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[laszla]

I was already very down having recently found out 3 years of hrt seem to have been virtually useless - my estrogen plasma levels are low - and now I have received my bone density results bearing the jolly news that I have osteopenia.

Can someone please help with the specific symbols and their meanings. The meno clinic wont give me feedback for another 2.5 months (and I've already been waiting for nearly 3 months) and I am really anxious to understand these.
I do all the right things - walking, resistence training (weights and elastics), meditation, fermented foods, fish, vegetables, e.v olive oil diet, multivitamins, bla bla bla, blood iron, thyroid and vit d are fine.
I am thin, have lost weight, about 10 pc of my existing weight and my BMI about 17. GP sent me for cancer checks, nothing.
But clearly if I'm not absorbing the estrogel then I wont be getting the bone protecting benefits of HRT

Numbers are: BMD T score
sp: 0.9 (spine maybe?)
hip: -2.1 (hip self explanatory)
nof: -2 (no idea what nof is)
osteopenia

thanks
p.s am 55

[laszla]

I rang the osteoporosis charity and Nof is neck of femur in case this is useful for anyone else

[Gracie]

Hi Laszla, My story is very similar to yours, I was also sent for tests and everything came back ok. After having an x ray on my back they said I had early signs of Osteopenia, doctor prescribed me calcium tablets but after doing well on them I ended up having to stop them because they caused reflux.

I need to have a bone density test but to be honest I am not that worried about it, I do all the things I'm supposed to do, diet, vitamins, lots of walking, etc  but in my case, old age is what it is!

I'm interested to know if you have been prescribed anything for your osteopenia?

[laszla]

Good to hear your story Gracie.
I haven't yet been prescribed anything as the meno clinic won't give me any feedback on my results until the end of March.

With both HRT and any of its subsidiary problems I've learned to take matters into my own hands as the support I've had has been dire.

I do know that bone thinning can be reversed or at least further loss prevented so whatever your age I do think it's worth taking action.

The big guns against bone loss are resistence training, calcium (not necessarily from dairy, consider sardines which also have lots of bone friendly omega 3), vitamin c and probiotics.
And of course estrogen.
Probiotics also good for reflux and gut health is essential for practically every aspect of mental and phyical health and has a lot of interaction with hormone health.
I like to reduce pill taking as much as possible to try to consume prebiotic food, eg fermented foods such as kimchi.
My mother in her mid 80s has osteoporosis and takes ibandronic acid once a month but I still get her to take all of the above steps.
It doesnt help that we are both very thin.

[Ana21]

Hi laszla!

A DEXA (dual energy x-ray absorptiometry) scan usually measures bone density at the lumbar spine (lower back), hip (a specific site near the hip joint), and the femoral neck (top of the thighbone or femur).  The test will give you a T-score, which represents how close you are to average peak bone density. 

Normal bone density:  T-score is above -1.

Osteopenia (Low bone mass):  T-score between -1.1 and -2.4.

Osteoporosis:  T-score is -2.5 or less.

My mother had osteoporosis, so I'm at increased risk.  That's one of my primary reasons for taking MHT.  My BMI is 23, so it's not an added risk factor.  I have not had a DEXA scan yet.

Hopefully you'll never develop osteoporosis, but FYI the FRAX tool is used to evaluate fracture risk, using bone mineral density at the femoral neck.

"The FRAX algorithms give the 10-year probability of fracture. The output is a 10-year probability of hip fracture and the 10-year probability of a major osteoporotic fracture (clinical spine, forearm, hip or shoulder fracture)."

https://www.sheffield.ac.uk/FRAX/

Sounds like you're doing everything right.  Your low BMI puts you at increased risk of osteoporosis, so it's great that you've had a scan.  If you're able to regain the lost weight, studies indicate the odds of bone loss decrease 12% for each unit increase in BMI (approximately 5-8 lbs).

I wasn't absorbing transdermal estrogen and was switched to oral.  Hopefully you'll be able to find the right MHT at the right dose for your body.  Looking forward to hearing about your follow-up appointment.

If you do develop osteoporosis, an appointment with an endocrinologist may be in your future, as they are the experts who treat osteoporosis.

[laszla]

Thanks so much Ana, that's much more helpful that the info I got from the clinic - I will check out the frax tool as well.
I am aiming to try a different estrogen route as clearly if I absorbed it decently that would be a fast-ish track to protecting bones. In my younger years I struggled to lose weight but now am finding it just as hard to gain but I will keep trying.

And it's very interesting to learn that one sees an endocrinologist for osteoporosis - I had been considering finding one since finding out I wasnt absorbing estrogen as I thought they might have a 'bigger picture' approach to balancing everything out so I will look into that.