Are small-boned girls being misdiagnosed with osteoporosis?
For many years, I’ve seen it repeatedly: petite, light-framed girls—typically lively, vibrant, and in any other case wholesome—being instructed they’ve osteoporosis based mostly on their bone density check outcomes. They haven’t had fractures. They don’t present main danger elements. But they depart the testing heart with a prognosis that may really feel devastating.
Over time, I started to suspect what now many researchers are confirming—these girls are being misdiagnosed. Their low DEXA (bone density) scores don’t essentially imply their bones are weak. Actually, for girls with smaller bones, these check outcomes could also be giving a false image of fragility.
What Dr. Henry Paul Golding’s analysis reveals
Lately, Australian researcher Dr. Henry Paul Golding revealed a groundbreaking research confirming what many people have noticed for years: people with smaller bones are disproportionately recognized with osteoporosis when, in actuality, their bones could also be completely sturdy and wholesome.
Dr. Golding’s 2022 research, revealed in Bone Studiesdemonstrated that the present bone mineral density (BMD) testing technique—DEXA—systematically underestimates bone power in smaller bones. His group used synthetic vertebrae of various sizes to indicate that DEXA readings decline as bone measurement decreases, regardless that the precise “true” bone density stays the identical.
In different phrases, the machine isn’t measuring bone weak spot—it’s measuring bone measurementand complicated smaller quantity with lesser power. This creates a widespread sample of false positives for osteoporosis amongst petite girls.
Why this occurs: DEXA’s design downside
To grasp this, we have to look carefully at what a DEXA scan actually measures. The time period “bone mineral density” makes it sound as if the check measures how dense or strong your bone tissue is—however that’s not fairly true.
A true density measurement would require a three-dimensional (3D) evaluation of bone quantity—its size, width, and depth. DEXA, nonetheless, is a two-dimensional (2D) imaging know-how. It initiatives X-rays via bone and data an areal (surface-based) measurement—basically the mineral content material unfold throughout an space of bone, not inside its full quantity.
As a result of the DEXA scan flattens a 3D construction right into a 2D picture, folks with smaller bones naturally seem to have “much less dense” bone, even when the mineral focus per unit of quantity is identical. That’s why a petite girl’s bones can look osteoporotic on paper, when in actuality, her bone power could also be completely regular.
The issue has been identified for many years
This isn’t a brand new revelation. The affect of bone measurement on DEXA readings has been identified within the scientific group for many years—however not often mentioned in medical apply or public well being messaging.
Sadly, DEXA producers haven’t corrected this flaw. As Dr. Golding emphasised, “the areal bone mineral density testing outcomes given by each DEXA units will not be in any means corrected for the distinction in bone measurement.”
So whereas DEXA know-how has turn out to be the “gold customary” for diagnosing osteoporosis, its outcomes might be deceptive for thousands and thousands of girls—significantly those that are brief, skinny, or small-framed.
Extra cracks within the DEXA mannequin
DEXA’s measurement bias isn’t the one downside. There are a number of different the explanation why bone density testing might not inform the total story:
- Excessive error fee: Research recommend that as many as 90% of DEXA scans include errorsand about half of those are important sufficient to change prognosis or remedy selections. Calibration points, positioning errors, and operator variability can all skew outcomes.
- Poor fracture prediction: DEXA outcomes are not dependable predictors of fracture danger. Analysis from around the globe paperwork that as much as 80% of fractures happen in folks with regular or osteopenic DEXA outcomesnot in these labeled osteoporotic. Clearly, one thing greater than “density” determines bone resilience.
- Slim definition of bone well being: Bone power is a posh interaction of bone structure, turnover fee, mineralization, collagen high quality, and muscle help—none of that are measured by DEXA. The check focuses narrowly on one quantity and ignores the dwelling, dynamic nature of bone tissue.
Taken collectively, these limitations make diagnosing the illness of osteoporosis by DEXA bone density, a “good strive that didn’t fairly work out.” DEXA bone density testing worth as one piece of data—however it ought to by no means be utilized in isolation to outline an individual’s bone well being , prognosis the illness of osteoporosis or to dictate remedy.
A greater technique to view bone well being
If bone density testing has these flaws, what ought to girls do as an alternative? The reply lies in taking a broader, extra holistic view of bone well being—one which considers the entire individual, not only a single scan end result.
Listed here are a couple of empowering steps you’ll be able to take proper now:
- Know your actual danger elements
Your fracture danger is dependent upon many variables—nutrient standing, train patterns, power irritation, antioxidant standing, poisonous load, household historical past, use of bone-depleting drugs, pH stability and diploma of power low grade metabolic acidosis, stability of quite a few hormones together with cortisol, DHEA, PTH, progesterone, estrogen and testosterone and far more.
Our Higher Bones Fracture Threat Evaluation may help you determine essentially the most related elements for you. A.
Bear in mind: a number of small danger elements matter greater than a single DEXA rating.
- Assist your muscle–bone connection
Bone and muscle are intimately linked. As analysis exhibits, you achieve and lose them collectively. Power coaching, resistance work, yoga, and even common brisk strolling can dramatically enhance bone density, stability, and fracture resilience.
- Optimize diet and pH stability
Your bones thrive in a barely alkaline setting. A weight loss plan wealthy in greens and fruits of all colours, enough protein, and all 20 key bone vitamins together with minerals—particularly calcium, magnesium, potassium, and nutritional vitamins K2, C and all B nutritional vitamins—assist protect bone construction and cut back bone-depleting acidity.
- Thoughts your hormones and thyroid
Hormones like cortisol, DHEA, PTH, estrogen, progesterone, and thyroid hormones profoundly affect bone transforming. In case you’re in midlife or post-menopausal, or in the event you’re on thyroid treatment, it’s value working with an integrative practitioner to maintain these hormones balanced. Each extra and thyroid hormone ranges jeopardize bone.
- Handle stress
Continual emotional, psychological stress and fear raises cortisol, which may rob calcium from bones. Cultivating resilience, working towards meditation and deep respiratory workouts, and enough relaxation will not be luxuries—they’re bone-building necessities.
- Get daylight and vitamin D
Your physique wants vitamin D to soak up calcium and keep wholesome bone turnover. Goal for smart solar publicity. Know that we produce vitamin D from a small spectrum of photo voltaic ultraviolet radiation. Dermal manufacturing of vitamin D precursors happen when your shadow is shorter then you’re.
As a result of restricted period of time we spend open air and modern issues with extreme unlight publicity, most people have to complement with vitamin D3. On the Heart for. We advise reaching an optimum. 50 to 60 ng/ml vitamin 25 OHD degree (equal to 125-150 nmol/L in European models.
The facility of perspective: take coronary heart and take motion
In case your DEXA outcomes have anxious you—particularly in the event you’re small-framed—take a deep breath. Numbers don’t outline your well being or your future. As Dr. Golding’s analysis and many years of medical commentary present, many small-boned girls have been unfairly labeled “osteoporotic” when they don’t seem to be.
Bone well being isn’t static—it’s dynamic and reversible. Your bones live tissues, consistently transforming in response to how you progress, eat, suppose, and relaxation. You could have huge capability to rebuild and keep bone power naturally.
At Higher Bones, our objective is that can assist you perceive the larger image—to exchange concern with information and confusion with empowerment. In case you’re able to go deeper, discover our Higher Bones Resolution 6-Step Program and the Higher Bones Resolution Masterclass to study how one can construct Higher Bones and a Higher Physique for all times.
Take coronary heart, take motion, and keep in mind: your physique has a unprecedented capacity to resume itself when given the suitable help.
Reference:
Golding, H. P. (2022). Twin-energy X-ray absorptiometry (DXA) to measure bone mineral density (BMD) for prognosis of osteoporosis—experimental knowledge from synthetic vertebrae confirms important dependence on bone measurement. Bone Studies. PubMed hyperlink
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