a part of every person over 50's routine.
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Old 06-21-12 | 09:04 AM
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Good idea, Blanchje. I finally bailed out of the AZ heat and joined a gym ~ a month ago. I'll keep an eye out for a class that teaches how to use weights. I'm in a weekly abs class and a weekly yoga class (ouch). What doesn't kill you makes you stronger
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Old 06-21-12 | 09:47 AM
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Originally Posted by Yumadons
I'm 52 & have had yearly bone scans for the past 3 years ever since my OB-gyn got a scanner. Maybe insurance is more generous checking BMDs on women than men.
Yes, osteopenia/osteoporosis is more common in post-menopausal women than in men. Osteoporosis runs in my wife's family, and several years ago she was found to be osteopenic after breaking several ribs from coughing. Lab work later showed she had hyperparathyroidism with very high serum calcium levels, which was frustrating since she had been taking calcium supplements for the osteopenia. Sometimes you just can't win!
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Old 06-22-12 | 05:43 AM
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Originally Posted by Yumadons
Good idea, Blanchje. I finally bailed out of the AZ heat and joined a gym ~ a month ago. I'll keep an eye out for a class that teaches how to use weights. I'm in a weekly abs class and a weekly yoga class (ouch). What doesn't kill you makes you stronger
When you think of older people (us) being frail and moving slow much of that is because of muscle loss. The beauty is we can gain and maintain muscle at any age. That allows us to stay functionally fit into our 80's. An added benefit is weight training amps up your metabolism and everybody wants that. One concern many women have is they are worried about "bulking up". That should not be a concern. Outside of the few women that train as body builders it just won't happen. Women don't have the testosterone levels to build that kind of muscle mass with normal workouts. Great idea to get some help from a trainer in proper techniques. Start slowly to get your joints, tendons, and ligaments used to the work and then continue to add weight. Most women, and many men, use too light a weight and too many repititions. I find it simplest to use the 6-12 rule of thumb. If you can't do 3 sets of 6 reps you are using too much weight. If you can do 3 sets of 12 reps you don't have enough. Muscle grows when it is challenged with something new. If you lift the same weight all the time your body will adapt and you won't get stronger. It's just like riding. If you ride the same pace the same distance all the time you plateau and don't get any better. When you throw intervals in that change stresses your muscles and you get stronger.
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Old 06-22-12 | 02:03 PM
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Originally Posted by Blanchje
One concern many women have is they are worried about "bulking up". That should not be a concern. Outside of the few women that train as body builders it just won't happen.
Yup, as a gym newbie where the female instructors are all muscly (and one is even fat), those were my thoughts exactly. At 5'8" 115# I favor the long, lean look and would like to keep it that way. I had read what you just said about weight bearing exercises somewhere but had forgotten all about it til now. Guess I might turn this membership into a year round deal . . .
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Old 06-22-12 | 05:38 PM
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Originally Posted by B. Carfree
I've never had a bone density scan, but about a decade ago when I had a soccer mishap that required that my leg be screwed back together, the team orthopedists for the Sacrament Kings were running up and down the halls with my X-Rays showing off the densest shin bones they had ever seen.

Maybe all that excess bone is affecting my climbing speed.
Which is comparatively unusual for the distances you ride because conventional wisdom says that cycling is not a good physical activity to maintain bone strength and to reduce the incidence of osteoporosis because it doesn't involve impact loading.

From my understanding, weights are not a significant prevention for osteoporosis, rather it is the need for impact on the skeletal structure, as in when walking, and particularly when running.

Last edited by Rowan; 06-22-12 at 05:42 PM.
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Old 06-22-12 | 08:44 PM
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Originally Posted by Rowan
Which is comparatively unusual for the distances you ride because conventional wisdom says that cycling is not a good physical activity to maintain bone strength and to reduce the incidence of osteoporosis because it doesn't involve impact loading.

From my understanding, weights are not a significant prevention for osteoporosis, rather it is the need for impact on the skeletal structure, as in when walking, and particularly when running.
What do you mean no impact loading? You should see the roads I ride on. Many of my old steel bikes from CA have been shaken to dust since I moved to OR twelve years ago. I've even had a couple of racks break from the bouncing.

Actually, I probably developed the boat anchor bones from many years of basketball. I finally quit playing in 2000 when it became apparent that my dunking days would soon end. The game just isn't as fun below the rim. My knees have been thanking me every day since then.
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Old 06-22-12 | 08:50 PM
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Originally Posted by Yumadons
Yup, as a gym newbie where the female instructors are all muscly (and one is even fat), those were my thoughts exactly. At 5'8" 115# I favor the long, lean look and would like to keep it that way. I had read what you just said about weight bearing exercises somewhere but had forgotten all about it til now. Guess I might turn this membership into a year round deal . . .
At 5'8" and 115# you have the long and lean down pat. Lifting will keep that while making you stronger and balance the muscles you use riding. I'm a believer in keeping your muscles balanced. Hiking develops your squads but not so much your hamstring's so its good to give them attention. For every pushing exercise do a pulling excerise to balance it. Use reasonably heavy weights meaning heavy for you. You have to challeng your muscles to makee them stronger. Finally, recovery is key. 3 workouts a week is plenty. Muuscles grow during rest, not during excerse. Warm up first and stretch after.
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Old 06-23-12 | 12:50 AM
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Originally Posted by Rowan
conventional wisdom says that cycling is not a good physical activity to maintain bone strength and to reduce the incidence of osteoporosis because it doesn't involve impact.
You would think. But I've got a client like Carfree, google "Bill Anderson Yuma" He told me that when he had x-rays, his docs had never seen bones so dense (why can't he share?) This guy is crraazy Every year on his birthday, he does something like ride from the Mexican to Canadian border and back, or around the perimeter of Arizona - doing 100+ mile days. Of course he also climbs in and out of the Grand Canyon and runs with his Rhodesian Ridgeback (my patient). I see his 86th birthday is coming up - maybe this time he'll take his poor wife on a cruise or something . . .
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Old 06-23-12 | 08:14 AM
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I had a bone density scan a few years ago as I fit the profile for osteoporosis - female, fifty (56), fair, tall & lean. Though my results were good, during my most recent l visit with my Ob/Gyn, she suggested I have another one done within the next year as I am on Synthroid for Hypo-thyroidism. She told me the drug is calcium depleting. I try hard to maintain a diet rich in calcium perform a good deal of weight-bearing exercise through yoga and free weights.
During my visit, she asked me a number of questions regarding conditions common with 50+ women. Each time she asked if I was experiencing a particular symptom/condition, I was able to answer "no." Each time, she responded, "that's because you exercise." (Yay, bikes & weights!)
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Old 06-23-12 | 08:25 AM
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Tums, a good source of calcium.
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Old 06-23-12 | 02:51 PM
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Originally Posted by miss kenton
I try hard to maintain a diet rich in calcium
Blueberries have 9 mg of calcium /cup https://ndb.nal.usda.gov/ndb/foods/show/2266
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Old 06-23-12 | 06:25 PM
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Originally Posted by akohekohe
Blueberries have 9 mg of calcium /cup https://ndb.nal.usda.gov/ndb/foods/show/2266
Oh yes, I know! I eat them every morning with my yogurt and granola and since you've brought them up I will mention something I just found out. Today while I was shopping for fruit, I discovered that New Jersey blueberries are now in season and available at my grocer. This is me.
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Old 06-23-12 | 09:48 PM
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Originally Posted by B. Carfree
What do you mean no impact loading? You should see the roads I ride on. Many of my old steel bikes from CA have been shaken to dust since I moved to OR twelve years ago. I've even had a couple of racks break from the bouncing.

Actually, I probably developed the boat anchor bones from many years of basketball. I finally quit playing in 2000 when it became apparent that my dunking days would soon end. The game just isn't as fun below the rim. My knees have been thanking me every day since then.
Well, those bone-shaker roads are among the reasons why your bones are so healthy, I would suggest.

From my understanding, it's the impact that encourages bone density, as in the leg bones, for instance, resisting force as the feet hit the ground running or walking. Weight lifting, to me, is not what this about because the muscles, tendons and ligaments are tending to take the load, rather than the skeletal structure.
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Old 06-23-12 | 10:23 PM
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Originally Posted by Rowan
Well, those bone-shaker roads are among the reasons why your bones are so healthy, I would suggest.

From my understanding, it's the impact that encourages bone density, as in the leg bones, for instance, resisting force as the feet hit the ground running or walking. Weight lifting, to me, is not what this about because the muscles, tendons and ligaments are tending to take the load, rather than the skeletal structure.
Do you have any sources for your statement or is that just your own theory? I ask because the Mayo Clinic and the CDC say differently.
https://www.mayoclinic.com/health/str...aining/HQ01710
https://www.cdc.gov/physicalactivity/...why/index.html
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Old 06-23-12 | 11:43 PM
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Originally Posted by miss kenton
Do you have any sources for your statement or is that just your own theory? I ask because the Mayo Clinic and the CDC say differently.
https://www.mayoclinic.com/health/str...aining/HQ01710
https://www.cdc.gov/physicalactivity/...why/index.html
It's not just Rowan's theory. All resistance exercise increases bone density, but high impact exercise seems significantly better.
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Old 07-19-12 | 10:09 PM
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I had my first bone density test today. A recent check of my vitamin D says it's below normal, a surprise since I am outdoors a lot on the bike or in the garden or walking, and I never put sunscreen on my legs. However, until I retired last year I worked for years in a windowless building... I wonder if it's possible my D was even lower before I retired and has since gone up due to being outdoors more often.

My mom has osteoporosis (severe in her lumbar spine). It may take 15 days to get the results, but my attitude is I either have it or I don't -- if I don't that's great, and if I do I'll start doing more high-impact exercise.
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Old 07-20-12 | 08:24 AM
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Originally Posted by Yen
I had my first bone density test today. A recent check of my vitamin D says it's below normal, a surprise since I am outdoors a lot on the bike or in the garden or walking,
What time of year were you checked? I've had mine checked twice; in Dec it was normal but in Apr it was below normal. Apparently this is typical, at least at the latitude I live in.
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Old 07-20-12 | 09:10 AM
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Originally Posted by gregf83
What time of year were you checked? I've had mine checked twice; in Dec it was normal but in Apr it was below normal. Apparently this is typical, at least at the latitude I live in.
It was tested last month June. We can ride year-round here.
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