DEXA Scan Confused? Why Your Bones Are Thinning & Medically Approved Next Steps

If you recently had a DEXA scan and were told you have bone loss, osteopenia, or osteoporosis, you're not alone. Many people are surprised by the results—especially if they feel completely fine.

Bone thinning usually happens silently. There are often no symptoms until a fracture occurs. The good news? A DEXA scan gives you early information, which means you can take action before serious complications develop.

Let's break down what your results mean, why bones thin, and what medically approved next steps actually work.

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What Is a DEXA Scan?

A DEXA scan (Dual-Energy X-ray Absorptiometry) is the gold standard test for measuring bone mineral density (BMD). It's:

• Quick (usually 10–20 minutes)
• Painless
• Low radiation (less than a chest X-ray)
• Highly accurate for fracture risk prediction

The test typically measures bone density in the:

• Hip
• Spine
• Sometimes the forearm

Understanding Your T-Score

Your DEXA scan results are reported as a T-score:

• -1.0 or higher → Normal bone density
• Between -1.0 and -2.5 → Osteopenia (low bone mass)
• -2.5 or lower → Osteoporosis

The lower the score, the weaker the bones and the higher the fracture risk.

This does not mean a fracture is inevitable—but it does mean action is important.

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Why Are Your Bones Thinning?

Bone is living tissue. Your body constantly breaks down old bone and builds new bone. When breakdown outpaces rebuilding, bones thin.

Here are the most common causes:

1. Aging

After age 30, bone breakdown slowly begins to outpace bone formation. This accelerates after:

• Menopause in women (due to loss of estrogen)
• Age 70 in men (testosterone decline plays a role)

2. Hormonal Changes

Estrogen protects bone. After menopause, women can lose up to 20% of bone mass within 5–7 years.
Men with low testosterone can also experience bone thinning.

3. Low Calcium or Vitamin D

Without enough calcium and vitamin D, your body pulls calcium from bones to maintain normal blood levels.

4. Sedentary Lifestyle

Bones strengthen in response to stress. Without weight-bearing activity, they weaken.

5. Certain Medications

Long-term use of:

• Steroids (like prednisone)
• Some cancer treatments
• Certain seizure medications
• Proton pump inhibitors (in some cases)

can reduce bone density.

6. Medical Conditions

Conditions that increase risk include:

• Thyroid disorders
• Rheumatoid arthritis
• Celiac disease
• Chronic kidney disease
• Eating disorders

If you're concerned about whether your symptoms might be related to bone loss, Ubie's free AI-powered Osteoporosis Symptom Checker can help you better understand your personal risk factors in just a few minutes.

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What Happens If You Do Nothing?

It's important to be honest here.

Untreated osteoporosis can lead to:

• Hip fractures
• Spinal compression fractures
• Loss of height
• Chronic pain
• Loss of independence

Hip fractures in older adults are especially serious and can significantly impact mobility and overall health.

However, early detection through a DEXA scan dramatically improves outcomes because you can intervene before fractures happen.

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Medically Approved Next Steps After a DEXA Scan

Your next steps depend on how low your bone density is and your overall fracture risk.

1. Assess Your Fracture Risk

Your doctor may calculate a FRAX score (Fracture Risk Assessment Tool). This estimates your 10-year risk of:

• Hip fracture
• Major osteoporotic fracture

This helps determine whether lifestyle changes alone are enough—or if medication is recommended.

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2. Lifestyle Changes That Actually Work

These are foundational—even if you need medication.

✅ Weight-Bearing Exercise

Aim for:

• Brisk walking
• Stair climbing
• Light jogging (if safe)
• Resistance training 2–3 times per week

Strength training is especially important. It stimulates bone-building cells.

✅ Adequate Calcium Intake

Most adults over 50 need:

• 1,200 mg of calcium daily

Best sources:

• Dairy products
• Leafy greens
• Fortified plant milks
• Tofu
• Sardines

Supplements may be used if dietary intake is insufficient—but do not exceed recommended doses without medical guidance.

✅ Vitamin D

Most adults need:

• 800–1,000 IU daily

Vitamin D helps absorb calcium. Blood testing can determine if you are deficient.

✅ Fall Prevention

Preventing falls reduces fracture risk significantly:

• Remove loose rugs
• Improve lighting
• Wear supportive shoes
• Consider balance exercises (like tai chi)

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3. Medications for Osteoporosis

If your DEXA scan shows osteoporosis or high fracture risk, medication may be strongly recommended.

These are evidence-based and widely used:

Bisphosphonates (First-Line Therapy)

Examples:

• Alendronate
• Risedronate
• Zoledronic acid

They:

• Slow bone breakdown
• Reduce fracture risk by up to 50%

Usually taken weekly, monthly, or yearly depending on type.

Denosumab

An injection given every 6 months.
Often used if bisphosphonates are not tolerated.

Anabolic (Bone-Building) Medications

For severe osteoporosis:

• Teriparatide
• Abaloparatide
• Romosozumab

These stimulate new bone formation and are used in higher-risk patients.

Medication decisions should always be individualized and discussed with your physician.

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4. Repeat DEXA Scan Timing

A repeat DEXA scan is typically done:

• Every 1–2 years if on treatment
• Every 2–3 years if monitoring osteopenia

Frequent scanning is not usually necessary unless there are major health changes.

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Common Questions About a DEXA Scan

"Can bone density improve?"

Yes. With proper treatment and lifestyle changes, bone density can stabilize or improve. The goal is fracture prevention.

"Is osteopenia the same as osteoporosis?"

No. Osteopenia is milder bone loss. It signals increased risk but does not automatically require medication.

"If I feel fine, is treatment really necessary?"

Possibly. Osteoporosis has no symptoms until a fracture occurs. The absence of pain does not mean bones are strong.

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When to Speak to a Doctor Urgently

Seek prompt medical evaluation if you experience:

• Sudden back pain after minor strain
• Loss of height
• A fracture after a minor fall
• Hip pain following a fall

These could indicate a compression fracture or hip fracture.

Always speak to a doctor about any potentially serious or life-threatening symptoms.

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The Bottom Line

A DEXA scan is not something to fear—it's a powerful tool. It gives you the opportunity to act early.

If your bones are thinning:

• Understand your T-score
• Assess fracture risk
• Optimize calcium and vitamin D
• Start weight-bearing exercise
• Discuss medication if appropriate
• Take fall prevention seriously

Bone health is not just about preventing fractures—it's about maintaining independence, mobility, and quality of life as you age.

If you haven't yet evaluated your symptoms or want to explore whether your concerns warrant medical attention, try using Ubie's AI-powered Osteoporosis Symptom Checker—it's quick, free, and can help you decide on your next steps before your appointment.

Most importantly, review your DEXA scan results with your doctor. Personalized medical advice is essential—especially when dealing with conditions that can become serious if left untreated.

With the right steps, osteoporosis is manageable. Early awareness is your advantage.