Using bone-mineral-density measurements to assess osteoporosis and risk of fracture is known to be quite flawed. There are several problems inherent with current screenings:
1. First, the goal is to correlate “bone mineral density” with “bone strength”–but this measurement (often called a DEXA scan) measures primarily the cortical bone which is the outer portion of our bones. Healthy bones also require healthy trabecular structure which comprises the center of our bones and isn’t assessed using DEXA scans.
2. The bottom line is to help reduce bone fracture rates. But a brittle bone that has a great bone-mineral-density result may in fact be brittle. Think of a stick of chalk–it would show great density but we all know that it is very brittle.
3. Current recommendation for monitoring bone density is only every 2 years–this is due to lack of sensitivity of the test in most cases relative to the rate of bone changes. Dramatic changes in bone health can occur during this time-frame, however.
The use of urinary metabolites is being recommended as an option to bone-mineral-density evaluations. Likely it will be best to combine these two monitoring techniques to monitor both bone turnover and bone density. Click here for more information.
Dr. Brown utilizes a urinary bone turnover assessment. Another advantage is that it can be measured more frequently to assess success of treatment with goal of optimizing your bone health. Call for an appointment to see if this test is right for you!