For the longest time, when talking about bone health and conditions such as osteopenia or osteoporosis, the gold standard for measurement of our bone strength has always been a DEXA scan.

A DEXA scan measures the density of our bone, giving us a Bone Mineral Density, or BMD, amount. Our BMD is then compared to the BMD of an average 30 year old female, because we reach peak bone mass at age 30.

That comparison is then converted into a measurement called a T-Score. The T-Score is then used to gauge our bone density & “health” of our bone in order to resist fracture.

One of the challenges we are finding is that the T-Score only gives us a very 2-dimensional picture of the true bone health.

Because what we are ultimately worried about in conditions such as Osteopenia and Osteoporosis is preventing fractures, primarily in our weight bearing bones – our hips and spine.

Over the years of treating and studying conditions such as osteoporosis, one thing that we have found is that fracture prevention really boils down to bone health and the ability of our bone to absorb an impact, regardless of bone density.

Sometimes this even means the bodies’ ability to withstand a sneeze or even just bending over without fracturing.

Because of this, in recent years there’s been increasing discussion on whether bone density (measured through a DEXA Scan) gives us the full picture to determine if an intervention is effective or even necessary.

Because, again, at the end of the day, the only thing we want is good bone quality that is fracture resistant.

One way to appreciate the concept of Bone Quality vs Bone Density is flexibility. Healthy bone has some flexibility and suppleness when pressure is applied to it.

BONE STRENGTH = BONE DENSITY + BONE QUALITY

Think of bending a healthy tree branch – it has some give. Dead tree branches snap easily. Same density, different quality.

Let's Consider 2 Scenarios: 

The 2 Scenarios above are actually quite common and it is stories like these that have led to investigating other ways to determine true bone health outside of just Bone Density.

Although there is no precise, quantifiable definition of bone quality at this time, many medical professionals understand it as the combination of all bone properties that impact a bone’s resistance to fracture.

The concept of bone quality extends beyond BMD measured through a DEXA scan to include aspects such as bone microarchitecture, new bone growth vs. old bone clearing, collagen structure, mineral crystal size, and bone composition.

Bone strength describes a bone’s resistance to fragility fractures. The stronger your bones, the less likely they are to break!

BONE STRENGTH = BONE DENSITY + BONE QUALITY

Although some professionals in the field of bone health consider BMD the best (if not the only) way to assess bone strength, research from the last few decades reveals that this is not entirely true.

That means DEXA technology, which only considers a bone density (BMD) measurement, has a limited ability to determine true fracture risk.

Research shows that bone quality is important in determining a bone’s ability to keep from fracturing. Therefore, testing for bone quality is an important part of assessing someone’s bone health status and assessing the risk of sustaining a fracture.

There are 4 blood tests that have been developed in recent years to determine our bone turnover, ie. bone quality. Two of those blood markers tell us how well our body is clearing out old, brittle bone and the other 2 blood markers tell us how well our body is building new healthy, flexible bone.

To get a full picture of bone strength, a BMD from a DEXA scan, along with bone turnover markers is necessary. This will also help determine if an intervention or treatment is necessary and/or if a current approach or intervention is effective and working.  

Always remember how important it is to consider true bone strength, as opposed to just bone density, when determining your fracture risk or evaluating the effectiveness of an intervention approach. 

Talk with your medical doctor about assessing your Blood Turnover Markers (four of them), along with a DEXA Scan, to determine your true bone health/strength.

BONE STRENGTH = BONE DENSITY + BONE QUALITY

Hopefully, this training on how important bone health is and how bone density is simply NOT the whole story has been helpful and truly valuable information!

On that note, don't forget to grab the 6 Surprising Misconceptions of Bone Health (and Why It Matters). 

After going through these Misconceptions, you'll be even more empowered to make informed decisions about your lifestyle to live the life you deserve & love! 

You can download this FREE resource by clicking the yellow button below