Bone Density Is Not Just for Older Women

Bone density screening is usually framed as something for women after menopause. Routine screening guidelines start with women at 65, so men and younger women rarely get checked. Bone loss does not follow that schedule, and the first sign of it is often a fracture.

Who else is at risk

Up to 1 in 4 men over 50 will break a bone because of osteoporosis, compared with about 1 in 2 women. Men tend to lose bone later, but when they do fracture a hip, the outcomes are often worse.

Bone is also a concern in younger people when something interferes with how it is built and maintained. Common reasons include:

• Low testosterone in men, or low estrogen in women, including missed periods.
• Eating too little for the amount of training you do.
• Long term use of steroid medications such as prednisone.
• Heavy alcohol use and smoking.
• Very low body weight.
• Conditions that limit absorption, such as celiac disease.

Most people reach their peak bone mass by around age 30. After that, the goal is to hold what you built. Someone who starts lower, or loses bone faster, reaches the fracture range sooner.

T score and Z score

A DEXA scan measures bone density and reports two scores. They answer different questions.

The T score compares your bone density with a healthy young adult of the same sex. It is the score used to diagnose osteoporosis in women after menopause and in men 50 and older:

• Minus 1.0 or higher is normal.
• Between minus 1.0 and minus 2.5 is low bone mass, often called osteopenia.
• Minus 2.5 or lower is osteoporosis.

The Z score compares you with people of your own age and sex. It is the score we lean on for men under 50 and women before menopause. A Z score of minus 2.0 or lower means your bone density is below what is expected for your age, and that usually prompts a look for a cause, such as a hormone problem or a nutrition gap.

Why measure it early

Bone loss is silent. You cannot feel it, and a basic lab panel does not show it. A hypothetical 42 year old man with low testosterone, or a 30 year old woman who trains hard and eats too little, could have a low Z score and no idea.

Our DEXA includes a whole body scan plus dedicated hip and spine scans, the sites used to diagnose osteoporosis, so one visit covers bone density and body composition together. We repeat DEXA about every 6 months for body composition. Bone changes more slowly, so the bone trend means the most over one to two years.

That's why we check it.

Book a DEXA scan at HYBRD Health ($199)

This article is educational and is not medical advice.