What is a bone density test. How is bone density measured. What are normal bone density ranges. When should you get a bone density test. How is osteoporosis diagnosed. What does a T-score mean in bone density.

The Importance of Bone Density Testing

Bone density testing plays a crucial role in assessing skeletal health and identifying potential risks for osteoporosis. This non-invasive diagnostic tool provides valuable insights into bone strength and fracture risk, enabling healthcare providers to make informed decisions about prevention and treatment strategies.

What exactly is a bone density test? It’s a medical procedure that measures the amount of mineral content in bones, typically in the hip and spine. The most common and reliable method for bone density testing is dual-energy X-ray absorptiometry (DXA or DEXA).

Key Benefits of Bone Density Testing

• Early detection of osteoporosis before fractures occur
• Assessment of fracture risk
• Monitoring of bone density changes over time
• Evaluation of treatment effectiveness
• Identification of low bone mass (osteopenia)

Understanding Bone Density Measurements and T-scores

Bone density test results are typically reported using T-scores, which compare an individual’s bone density to that of a healthy young adult of the same gender. But what do these T-scores actually mean?

T-scores are expressed in standard deviations (SD) from the mean bone density of young adults. Here’s how to interpret T-scores:

• T-score of -1.0 or above: Normal bone density
• T-score between -1.0 and -2.5: Low bone mass (osteopenia)
• T-score of -2.5 or below: Osteoporosis

What constitutes a normal bone density range? Generally, a T-score above -1.0 is considered normal. However, it’s essential to remember that bone density exists on a continuum, and fracture risk increases as T-scores decrease, even within the normal range.

Who Should Undergo Bone Density Testing?

Determining who needs a bone density test is crucial for early detection and prevention of osteoporosis. The National Osteoporosis Foundation (NOF) provides clear guidelines on who should consider bone density testing.

NOF Recommendations for Bone Density Testing

• Women aged 65 and older
• Men aged 70 and older
• Postmenopausal women under 65 with risk factors
• Men aged 50-69 with risk factors
• Adults who have broken a bone after age 50
• Adults with a condition or taking medication associated with bone loss

What are some risk factors that might necessitate earlier testing? These include a family history of osteoporosis, smoking, excessive alcohol consumption, low body weight, and certain medical conditions such as rheumatoid arthritis or hyperthyroidism.

Types of Bone Density Tests: Beyond Central DXA

While central DXA remains the gold standard for bone density testing, other screening methods can provide valuable information about bone health. What are these alternative testing methods?

Peripheral Bone Density Tests

• pDXA (peripheral dual-energy X-ray absorptiometry)
• QUS (quantitative ultrasound)
• pQCT (peripheral quantitative computed tomography)

These screening tests measure bone density in peripheral sites such as the heel, wrist, or finger. While they can’t diagnose osteoporosis as definitively as central DXA, they can help identify individuals who may benefit from further testing.

How do peripheral tests compare to central DXA? Peripheral tests are generally quicker, more portable, and use less radiation. However, they are less precise and can’t measure bone density in the hip and spine, which are the most clinically relevant sites for fracture risk assessment.

The Role of Bone Density Testing in Osteoporosis Management

Bone density testing is not just a diagnostic tool; it plays a crucial role in the ongoing management of osteoporosis. How does bone density testing contribute to osteoporosis care?

Key Functions of Bone Density Testing in Osteoporosis Management

1. Diagnosis: Identifying osteoporosis before fractures occur
2. Risk assessment: Predicting the likelihood of future fractures
3. Treatment initiation: Guiding decisions on when to start osteoporosis therapy
4. Monitoring: Evaluating the effectiveness of lifestyle changes and medications
5. Prognosis: Assessing long-term fracture risk and overall bone health

How often should bone density tests be repeated? For most people, follow-up scans are typically recommended every 1-2 years, but this can vary based on individual risk factors and treatment plans.

Interpreting Bone Density Results: Beyond the T-score

While T-scores are the primary metric used in bone density interpretation, they’re not the only factor to consider. What other elements contribute to a comprehensive assessment of bone health?

Additional Factors in Bone Density Interpretation

• Z-scores: Compare bone density to age-matched peers
• Absolute BMD values: Measured in g/cm²
• Bone geometry and microarchitecture
• Clinical risk factors (e.g., age, fracture history, medications)
• FRAX® score: Estimates 10-year fracture probability

How do these factors work together? By considering multiple aspects of bone health and fracture risk, healthcare providers can develop more personalized and effective treatment strategies for patients with low bone mass or osteoporosis.

Preparing for a Bone Density Test: What to Expect

Understanding what to expect during a bone density test can help alleviate anxiety and ensure accurate results. What should patients know before undergoing a bone density scan?

Key Points for Bone Density Test Preparation

• Wear comfortable, loose-fitting clothing without metal fasteners
• Avoid calcium supplements for 24 hours before the test
• Inform the technician of any recent barium studies or nuclear medicine tests
• Expect the test to take about 10-30 minutes
• No special dietary restrictions are necessary

What happens during the actual test? Patients lie on a padded table while a scanner arm passes over the body, emitting low-dose X-rays. The process is painless and non-invasive, with no need for injections or special preparations.

Beyond Testing: Comprehensive Approach to Bone Health

While bone density testing is a crucial component of skeletal health assessment, it’s just one part of a broader approach to maintaining strong bones. What other factors contribute to overall bone health?

Key Elements of Bone Health Management

1. Nutrition: Adequate calcium and vitamin D intake
2. Exercise: Weight-bearing and resistance training
3. Lifestyle modifications: Smoking cessation, limiting alcohol intake
4. Fall prevention: Improving balance and removing home hazards
5. Medication management: Assessing the impact of certain drugs on bone health

How can individuals take an active role in their bone health? By adopting a holistic approach that combines regular bone density testing with healthy lifestyle choices, people can significantly reduce their risk of osteoporosis and fractures.

Advances in Bone Density Testing Technology

The field of bone density testing is continuously evolving, with new technologies emerging to provide more detailed and accurate assessments of bone health. What are some of the latest developments in bone density testing?

Emerging Technologies in Bone Density Assessment

• High-resolution peripheral quantitative computed tomography (HR-pQCT)
• Trabecular bone score (TBS)
• Dual-energy X-ray absorptiometry (DXA)-based 3D modeling
• Radiofrequency echographic multi-spectrometry (REMS)
• Artificial intelligence-assisted interpretation of DXA scans

How do these new technologies enhance bone health assessment? By providing more detailed information about bone microarchitecture and strength, these advanced techniques can offer a more comprehensive picture of fracture risk and bone quality beyond what traditional DXA scans can reveal.

Bone Density Testing in Special Populations

While general guidelines for bone density testing are well-established, certain populations may require special considerations. How does bone density testing differ for various groups?

Special Considerations for Bone Density Testing

• Children and adolescents: Use of age- and sex-specific Z-scores
• Pregnant women: Generally avoided due to radiation exposure
• Very obese individuals: May require specialized equipment
• Patients with hyperparathyroidism: Often require additional testing
• Individuals with metal implants: May affect scan accuracy in certain areas

What adaptations are made for these special populations? Healthcare providers may use alternative testing sites, adjust interpretation criteria, or employ complementary diagnostic tools to ensure accurate assessment of bone health in these groups.

The Future of Bone Health: Personalized Medicine and Prevention

As our understanding of bone biology and osteoporosis risk factors continues to grow, the future of bone health management is moving towards more personalized approaches. What developments can we expect in the coming years?

Emerging Trends in Bone Health Management

1. Genetic testing for osteoporosis susceptibility
2. Biomarker-based fracture risk assessment
3. Personalized exercise and nutrition plans based on bone density profiles
4. Integration of bone health data with wearable technology
5. Development of targeted therapies based on individual bone metabolism

How will these advancements impact patient care? By tailoring prevention and treatment strategies to individual genetic, biochemical, and lifestyle factors, healthcare providers may be able to more effectively prevent bone loss and reduce fracture risk in the future.

Overcoming Barriers to Bone Density Testing

Despite the importance of bone density testing in osteoporosis prevention and management, many individuals who could benefit from testing do not undergo screening. What are the main barriers to bone density testing, and how can they be addressed?

Common Barriers to Bone Density Testing

• Lack of awareness about the importance of bone health
• Limited access to DXA machines in some areas
• Cost and insurance coverage issues
• Fear of radiation exposure
• Misconceptions about the testing process

How can these barriers be overcome? Strategies may include public education campaigns, increased availability of mobile screening units, policy changes to improve insurance coverage, and clear communication from healthcare providers about the safety and importance of bone density testing.

Integrating Bone Density Testing into Overall Health Management

Bone health is an integral part of overall wellness, yet it’s often overlooked in routine health screenings. How can bone density testing be better integrated into comprehensive health management?

Strategies for Integrating Bone Health Assessment

1. Incorporating bone health discussions into annual check-ups
2. Coordinating bone density testing with other routine screenings
3. Developing interdisciplinary approaches to bone health management
4. Utilizing electronic health records to track bone health over time
5. Promoting bone health education in schools and workplaces

What benefits can this integration provide? By making bone health a routine part of overall health assessment, healthcare providers can identify and address potential issues earlier, leading to better outcomes and reduced fracture risk for patients across the lifespan.

Bone Density Test, Osteoporosis Screening & T-score Interpretation

Bone Density Test

A bone density test is the only test that can diagnose osteoporosis before a broken bone occurs. This test helps to estimate the density of your bones and your chance of breaking a bone. NOF recommends a bone density test of the hip and spine by a central DXA machine to diagnose osteoporosis. DXA stands for dual energy x-ray absorptiometry.

You can find out whether you have osteoporosis or if you should be concerned about your bones by getting a bone density test. Some people also call it a bone mass measurement test. This test uses a machine to measure your bone density. It estimates the amount of bone in your hip, spine and sometimes other bones. Your test result will help your healthcare provider make recommendations to help you protect your bones.

Are you a postmenopausal woman or man age 50 and older? Have you recently broken a bone? If you answered “yes” to both questions, you should talk to your doctor or other healthcare provider about getting a bone density test if you’ve never had one.

What a Bone Density Test Can Do

A bone density test tells you if you have normal bone density, low bone density (osteopenia) or osteoporosis. It is the only test that can diagnose osteoporosis. The lower your bone density, the greater your risk of breaking a bone. A bone density test can help you and your healthcare provider:

• learn if you have weak bones or osteoporosis before you break a bone
• predict your chance of breaking a bone in the future
• see if your bone density is improving, getting worse or staying the same
• find out how well an osteoporosis medicine is working
• let you know if you have osteoporosis after you break a bone

Who Should Have a Bone Density Test?

NOF recommends that you have a bone density test if:

• you are a woman age 65 or older
• you are a man age 70 or older
• you break a bone after age 50
• you are a woman of menopausal age with risk factors
• you are a postmenopausal woman under age 65 with risk factors
• you are a man age 50-69 with risk factors

A bone density test may also be necessary if you have any of the following:

• an X-ray of your spine showing a break or bone loss in your spine
• back pain with a possible break in your spine
• height loss of ½ inch or more within one year
• total height loss of 1½ inches from your original height

Types of Bone Density Tests

DEXA is a non-invasive test to measure bone density.

Central DXA

NOF recommends a bone density test of the hip and spine using a central DXA machine to diagnose osteoporosis. DXA stands for dual energy x-ray absorptiometry. When testing can’t be done on the hip and spine, NOF suggests a central DXA test of the radius bone in the forearm. In some cases, the type of bone density testing equipment used depends on what is available in your community.

Healthcare providers measure bone density in the hip and spine for several reasons. First, people with osteoporosis have a greater chance of fracturing these bones. Second, broken bones in the hip and spine can cause more serious problems, including longer recovery time, greater pain and even disability. Bone density in the hip and spine can also predict the likelihood of future breaks in other bones.

With most types of bone density tests, a person remains fully dressed, but you do need to make sure no buttons or zippers are in the way of the area to be scanned. The test usually takes less than 15 minutes. Bone density tests are non-invasive and painless. This means that no needles or instruments are placed through the skin or body. A central DXA uses very little radiation. You are actually exposed to 10–15 times more radiation when you fly roundtrip between New York and San Francisco.

When repeating a bone density test, it is best to use the same testing equipment and have the test done at the same place each time. This provides a more accurate comparison with your last test result. Although it is not always possible to have your bone density test at the same place, it is still important to compare your current bone density scores to your previous scores.

Standard x-rays cannot be used in place of bone density tests. Unlike bone density tests, X-rays are not able to show osteoporosis until the disease is well advanced. However, X-rays can be used in addition to a DXA to detect broken bones in the spine or elsewhere.

Screening Tests

Also called peripheral tests, screening tests measure bone density in the lower arm, wrist, finger or heel. The types of peripheral tests are:

• pDXA (peripheral dual energy x-ray absorptiometry)
• QUS (quantitative ultrasound)
• pQCT (peripheral quantitative computed tomography)

Screening tests can help identify people who are most likely to benefit from further bone density testing. They are also useful when a central DXA is not available. These tests are often done at health fairs and in some medical offices. Screening tests cannot accurately diagnose osteoporosis and they should not be used to see how well an osteoporosis medicine is working.

If you have a peripheral bone density test, you should follow up with your healthcare provider. Discuss whether you need additional testing, such as a central DXA test of the hip and/or spine. The results of a peripheral test cannot be compared with the results of a central DXA.

People of Larger Size. Most central DXA machines cannot measure bone density in the hip and spine of patients who weigh more than 300 pounds. Some newer machines can measure bone density in people who weigh up to 400 pounds, but these machines are not widely available. When the hip and spine cannot be measured, some healthcare providers recommend a central DXA test of the radius bone in the forearm and a peripheral bone density test of the heel or another bone. Doing both of these tests might provide more complete information.

Where to Have a Bone Density Test

Most people need a prescription or referral from their healthcare provider to have a bone density test. If you’re not sure where to go for a bone density test, contact your healthcare provider or your insurance plan to find out where the test is available. Also, most hospital radiology departments, private radiology groups and some medical practices offer bone density testing.

When you go for your appointment, be sure to take the prescription or referral with you. The testing center will send your bone density test results to your healthcare provider. You may want to make an appointment to discuss your results with your healthcare provider.

How Often to Repeat a Bone Density Test

People taking an osteoporosis medicine should repeat their bone density test by central DXA every one – two years. After starting a new osteoporosis medicine, many healthcare providers will repeat a bone density test after one year.

Understanding Bone Density Test Results

Your bone density test results are reported using T-scores. A T-score shows how much your bone density is higher or lower than the bone density of a healthy 30-year old adult. A healthcare provider looks at the lowest T-score to diagnosis osteoporosis.

What Your T-score Means. According to the World Health Organization (WHO):

• A T-score of -1.0 or above is normal bone density. Examples are 0.9, 0 and -0.9.
• A T-score between -1.0 and -2.5 means you have low bone density or osteopenia. Examples are T-scores of -1.1, -1.6 and -2.4.
• A T-score of -2. 5 or below is a diagnosis of osteoporosis. Examples are T-scores of -2.6, -3.3 and -3.9.
• The lower a person’s T-score, the lower the bone density. A T-score of -1.0 is lower than a T-score of 0.5 and a T-score of -3.5 is lower than a T-score of -3.0.

Your bone density test result also includes a Z-score that compares your bone density to what is normal in someone your age and body size. Among older adults low bone mineral density is common, so Z-scores can be misleading.

Most experts recommend using Z-scores rather than T-scores for children, teens, women still having periods and younger men. NOF does not recommend routine bone density testing in these age groups. A Z-score above -2.0 is normal according to the International Society for Clinical Densitometry (ISCD). A diagnosis of osteoporosis in younger men, premenopausal women and children should not be based on a bone density test result alone.

When to Consider Treatment

The results of a bone density test help your healthcare provider make recommendations about what you can do to reduce your chance of breaking a bone. When making a decision about treatment with an osteoporosis medicine, your healthcare provider will also consider your risk factors for osteoporosis, your likelihood of breaking a bone in the future, your medical history and your current health.

Below are treatment guidelines for postmenopausal women and men age 50 or older:

• Most people with T-scores of -1. 0 and above (normal bone density) do not need to take an osteoporosis medicine.
• Some people with T-scores between -1.0 and -2.5 (low bone density or osteopenia) should consider taking an osteoporosis medicine when they have certain risk factors.
• All people with T-scores of -2.5 and below (osteoporosis) should consider taking an osteoporosis medicine.

What About Low Bone Density?

Having low bone density or osteopenia does not mean you will get osteoporosis. It means you have a greater chance of developing osteoporosis if you lose bone in the future. While we’ve known that people with osteoporosis should consider treatment to reduce the risk of broken bones, it hasn’t always been clear when to treat people who have low bone density.

The online fracture risk assessment tool called FRAX® can assist healthcare providers with these decisions. FRAX is a tool that calculates a person’s absolute fracture risk or an estimate of the chance of breaking a bone in the next ten years. FRAX can help to identify people who have a greater chance of breaking a bone as well as people who might benefit from taking an osteoporosis medicine.

Bone Mass Measurement: What the Numbers Mean

What is a bone density test?

A bone mineral density (BMD) test can provide a snapshot of your bone health. The test can identify osteoporosis, determine your risk for fractures (broken bones), and measure your response to osteoporosis treatment. The most commonly used BMD test is called a central dual-energy x-ray absorptiometry, or central DXA test. It is painless – a bit like having an x-ray. The test can measure bone density at your hip and lumbar spine.

Peripheral bone density tests measure bone density in the lower arm, wrist, finger or heel. These tests are often used for screening purposes and can help identify people who might benefit from follow-up bone density testing at the hip and lumbar spine.

What does the test do?

A BMD test measures your bone mineral density and compares it to that of an established norm or standard to give you a score. Although no bone density test is 100-percent accurate, the BMD test is an important predictor of whether a person will have a fracture in the future.

The T-score

Most commonly, your BMD test results are compared to the bone mineral density of a healthy young adult, and you are given a T-score. A score of 0 means your BMD is equal to the norm for a healthy young adult. Differences between your BMD and that of the healthy young adult norm are measured in units called standard deviations (SDs). The more standard deviations below 0, indicated as negative numbers, the lower your BMD and the higher your risk of fracture.

As shown in the table below, a T-score between +1 and −1 is considered normal or healthy. A T-score between −1 and −2.5 indicates that you have low bone mass, although not low enough to be diagnosed with osteoporosis. A T-score of −2.5 or lower indicates that you have osteoporosis. The greater the negative number, the more severe the osteoporosis.

World Health Organization definitions based on bone density levels

Level	Definition
Normal	Bone density is within 1 SD (+1 or −1) of the young adult mean.
Low bone mass	Bone density is between 1 and 2.5 SD below the young adult mean (−1 to −2.5 SD).
Osteoporosis	Bone density is 2.5 SD or more below the young adult mean (−2.5 SD or lower).
Severe (established) osteoporosis	Bone density is more than 2.5 SD below the young adult mean, and there have been one or more osteoporotic fractures.

Low bone mass versus osteoporosis

The information provided by a BMD test can help your doctor decide which prevention or treatment options are right for you.

If you have low bone mass that is not low enough to be diagnosed as osteoporosis, this is sometimes referred to as osteopenia. Low bone mass can be caused by many factors such as:

• Heredity.
• Low body weight.
• A medical condition or medication to treat such a condition that negatively affects bone.

Although not everyone who has low bone mass will develop osteoporosis, low bone mass is an important risk factor for osteoporosis fractures.

As a person with low bone mass, you can take steps to help slow down your bone loss and prevent osteoporosis in your future. Your doctor will want you to develop – or keep – healthy habits such as eating foods rich in calcium and vitamin D and doing weight-bearing exercise such as walking, jogging, or dancing. In some cases, your doctor may recommend medication to prevent osteoporosis.

Osteoporosis: If you are diagnosed with osteoporosis, these healthy habits will help, but your doctor will probably also recommend that you take medication. Several effective medications are available to slow – or even reverse – bone loss. If you do take medication to treat osteoporosis, your doctor can advise you concerning the need for future BMD tests to check your progress.

Who should get a bone density test?

The U. S. Preventive Services Task Force recommends that all women age 65 and older should have a bone density test. Postmenopausal women who are younger than age 65 and at increased risk of osteoporosis – as determined by a formal clinical risk assessment tool – should also have a BMD test.

Due to a lack of available evidence, the Task Force did not make recommendations regarding osteoporosis screening in men.

For your information

This publication contains information about medications used to treat the health condition discussed here. When this publication was developed, we included the most up-to-date (accurate) information available. Occasionally, new information on medication is released.

For updates and for any questions about any medications you are taking, please contact

U.S. Food and Drug Administration
Toll Free: 888-INFO-FDA (888-463-6332)
Website: https://www.fda.gov

For additional information on specific medications, visit Drugs@FDA at https://www. accessdata.fda.gov/scripts/cder/daf. Drugs@FDA is a searchable catalog of FDA-approved drug products.

NIH Pub. No. 18-7877-E

Bone Densitometry | Johns Hopkins Medicine

A bone density test determines the bone mineral density (BMD). Your BMD is compared to 2 norms—healthy young adults (your T-score) and age-matched adults (your Z-score).

First, your BMD result is compared with the BMD results from healthy 25- to 35-year-old adults of your same sex and ethnicity. The standard deviation (SD) is the difference between your BMD and that of the healthy young adults. This result is your T-score. Positive T-scores indicate the bone is stronger than normal; negative T-scores indicate the bone is weaker than normal.

According to the World Health Organization, osteoporosis is defined based on the following bone density levels:

• A T-score within 1 SD (+1 or -1) of the young adult mean indicates normal bone density.

• A T-score of 1 to 2. 5 SD below the young adult mean (-1 to -2.5 SD) indicates low bone mass.

• A T-score of 2.5 SD or more below the young adult mean (more than -2.5 SD) indicates the presence of osteoporosis.

In general, the risk for bone fracture doubles with every SD below normal. Thus, a person with a BMD of 1 SD below normal (T-score of -1) has twice the risk for bone fracture as a person with a normal BMD. When this information is known, people with a high risk for bone fracture can be treated with the goal of preventing future fractures. Severe (established) osteoporosis is defined as having a bone density that is more than 2.5 SD below the young adult mean with one or more past fractures due to osteoporosis.

Secondly, your BMD is compared to an age-matched norm. This is called your Z-score. Z-scores are calculated in the same way, but the comparisons are made to someone of your age, sex, race, height, and weight.

In addition to bone densitometry testing, your healthcare provider may recommend other types of tests, such as blood tests, which may be used to find the presence of kidney disease, evaluate the function of the parathyroid gland, evaluate the effects of cortisone therapy, and/or assess the levels of minerals in the body related to bone strength, such as calcium.

Why might I need a bone density test?

A bone density test is mainly done to look for osteoporosis (thin, weak bones) and osteopenia (decreased bone mass) so that these problems can be treated as soon as possible. Early treatment helps to prevent bone fractures. The complications of broken bones related to osteoporosis are often severe, particularly in the elderly. The earlier osteoporosis can be diagnosed, the sooner treatment can be started to improve the condition and/or keep it from getting worse.

A bone density testing may be used to:

• Confirm a diagnosis of osteoporosis if you have already had a bone fracture

• Predict your chances of fracturing a bone in the future

• Determine your rate of bone loss

• See if treatment is working

There are many risk factors for osteoporosis and indications for densitometry testing. Some common risk factors for osteoporosis include:

• Post-menopausal women not taking estrogen

• Advancing age, women over 65 and men over 70

• Smoking

• Family history of hip fracture

• Using steroids long-term or certain other medicines

• Certain diseases, including rheumatoid arthritis, type 1 diabetes mellitus, liver disease, kidney disease, hyperthyroidism, or hyperparathyroidism

• Excessive alcohol consumption

• Low BMI (body mass index)

Bone Densitometry (DEXA , DXA)

Bone densitometry, also called dual-energy x-ray absorptiometry, DEXA or DXA, uses a very small dose of ionizing radiation to produce pictures of the inside of the body (usually the lower (or lumbar) spine and hips) to measure bone loss. It is commonly used to diagnose osteoporosis, to assess an individual’s risk for developing osteoporotic fractures. DXA is simple, quick and noninvasive. It’s also the most commonly used and the most standard method for diagnosing osteoporosis.

This exam requires little to no special preparation. Tell your doctor and the technologist if there is a possibility you are pregnant or if you recently had a barium exam or received an injection of contrast material for a CT or radioisotope scan. Leave jewelry at home and wear loose, comfortable clothing. You may be asked to wear a gown. You should not take calcium supplements for at least 24 hours before your exam.

What is a Bone Density Scan (DEXA,DXA)?

Bone density scanning, also called dual-energy x-ray absorptiometry (DXA) or bone densitometry, is an enhanced form of x-ray technology that is used to measure bone loss. DXA is today’s established standard for measuring bone mineral density (BMD).

An x-ray exam helps doctors diagnose and treat medical conditions. It exposes you to a small dose of ionizing radiation to produce pictures of the inside of the body. X-rays are the oldest and most often used form of medical imaging.

DXA is most often performed on the lower spine and hips. In children and some adults, the whole body is sometimes scanned. Peripheral devices that use x-ray or ultrasound are sometimes used to screen for low bone mass, mostly at the forearm. In some communities, a CT scan with special software can also be used to diagnose or monitor low bone mass (QCT). This is accurate but less commonly used than DXA scanning.

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What are some common uses of the procedure?

DXA is most often used to diagnose osteoporosis, a condition that often affects women after menopause but may also be found in men and rarely in children. Osteoporosis involves a gradual loss of bone, as well as structural changes, causing the bones to become thinner, more fragile and more likely to break.

DXA is also effective in tracking the effects of treatment for osteoporosis and other conditions that cause bone loss.

The DXA test can also assess an individual’s risk for developing fractures. The risk of fracture is affected by age, body weight, history of prior fracture, family history of osteoporotic fractures and life style issues such as cigarette smoking and excessive alcohol consumption. These factors are taken into consideration when deciding if a patient needs therapy.

Bone density testing is strongly recommended if you:

• are a post-menopausal woman and not taking estrogen.
• have a personal or maternal history of hip fracture or smoking.
• are a post-menopausal woman who is tall (over 5 feet 7 inches) or thin (less than 125 pounds).
• are a man with clinical conditions associated with bone loss, such as rheumatoid arthritis, chronic kidney or liver disease.
• use medications that are known to cause bone loss, including corticosteroids such as Prednisone, various anti-seizure medications such as Dilantin and certain barbiturates, or high-dose thyroid replacement drugs.
• have type 1 (formerly called juvenile or insulin-dependent) diabetes, liver disease, kidney disease or a family history of osteoporosis.
• have high bone turnover, which shows up in the form of excessive collagen in urine samples.
• have a thyroid condition, such as hyperthyroidism.
• have a parathyroid condition, such as hyperparathyroidism.
• have experienced a fracture after only mild trauma.
• have had x-ray evidence of vertebral fracture or other signs of osteoporosis.

The Vertebral Fracture Assessment (VFA), a low-dose x-ray examination of the spine to screen for vertebral fractures that is performed on the DXA machine, may be recommended for older patients, especially if:

• they have lost more than an inch of height.
• have unexplained back pain.
• if a DXA scan gives borderline readings.
• the DXA images of the spine suggest a vertebral deformity or fracture.

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How should I prepare?

On the day of the exam you may eat normally. You should not take calcium supplements for at least 24 hours before your exam.

You should wear loose, comfortable clothing, avoiding garments that have zippers, belts or buttons made of metal. Objects such as keys or wallets that would be in the area being scanned should be removed.

You may need to remove some clothing and/or change into a gown for the exam. Remove jewelry, removable dental appliances, eyeglasses, and any metal objects or clothing that might interfere with the x-ray images.

Inform your physician if you recently had a barium examination or have been injected with a contrast material for a computed tomography (CT) scan or radioisotope scan. You may have to wait 10 to 14 days before undergoing a DXA test.

Women should always tell their doctor and technologist
if they are pregnant. Doctors will not perform many tests during pregnancy to avoid exposing the fetus to radiation. If an x-ray is necessary, the doctor will take precautions to minimize radiation exposure to the baby. See the Safety in X-ray, Interventional Radiology and Nuclear Medicine Procedures page for more information about pregnancy and x-rays.

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What does the equipment look like?

There are two types of DXA equipment: a central device and a peripheral device.

Most of the devices used for DXA are central devices, which are used to measure bone density in the hip and spine. They are usually located in hospitals and medical offices. Central devices have a large, flat table and an “arm” suspended overhead.

Peripheral devices measure bone density in the wrist, heel or finger and are often available in drugstores and on mobile health vans in the community. The pDXA devices are smaller than the central DXA devices, weighing only about 60 pounds. They may have a portable box-like structure with a space for the foot or forearm to be placed for imaging. Other portable technologies such as specially designed ultrasound machines, are also sometimes used for screening. However, central DXA is the standard technique.

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How does the procedure work?

The DXA machine sends a thin, invisible beam of low-dose x-rays with two distinct energy peaks through the bones being examined. One peak is absorbed mainly by soft tissue and the other by bone. The soft tissue amount can be subtracted from the total and what remains is a patient’s bone mineral density.

DXA machines feature special software that compute and display the bone density measurements on a computer monitor.

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How is the procedure performed?

Your doctor will likely do this exam on an outpatient basis.

In the central DXA examination, which measures bone density of the hip and spine, the patient lies on a padded table. An x-ray generator is located below the patient and an imaging device, or detector, is positioned above.

To assess the spine, the patient’s legs are supported on a padded box to flatten the pelvis and lower (lumbar) spine. To assess the hip, the patient’s foot is placed in a brace that rotates the hip inward. In both cases, the detector is slowly passed over the area, generating images on a computer monitor.

You must hold very still and may need to hold your breath for a few seconds while the technologist takes the x-ray. This helps reduce the possibility of a blurred image. The technologist will walk behind a wall or into the next room to activate the x-ray machine.

The peripheral tests are simpler. The finger, hand, forearm or foot is placed in a small device that obtains a bone density reading within a few minutes.

An additional procedure called Vertebral Fracture Assessment (VFA) is now being done at many centers. VFA is a low-dose x-ray examination of the spine to screen for vertebral fractures that is performed on the DXA machine.

The VFA test adds only a few minutes to the DXA procedure.

The DXA bone density test is usually completed within 10 to 30 minutes, depending on the equipment used and the parts of the body being examined.

You will probably be asked to fill out a questionnaire that will help the doctor determine if you have medical conditions or take certain medications that either increase or decrease your risk of a fracture. The World Health Organization has recently released an online survey that combines the DXA results and a few basic questions and can be used to predict 10-year risk of hip fracture or other major osteoporotic fractures for post-menopausal women.

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What will I experience during and after the procedure?

Bone density tests are a quick and painless procedure.

Routine evaluations every two years may be needed to see a significant change in bone mineral density, decrease or increase. Few patients, such as patients on high dose steroid medication, may need follow-up at six months.

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Who interprets the results and how will I get them?

A radiologist, a doctor trained to supervise and interpret radiology examinations, will analyze the images. The radiologist will send a signed report to your primary care or referring physician who will discuss the results with you.

DXA scans are also interpreted by other physicians such as rheumatologists and endocrinologists. A clinician should review your DXA scan while assessing the presence of clinical risk factors such as:

• rheumatoid arthritis
• chronic renal and liver disease
• respiratory disease
• inflammatory bowel disease

Your test results will be in the form of two scores:

T score — This number shows the amount of bone you have compared with a young adult of the same gender with peak bone mass. A score of -1 and above is considered normal. A score between -1.1 and -2.4 is classified as osteopenia (low bone mass). A score of -2.5 and below is defined as osteoporosis. The T score is used to estimate your risk of developing a fracture and also to determine if treatment is required.

Z score — This number reflects the amount of bone you have compared with other people in your age group and of the same size and gender. If this score is unusually high or low, it may indicate a need for further medical tests.

Small changes may normally be observed between scans due to differences in positioning and usually are not significant.

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What are the benefits vs. risks?

Benefits

• DXA bone densitometry is a simple, quick and noninvasive procedure.
• No anesthesia is required.
• The amount of radiation used is extremely small—less than one-tenth the dose of a standard chest x-ray, and less than a day’s exposure to natural radiation.
• DXA bone density testing is currently the best standardized method available to diagnose osteoporosis and is also considered an accurate estimator of fracture risk.
• DXA is used to make a decision whether treatment is required and it can be used to monitor the effects of the treatment.
• DXA equipment is widely available making DXA bone densitometry testing convenient for patients and physicians alike.
• No radiation stays in your body after an x-ray exam.
• X-rays usually have no side effects in the typical diagnostic range for this exam.

Risks

• There is always a slight chance of cancer from excessive exposure to radiation. However, given the small amount of radiation used in medical imaging, the benefit of an accurate diagnosis far outweighs the associated risk.
• Women should always tell their doctor and x-ray technologist if they are pregnant. See the Safety in X-ray, Interventional Radiology and Nuclear Medicine Procedures page for more information about pregnancy and x-rays.
• The radiation dose for this procedure varies. See the Radiation Dose in X-Ray and CT Exams page for more information about radiation dose.
• No complications are expected with the DXA procedure.

A Word About Minimizing Radiation Exposure

Doctors take special care during x-ray exams to use the lowest radiation dose possible while producing the best images for evaluation. National and international radiology protection organizations continually review and update the technique standards radiology professionals use.

Modern x-ray systems minimize stray (scatter) radiation by using controlled x-ray beams and dose control methods. This ensures that the areas of your body not being imaged receive minimal radiation exposure.

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What are the limitations of Bone Densitometry (DEXA, DXA)?

• A DXA test cannot predict who will experience a fracture but can provide a relative risk and it is used to determine whether treatment is required.
• Despite its effectiveness as a method of measuring bone density, DXA is of limited use in people with a spinal deformity or those who have had previous spinal surgery. The presence of vertebral compression fractures or osteoarthritis may interfere with the accuracy of the test; in such instances, CT scans may be more useful.
• Central DXA devices are more sensitive and better standardized than pDXA devices but they are also somewhat more expensive.
• A test done on a peripheral location, such as the heel or wrist, may help predict the risk of fracture in the spine or hip. These tests are not as helpful in following response to treatment, however, and if they indicate that drug therapy is needed, a baseline central DXA scan should be obtained.
• Follow-up DXA exams should be performed at the same institution and ideally with the same machine. Bone density measurements obtained with different DXA equipment cannot be directly compared.

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This page was reviewed on January, 16, 2020

Bone Mineral Density Testing

What is a Bone Mineral Density (BMD) Test?

Osteoporosis is a silent disease. You cannot see or feel your bones getting thinner. A bone mineral density test is an easy, reliable test that measures the density, or thickness, of your bones. Dual X-ray Absorptionmetry (DXA) of the hip and spine is the preferred method to diagnosis osteoporosis. A BMD test is the only way to accurately determine if you have osteoporosis before a bone breaks.

Who should have a Bone Mineral Density (BMD) test?

The decision to have a BMD test should be made in collaboration with your health care provider. The first and most important step is to determine if you are at risk for osteoporosis (see risk factors for osteoporosis). Guidelines have been established to determine who should have a BMD test. In general, bone mineral density testing is recommended for the following individuals:

• All women aged 65 or older
• All men aged 70 or older
• Women younger than 65 who have reached menopause and have risk factors for osteoporosis
  (family history of osteoporosis, being small and thin, smoking)
• Adults who break a bone after age 50 or have lost more than 1 ½ inches of height
• Adults over age 50 with a disease or medical condition associated with low bone mass or bone loss
• Adults over age 50 taking medications associated with low bone mass or bone loss
• Premenopausal women and men under age 50, only in rare cases

What do my BMD test results mean?

At first, you may find it difficult to understand your bone density test results. The following information should help you understand what your test results mean but you should always discuss your results with your health care provider. Your first bone density test tells you the current density of your bones. However, it cannot tell you if you have lost bone or are currently losing bone. The only way to diagnose bone loss is to have a repeat bone density test, usually two years later. Your health care provider can determine whether you are losing bone by comparing the initial and repeat bone density test results. There are two scores used by experts to interpret your bone density test results, the T-score and the Z-score.

What is a Z-score and what does it mean?

A Z-score compares your bone density to the average values for a person of your same age and gender. A low Z-score
(below -2.0) is a warning sign that you have less bone mass (and/or may be losing bone more rapidly) than expected for someone your age. If your Z-score is low, your health care provider may recommend additional tests to better understand why your bone mass is so low or she/he may refer you to an osteoporosis specialist.

What is a T-score and what does it mean?

T-scores are used to help diagnose normal bone mass, low bone mass (or osteopenia), and osteoporosis. The T-score compares your bone density to the average bone density of young healthy adults of your same gender and it is expressed in standard deviations above and below the average. The chart below will help you determine what your T score means.

What is low bone mass and how is it diagnosed?

Low bone mass, often called osteopenia, is not a disease but a condition in which your bone density is lower than the average bone density of young healthy adults of your same gender. Low bone mass is diagnosed when your T-score is between -1 and
-2.5. Your health care provider will monitor your bone health and discuss the steps you need to take to protect your bones.

What is osteoporosis and how is it diagnosed?

Osteoporosis is a disease that causes bones to become thin and weak, increasing your risk for fractures (broken bones). A bone density test can diagnose osteoporosis when your T-score is -2.5 or below. The lower your bone mass measurement, the greater your risk for fracture. Osteoporosis can also be diagnosed if you have a history of fractures (broken bones) without trauma.

Will a BMD test alone tell me my risk for breaking a bone?

The BMD test measures the amount of bone mineral you have. It will tell you if you have a low bone mass or osteoporosis. Your BMD is one of the best predictors of your risk for breaking a bone. In addition to your BMD results, your health care provider will also consider several other factors that can be put in a computer program (FRAX) to see how likely you are to break a bone in the next 10 years. The risk factors in FRAX include:

• A personal history of fracture (you are more likely to break a bone if you have already broken one)
• Family history of hip fracture (if your parent broke their hip, you are at greater risk for a hip fracture)
• Low body weight in relation to height
• Current cigarette smoker
• If you have been diagnosed with certain diseases or use certain medications.

Contact Information

NYSOPEP Resource Center
Helen Hayes Hospital, West Haverstraw, NY
845.786.4772
www.NYSOPEP.org

Publication 2045, Version 7/2014

Bone Density Scans and Bone Health Screenings

A bone density scan can detect thinning bones at an early stage. If you already have osteoporosis, bone scans can also tell you how fast the disease is progressing.

But an abnormal bone scan can create as many questions as it answers. Who should get a bone density scan, and what do the results mean? If your bone density is below normal, what can you expect, and what should you do?

A Date With DEXA

Most bone scans use a technology called DEXA (for dual energy X-ray absorptiometry). In a DEXA scan, a person lies on a table while a technician aims a scanner mounted on a long arm. (Think of the machine that X-rays your teeth at the dentist; the difference is that this test uses very low energy radiation.)

“DEXA currently is the easiest, most standardized form of bone density testing, so that’s what we use,” says Mary Rhee, MD, MS, an endocrinologist and assistant professor of medicine at Emory University in Atlanta.

The DEXA scanner uses beams of very low-energy radiation to determine the density of the bone. The amount of radiation is tiny: about one-tenth of a chest X-ray. The test is painless, and considered completely safe. Pregnant women should not get DEXA scans because the developing baby shouldn’t be exposed to radiation, no matter how low the dose, if possible.

Measurements are usually taken at the hip, and sometimes the spine and other sites. Insurance or Medicare generally pays for the test in women considered at risk for osteoporosis, or those already diagnosed with osteoporosis or osteopenia.

Other less commonly used technologies can measure bone density. They include:

• Variations of DEXA, which measure bone density in the forearm, finger, or heel.
• Quantitative computed tomography (QCT). Essentially a CAT scan of the bones, QCT provides more detailed images than DEXA.
• Ultrasound of the bones in the heel, leg, kneecap, or other areas.

While all of these can determine bone density and osteoporosis risk, “DEXA is the most important test and is the gold standard,” says Felicia Cosman, MD, clinical director for the National Osteoporosis Foundation.

Interpreting Your DEXA Bone Scan Results: T-Scores and Z-Scores

DEXA scores are reported as “T-scores” and “Z-scores.”

• The T-score is a comparison of a person’s bone density with that of a healthy 30-year-old of the same sex.
• The Z-score is a comparison of a person’s bone density with that of an average person of the same age and sex.

Lower scores (more negative) mean lower bone density:

• A T-score of -2.5 or lower qualifies as osteoporosis.
• A T-score of -1.0 to -2.5 signifies osteopenia, meaning below-normal bone density without full osteoporosis.

Multiplying the T-score by 10% gives a rough estimate of how much bone density has been lost.

Z-scores are not used to formally diagnose osteoporosis. Low Z-scores can sometimes be a clue to look for a cause of osteoporosis.

DEXA Bone Scans: What Your T-Score Means

Being told your bones are thin is cause for concern, but not alarm. If your T-score is low, what can you expect?

First of all, unless you’re a woman past menopause or a man older than 50, your risk of fracture is very low. In these groups, even with a T-score less than -2.5, bones are usually strong and treatment isn’t recommended.

On the other hand, if you’ve been told you have osteoporosis, take it seriously. Feeling fine is no protection at all: fractures of the spine can be silent and painless. “Anyone with osteoporosis should be on some kind of treatment,” according to Baker.

For those with osteopenia (T-score between -1.0 and -2.5), the picture gets confusing. It’s harder to predict fracture risk in this group of people. Focusing too closely on the T-score can be a mistake. “The DEXA T-score is not a perfect predictor for bone health or fracture risk,” says Rhee.

Actually, bone density (measured by T-score) is only one aspect of fracture risk. Your risk factors (see above) can be just as important. Using both the T-score and risk factors for fracture leads to better predictions.

The World Health Organization is developing a formula using risk factors in combination with the T-score to determine 10-year fracture risk. “We’ll probably see this coming into use in the next few years,” says Rhee.

Bone Scan T-Scores: When It’s Time to Treat

The National Osteoporosis Foundation recommends treatment for:

• Postmenopausal women with T-scores less than -2.0, regardless of risk factors.
• Postmenopausal women with T-scores less than -1.5, with osteoporosis risk factors present.

In addition, anyone with a fragility fracture (a fracture from a minor injury) should be treated for osteoporosis. This is true regardless of the DEXA scan results.

Treatment generally begins with a bisphosphonate medicine (Actonel, Fosamax, Boniva, or Reclast). These drugs are proven to increase bone density and reduce the risk of fracture. Other options include:

In addition, the National Osteoporosis Foundation recommends 1,200 milligrams of daily calcium intake — through diet and/or supplements.

When Should You Get a Bone Density Scan?

When, and how often, you should get a bone density scan depends on your age, risk factors, and whether you’ve already been diagnosed with thinning bones.

The general rule: anyone at risk for osteoporosis should get a bone density scan. Don’t wait for a fracture or a formal diagnosis.

Postmenopausal women are at highest risk, because estrogen (which falls after menopause) preserves bone strength. But men get osteoporosis, too. “They just get it later,” says Mary Zoe Baker, MD, an endocrinologist and professor of medicine at the University of Oklahoma Health Sciences Center. Usually around age 70, “men start to catch up to women” in developing osteoporosis, according to Baker.

Major expert groups make the following recommendations for osteoporosis screening and bone scans:

Women over age 65: All women over the age of 65 should get a DEXA scan, according to the National Osteoporosis Foundation and the U. S. Preventive Services Task Force.

Postmenopausal women under age 65: For women under 65, a bone scan is not universally recommended. The National Osteoporosis Foundation recommends a bone scan for women with risk factors for osteoporosis:

• History of bone fracture as an adult
• Current smoking
• History of ever taking oral steroids for more than 3 months
• Body weight under 127 pounds
• Having an immediate family member with a fragility fracture (a broken bone from a minor injury, suggesting osteoporosis).

Premenopausal women: Generally, premenopausal women should not get bone scans. Even with an abnormal DEXA scan, the risk of fracture is still very low, and treatment isn’t recommended. “The No. 1 rule is, don’t get the test unless you know you’re going to treat” if the result is abnormal, says Baker.

Men: Experts differ in their recommendations for bone scans for men. The National Osteoporosis Foundation recommends all men over the age of 70 should get a bone scan. At that age, “many men are on their way to developing osteoporosis,” says Cosman.

Bone Scans for Osteoporosis: How Often?

If you’ve been told you have thin bones, you’ll want to know if they’re improving or getting worse over time. How often should a bone scan be done?

Medicare and many insurance companies will pay for a bone scan every two years in women with osteoporosis or who are at high risk. Because the response to treatment occurs slowly, this is usually an acceptable time interval, according to Rhee.

“In cases with high bone turnover rates, like women taking high-dose steroids,” checking bone density as often as every six months may be necessary, says Rhee.

For women with a normal bone scan, waiting a few years to retest is fine, adds Rhee.

Another thing to keep in mind: not all DEXA scanners are created equal. There are slight differences in the calibration of different manufacturers’ machines. Ideally, you should get all your bone scans on the same DEXA scanner. Getting retested on a different manufacturer’s scanner could give a false impression of bone loss (or gain).

Besides the Bone Scan: Other Tests for Osteoporosis

Are other tests needed besides a bone scan for osteoporosis? Certain medical conditions can cause thinning of the bones. These include:

By taking your medical history and checking routine laboratory blood tests, your doctor can detect these and other causes for low bone density.

Since estrogen keeps bones strong, can getting your estrogen levels checked help? “Probably not,” says Baker. Rarely, perimenopausal women with heavy periods might need hormone checks. But for the vast majority, “DEXA is the only test they need.”

Do you know your T-score?

If you’re a woman and your doctors haven’t already spoken to you about your T-score, chances are they will – especially if you’re nearing age 65 or if you have an increased risk of osteoporosis. Osteoporosis means “porous bone,” and those with the disease have fragile bones that are more likely to break or fracture.

A bone density test can help you determine your risk of osteoporosis. Your T-score represents the result from a bone density test.

Put simply, T-scores offer a way to measure your bone health. Armed with knowledge of your T-score, you’ll know if you need to take steps to keep your bones healthy and strong.

Because the risk of osteoporosis increases with age, we recommend that all women aged 65 or older have a bone density test,” says Elizabeth Lunsford, M.D., a board-certified obstetrician/gynecologist. “With a patient’s T-score in hand, we can suggest steps to take now to help prevent bone fractures or breaks in the future.”

What is a bone density test?

A bone density test – sometimes referred to as a bone mineral density, or BMD, test – uses X-ray measurements to determine the amount of calcium and other minerals in your bones.

Typically, the test is conducted using a dual energy X-ray absorptiometry machine. This DXA machine scans bones most likely to break due to osteoporosis, such as your hip, forearm and lower spine.  

Having a bone density test is the only way to definitively diagnose osteoporosis. Your score can help you access your risk of developing a bone fracture as you age. For the test, you’ll lie on a padded platform, while a mechanical arm scans your body. The procedure takes under 30 minutes, is painless, and omits less radiation than a standard chest X-ray. 

How T-scores are reported

Your T-score compares your bone mass to that of a healthy young adult.

The “T” in T-score represents the number of standard deviations, or units of measurement, your score is above or below the average bone density for a young, healthy adult of your same sex.

Lower T-scores mean you could be at risk for developing osteoporosis or that you might already have the condition. Here are the ranges: 

• A normal T-score falls between +1 and -1. 
• Scores between -1 and -2.5 indicate low bone density, also called osteopenia. 
• A T-score of -2.5 or lower indicates an established case of osteoporosis.  

Who should get tested?

Every woman age 65 or older should consider getting a bone density test. You may want to consider getting a test earlier than 65 if you:

• Have a family history of osteoporosis 
• Have broken a bone past age 50

These factors may put you at higher risk. 

What to do if your T-scores are low

A low T-score means you’re at increased risk of fracturing or breaking a bone. Depending on your score, your physician may recommend that you begin taking a prescription osteoporosis medicine or that you work to introduce more calcium, vitamin D and exercise into your daily routine. 

Eliminating smoking and decreasing alcohol consumption have also been shown to support bone health.

“With proper treatment, your bone health can improve,” says Dr. Lunsford. “We work with patients to develop a customized plan to support bone strength, so they can stay nimble and active throughout their lives.”

If you have questions about osteoporosis, talk to your provider today. Find a Women’s health doctor near you.

hormone testosterone in men

hormone testosterone in men

Comparing the nervous system with the endocrine system is like comparing a telephone and a radio. The nervous system is a telephone: nerve wires that run from the brain and transmit information to a specific point. The hormonal gland produces information that is carried through the blood to very many – like a radio that broadcasts from one point, but everyone can hear it. That is, the impulse of the endocrine system is a speakerphone. In the event of a malfunction in the nervous system, only that which is activated by this nerve – one muscle – stops working: as if you interrupt the telephone wire, only the telephone will not work.And if the radio station breaks down, no one will hear the message. That is, the pathology of the endocrine system is polysystemic – it is the pathology of many structures at once. An example is hormones of the same thyroid gland, which act on almost all cells in our body. Everything in our cell is energy-dependent – all enzyme systems, all their functioning, since every cell has ATP, adenosine triphosphate is our battery. And the intensity of energy production in it is regulated by thyroid hormones.

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Testosterone in men is produced by the glands of the genital organs located in the testes.Under its action, the development of the organs of the reproductive system and secondary sexual characteristics is enhanced. It stimulates sperm production and is also responsible for sex drive. The name of the main hormone in men comes from the words testicle and steroid. By its chemical nature, it belongs to steroids. In higher vertebrates and humans, it is produced by the glands of the genital organs, more precisely, by the testes, and also by the liver; a smaller amount is synthesized by the cells of the reticular layer of the adrenal glands. The intermediate products of hormone biosynthesis are progesterone and cholesterol.Testosterone is a male steroid hormone. But I will immediately make a reservation that it is produced not only in men, but also (in smaller quantities) in women. Today we are going to talk about adult men. They have it synthesized in the male gonads – the testes. What is testosterone responsible for? The main biological function of testosterone is to maintain reproduction in men. In addition, it performs a number of other important functions. Among them: – control of the prostate gland; – shaping the appearance of a man; – participation in the formation of sperm; – the formation of sexual desire (libido) Testosterone is the main male sex hormone, which determines the development of secondary sexual characteristics, puberty and normal sexual function in men.It is present in the body of women, but in a much lower concentration. It is produced in the adrenal cortex, in the testes – in men and in the ovaries – in women. The main functions of testosterone include activation of potency and libido – sexual desire, control of sperm synthesis and maintenance of their viability, activation of metabolic processes, maintenance of optimal bone density, stimulation of muscle growth. It turns out that you can control the main male hormone – testosterone! Do not create the illusion that testosterone will never run out.According to research, 25 percent of men over the age of 30 suffer from low testosterone levels. So you need to pay attention to symptoms that indicate a lack of testosterone, and respond in a timely manner. Hair loss. Hair loss is one of the most common symptoms of low testosterone levels. Although male pattern baldness is also linked to many other factors and genetics. Research confirms that testosterone plays an important role in hair growth. The steroid hormone testosterone in men is produced in the testes.It is he who makes men out of men. Has a biological effect on almost all organs and tissues. At 10-12 years of age (puberty), increased testosterone production begins, which leads. change in character (transitional age). the emergence of interest in the opposite sex (the emergence of libido). Historically, the absence of all these changes could be seen in adolescent singers in Italy, who were castrated in order to preserve the high timbre of the voice. Testosterone levels peak at the age of 20, when we are active, energetic, cheerful, in good physical shape (no obesity).Testosterone is the main male sex hormone that is present in both men and women. The value and influence of testosterone can hardly be overestimated. It should be in any organism: its norm for men and women is different, but without it healthy sexual development is impossible. Bound + Free Testosterone = Total Testosterone. The hormone free and bound to albumin is biologically active. SHBG slows down its action. Free testosterone in women and men is the active form of the hormone. Its deficiency leads to impotence.It determines the development of secondary sexual characteristics and libido. Men most often develop an active hormone deficiency. Testosterone is a very interesting hormone, one might say insidious. The 21st century is in the yard, and there is still no understanding of how to accurately determine it – all methods have flaws. Measurement of hormone levels is carried out by immunometric methods, that is, using antibodies. Testosterone is a steroid hormone that is very small in structure; the size of the antibody is a certain number of times larger.That is, the testosterone figure is a very delicate matter. There are not many studies that have examined testosterone prescription to older men, firstly, and secondly, they are not as long. Some of them had positive results, some – negative in terms of cardiovascular risk. Testosterone is a steroid hormone from the androgen group that is responsible for the formation of secondary sexual characteristics and sexual function. English synonyms. Testosterone, total testosterone. Research method.Electrochemiluminescence immunoassay (ECLIA). Detection range: 0.087 – 520 nmol / l. Units. The hormone rate in men. Low testosterone: what to do and how to get tested. A cause for alarm appears when a man has low testosterone at the age of 18-50 years, and the patient’s hormone level differs significantly from the testosterone norm in men in this age group. A decrease in the level of a substance often indicates the development of the following pathological conditions: diseases of the pituitary gland ¾ functional or organic lesions of the pituitary gland, which lead to a disruption in the synthesis of gonadotropic hormones, which affects the production of testosterone in the gonads

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Testosterone is a steroid hormone from the androgen group and the most important male hormone.If you want to be a strong alpha male, full of strength, charisma and self-confidence, you need enough testosterone. If a person suspects that he has an excess of testosterone or, on the contrary, a lack of it, then it is imperative to consult a doctor. The amount of the hormone, which exceeds the norm or does not reach it, indicates a violation of the endocrine system. A testosterone test can be taken in any equipped laboratory. The results should be shown to an endocrinologist who will diagnose and prescribe the necessary treatment.In the first study, the researchers divided the subjects into two groups. One group ate a carbohydrate-rich diet with less protein. The second group received a protein-rich diet with fewer carbohydrates. Fat intake was the same in both groups. After 10 days, the group with the higher carbohydrate intake had 36% higher free testosterone levels and the stress hormone cortisol lower than the other group.

90,000 testosterone 16 nmol L in men

Testosterone 16 nmol L in men

Strong experiences increase the level of cortisol in the body.It is a stress hormone that interferes with testosterone production. This is because cortisol is one of its direct antagonists (acts in the opposite way). Stress hormone levels increase with mental strain and prolonged stress caused by different situations.

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The steroid hormone testosterone in men is produced in the testes.It is he who makes men out of men. Has a biological effect on almost all organs and tissues. The level of total testosterone in the blood of 3.5 ng / ml (or 12 nmol / l) and lower is confirmed by the majority of urologists in the world as a diagnosis of laboratory androgen deficiency (hypogonadism). Life hack from the Avenue. All men over 50 years of age or with symptoms of testosterone deficiency have a blood test for: total testosterone. luteinizing hormone (LH). Testosterone is a steroid hormone from the androgen group that is responsible for the formation of secondary sexual characteristics and sexual function.Nmol / L (nanomole per liter). What biomaterial can be used for research? Venous blood. Normal testosterone levels in men vary depending on the stage of puberty and age, with the older the man gets, the lower the testosterone concentration. The reason for the low testosterone level in men may be: a disease of the hypothalamus or pituitary gland Test for testosterone in men: the norm in men from 16 to 50 years old is 5.13 – 30.43 nmol / l. The testosterone level in older men decreases and remains in the range of 5.4 – 19.5 nmol / l.In girls under 13, testosterone levels usually do not exceed 0.98 nmol / L. We must also remember that all people usually have hormone levels fluctuating during the day: from the maximum value in the morning to the minimum in the evening. Decoding of all tests for testosterone should be carried out by a doctor, who takes into account not only the average generally accepted values ​​of indicators, but also other factors that can affect the concentration of total testosterone in the blood. Testosterone is the main male sex hormone that is responsible for the development of secondary sexual characteristics, puberty and normal sexual function in men.It is present in the body of women, but in a much lower concentration. It is produced in the adrenal cortex, in the testes – in men and in the ovaries – in women. The main functions of testosterone include activation of potency and libido – sexual desire, control of sperm synthesis and maintenance of their viability, activation of metabolic processes, maintenance of optimal bone density, stimulation of muscle growth. How to increase testosterone and what foods help. The hormone rate in men. Low testosterone: what to do and how to get tested.in women over 18 years old ¾ from 0.31 to 3.78 nmol / l; in pregnant women, the concentration of the hormone increases 3-4 times compared with the age norm; in the postmenopausal period ¾ 0.42–4.51 nmol / l. however, normal performance is sometimes subject to individual fluctuations. Therefore, the interpretation of the study should be exclusively handled by your treating physician. Testosterone is a male steroid hormone. But I will immediately make a reservation that it is produced not only in men, but also (in smaller quantities) in women. Today we are going to talk about adult men.They have it synthesized in the male gonads – the testes. What is testosterone responsible for? The main biological function of testosterone is to maintain reproduction in men. The more common normal range is 11 to 33 nmol / L (nanomole per liter). – You spoke about the accepted norms. Do men have individual testosterone norms? No. A healthy adult male has a certain range that is common to all. Testosterone in men – age norms, reasons for a decrease in the level of a sex hormone, prevention of changes in testosterone levels.03/29/2019 16:45. Testosterone in men. Its rate and table of dependence of the level of the hormone on age. The most important hormone in the male body is testosterone. It affects physical, sexual and emotional function, so it is the duty of every man to monitor the level of the sex hormone and keep it normal. The average testosterone level should be 12-33 nmol / L (345-950 ng / dL). If the level of the hormone testosterone deviates from the permissible norms, then control is necessary for it.The testosterone level in men increases at puberty and remains at high levels until almost 60 years of age. The hormone is subject to daily fluctuations. The maximum concentration is observed in the morning, the minimum in the evening. In the fall, testosterone levels rise. In older men, the indicators are lower, from 5.41 to 19.54 nmol / l. The norm of the hormone in the blood in women: from twenty to forty years – 0.12-3.1 nmol / l; from forty to sixty years – from 0.12-2.6 nmol / l; over 60 – from 0.12 to 1.7 nmol / l.16 – 18 years old. 5.13-27.53. 18 – 50 years old. 8.9-42.0 The lower diagnostic threshold recommended by ISSAM: 12 nmol / L. Over 50 years old. Testosterone in non-obese men can be assessed using a set of three indicators: total testosterone + SHBG (sex binding globulin) + LH (luteinizing hormone). Analysis of male hormones in obese men at the Astramed Medical Center includes: Total Testosterone + SHBG + LH + Estradiol + Prolactin. A total testosterone level of 3.45 μg / L or 12 nmol / L is a critically low level of testosterone in the blood of a man.From this testosterone figure, a man has subjective sensations of low testosterone – hormone deficiency. You can learn more about the symptoms of androgen deficiency here. For this, 351 healthy eugonadic men were examined, whose total testosterone level was determined using four immunometric analyzers (IMA): ARCHITECT i1000SR (Abbot), UniCel DxI800 (Beckman Coulter), Cobas e601 (Roche), IMMULITE 2000 (Siemens) and using liquid chromatography-tandem mass spectrometry (LC-TMS).The total normal range of testosterone in non-obese people aged 18-39 years, as measured by LC-TMS, was 9.038-41.310 nmol / L.

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Most testosterone is produced during sleep.If you don’t sleep enough, then the production of the sex hormone slows down. If you sleep less than 5 hours during 7 days, then the concentration of androgen will decrease by 15-25%. It is not only the amount of sleep that matters, but also the time. You must go to bed at 10-11 pm. For quality sleep, the room must be dark, so you should turn off all light sources and tightly curtain the windows. An interesting fact was that every morning, when men usually have higher testosterone levels, they also achieve better results.There is an aspect in which the male body is more gentle than the female – I’m talking about the production of sperm. Externally prescribing testosterone suppresses it. In general, if a person gets at least a severe runny nose with a fever, spermatogenesis will be suppressed for some time. Nature arranged it this way: a sick male should not fertilize females. You don’t even need a runny nose: let’s say a man is wrapped up at work, gets nervous, doesn’t get enough sleep at night – in this situation he will have low testosterone simply due to a general breakdown.Even at a young age. We experimented in our clinic: testosterone was monitored in patients with diabetes mellitus during hospitalization, and then two weeks after it was in our hospital. First, the man slept well. Secondly, we have put in order some general indicators. And after two weeks his testosterone is already normal! A single definition of testosterone cannot be trusted at all. And when they begin to assess the spermogram in a man who is sick with some kind of chronic disease, uncompensated, this is also absurd.The first step is to cure him. Bring it to a normal state, and then evaluate the work of the reproductive system. Either he’s on a binge …

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Testosterone therapy is not a source of youth.There is no evidence that it will restore you to levels of physical fitness or sexual function in adolescence, prolong life, prevent heart disease or prostate cancer, or improve memory or mental acuity. If erectile function was a problem, testosterone therapy may not correct it. In fact, it can increase your sex drive, but it will prevent you from acting on it. You may also need medication or other therapy to get or maintain an erection.Testosterone needs and can be increased in natural ways, without resorting to hormone therapy, Testosterone Max subscription will help you with this.

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And if you don’t know how to control your testosterone or don’t even try to do it, then your body slowly but surely turns you into a woman, more and more reducing the level of this hormone in the body. Come to the Testosterone Max course and find out how to always stay in shape.

Expert opinion

Testosterone therapy is not a source of youth. There is no evidence that it will restore you to levels of physical fitness or sexual function in adolescence, prolong life, prevent heart disease or prostate cancer, or improve memory or mental acuity. If erectile function was a problem, testosterone therapy may not correct it. In fact, it can increase your sex drive, but it will prevent you from acting on it.You may also need medication or other therapy to get or maintain an erection. Testosterone needs and can be increased in natural ways, without resorting to hormone therapy, Testosterone Max subscription will help you with this.

How to order

In order to place an order for pregnancy planning increased testosterone, you must leave your contact information on the site. The operator will contact you within 15 minutes. Will clarify all the details with you and we will send your order.In 3-10 days you will receive the parcel and pay for it upon receipt.

Customer Reviews:

Vera

Medicines to increase testosterone – a bad and weak move. You need to establish the natural production of the hormone you need, and not get addicted to pills for the rest of your life. After all, until you change your lifestyle, the problem will not disappear. Try at least for a month to work on yourself, do the exercises presented in the Testosterone Max course and you will see how your life will begin to change for the better.

Varya

Testosterone is a very interesting hormone, one might say insidious. Taking it in pill form does not always lead to the desired result. Because testosterone is not only the amount of the hormone contained in the blood, it is also the standard of living, its quality. Yes, in order to change the level of testosterone, sometimes you need to change your life, change your thinking, for this it is not enough to drink a magic pill (it does not exist), come to the Testosterone Max course and learn how to change your life, change the level of testosterone, increase your vital, male energy …

The Testosterone Max course will help you stop procrastinating until later, stop wasting time and teach you to direct your resources where you really need it, will also help you learn to control your emotions, take responsibility for your life and manage it, learn to relax in order to feel yourself at the peak of vivacity. After completing the Testosterone Max course, you will be able to deal with stress and cope with large volumes of tasks. Testosterone therapy is not a fountain of youth.There is no evidence that it will restore you to levels of physical fitness or sexual function in adolescence, prolong life, prevent heart disease or prostate cancer, or improve memory or mental acuity. If erectile function was a problem, testosterone therapy may not correct it. In fact, it can increase your sex drive, but it will prevent you from acting on it. You may also need medication or other therapy to get or maintain an erection.Testosterone needs and can be increased in natural ways, without resorting to hormone therapy, Testosterone Max subscription will help you with this.

Increased testosterone during pregnancy. If a woman was found to have an excess of testosterone levels in the blood even at the planning stage of pregnancy, then without special treatment she may have serious problems with conception. The fact is that testosterone affects the formation of follicles and the development of the egg, in other words, in excess, it can cause the absence of ovulation as such! …An increased testosterone content is especially dangerous at 4-8 and 13-20 weeks of pregnancy, it is during this period that its excess can cause premature termination of pregnancy or its fading. The reasons for high testosterone during pregnancy are different. If the testosterone level is increased. How dangerous is an increased level of male hormones for a woman who is already pregnant and just planning her pregnancy? The head physician of the MAMA Clinic Viktoria Viktorovna ZALETOVA answers the question of the site reader.I was prescribed dexamethasone to correct my testosterone levels. Is it somewhat dangerous for my pregnancy? I was also told that I would have to take this same drug to support pregnancy after IVF. The annotation clearly states that this medication is contraindicated in pregnant women. Does this mean that they are going to put an experiment on me? Yuliya. Typically, a couple is given a planning year without a survey. Perfect answer to dyufaston. If there is no ovulation after 14 days, you no longer need to track. … Testosterone and DHEA sulfate are not significantly increased, they are not the reason for the absence of pregnancy, you do not need to take metipred! Metipred is recommended for admission with confirmed VDKN, you have 17-one Progesterone in the norm, there is no VDKN diagnosis.There is increased hair growth: core hair above the upper lip, in the midline of the abdomen, on the inner thighs, acne? For hormones, there is no basic analysis of AMG, it shows the supply of eggs in the ovaries, with a significant increase it speaks of polycystic disease. Confused by LH levels. During pregnancy, the testosterone values ​​periodically change due to the hormonal transformations taking place. Pathological changes in this androgen can complicate gestation, therefore, constant antenatal care by qualified specialists.At the Aymed clinic, a patient with excessive testosterone abnormalities will receive timely treatment in order to preserve the pregnancy and give birth to a healthy baby. Increased testosterone. The physiological increase in testosterone in pregnant women is associated with the formation of the placenta and the beginning of the production of hormones in the fetus. Excessive growth of androgen in a pregnant woman is dangerous with severe complications. One of the most common causes of female infertility is hyperandrogenism, which is characterized by an increase in the level of male sex hormones in a woman’s body or increased tissue sensitivity to them.However, this disease is not a verdict at all, it is quite amenable to treatment with timely diagnosis. In order to consult a doctor on time and not start the disease, it will be useful for all women, and especially those planning to become mothers, to have an idea about it. Causes of hyperandrogenism. There are several types of hyperandrogenism, depending on the level of disorders and the causes of the disease Testosterone – testosterone concentrations in the serum of male fetuses are higher than in female fetuses, while the concentrations of dihydrotestosterone are similar.In male fetuses, testosterone concentration peaks at the end of the first trimester of pregnancy – about 150 ng / ml (5.2 nmol / L; which is half of the lower limit of the norm in adult males), and then gradually decreases from about 60 to 70 percent … Little is known about the regulation of fetal testosterone, but it is thought to be more dependent on maternal hCG levels than on fetal pituitary luteinizing hormone (LH). The concentration of hCG in the blood of the mother and fetus reaches.Pregnancy of a woman and the role of hormones FSH, LH, testosterone. A woman’s body is a complex system, the main feature of which is the ability to conceive and bear a child. … Testosterone is a hormone that is produced in the female body in the adrenal cortex and ovaries. Distinguish between free and total testosterone. Free – indicates the content of a hormone that is not bound to proteins. … Most pregnancy planning experts advise to undergo a hormonal examination of both partners, as it is better to identify possible problems and begin to deal with them than to waste time.In any case, self-medication is not worth it. Testosterone is the main male sex hormone that is responsible for the development of secondary sexual characteristics, puberty and normal sexual function in men. It is present in the body of women, but in a much lower concentration. It is produced in the adrenal cortex, in the testes – in men and in the ovaries – in women. The main functions of testosterone include activation of potency and libido – sexual desire, control of sperm synthesis and maintenance of their viability, activation of metabolic processes, maintenance of optimal bone density, stimulation of muscle growth.Increased testosterone is the norm for a woman during ovulation. But an excess of testosterone in a woman can also occur with ovarian tumors, adrenal hyperplasia, and various tumors. A decrease in the level of this hormone is characteristic of Down’s syndrome, with renal failure, obesity, insufficient function of the gonads, chronic prostatitis. … The level of testosterone in women during pregnancy rises significantly, and reaches its maximum values ​​by the third trimester. Testosterone increases significantly during pregnancy – this is a variant of the norm, but increased testosterone during a planned pregnancy is dangerous due to miscarriage.Blood test for hormones when planning pregnancy. It is very important to have a blood test for hormones when planning a pregnancy. Timely assessment of hormonal levels will avoid possible problems. The main hormones that are tested when planning a pregnancy. Testosterone is a male sex hormone, an increased amount of testosterone in women can lead to miscarriage, and a lower amount in men can lead to a decrease in sperm quality. DEA-sulphate (DEA-s or DEAS) – in the body of women is produced in small quantities.An increased concentration of this hormone can lead to infertility. Thyroid hormones.

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And if you do not know how to manage your testosterone, or even do not try to do it, then your body is slowly but surely transforming you into a woman, more and more reducing the level of this hormone in the body. Come to the Testosterone Max course and find out how to always stay in shape.

planning pregnancy increased testosterone

Testosterone therapy is not a fountain of youth.There is no evidence that it will restore you to levels of physical fitness or sexual function in adolescence, prolong life, prevent heart disease or prostate cancer, or improve memory or mental acuity. If erectile function was a problem, testosterone therapy may not correct it. In fact, it can increase your sex drive, but it will prevent you from acting on it. You may also need medication or other therapy to get or maintain an erection.Testosterone needs and can be increased in natural ways, without resorting to hormone therapy, Testosterone Max subscription will help you with this.

Low testosterone levels in men can also be associated with diseases of other organs such as coronary heart disease, hypertension, diabetes mellitus, bronchial asthma, lung disease, atherosclerosis, and liver disease. Strength exercises such as dumbbells significantly increase testosterone levels. Lack of testosterone can cause behavioral changes in men, making them nervous and fidgety.They often experience bouts of depressed mood. Educational video androgens in health and disease in women and men. Low testosterone levels in men. Testosterone is popularly known as the main superior of male qualities. Physical strength, muscle strength, degree of hair growth, voice data will depend on how high its level in the blood is. The work of many organs is also associated with the content of this hormone and its activity. … Testosterone is one of the most important hormones for men.It is he who determines such masculine traits as voice, appearance and even some behavioral features. However, there is no need to wonder how to increase testosterone in men if the goal is to become more masculine and attractive to women, or to improve personal life. Diagnosis and treatment of testosterone deficiency (hypogonadism) in men, Community organizer … Hypogonadism in men, defined as a decrease in serum testosterone levels in combination with characteristic symptoms and / or signs (described in detail below), can be observed with pathological changes in the testes and / or pituitary gland, such as Klinefelter’s syndrome, Kalman’s syndrome, as well as in men with idiopathic, metabolic or iatrogenic disorders leading to androgen deficiency.Testosterone largely determines not only the appearance, but some of the behavioral features of men, more characteristic of them than the female sex. And if suddenly this valuable hormone in the body begins to be produced frankly little, certain changes occur – usually negative. … In men, testosterone is produced mainly by the testes, and they also begin to work worse over the years, although not so much worse compared to the ovaries of women. … Between the ages of 60 and 70, 2 out of 10 men have testosterone levels below normal, and between the ages of 70 and 80, this figure rises to 3 out of 10.Testosterone levels in the body change throughout the day. The steroid hormone testosterone in men is produced in the testes. It is he who makes men out of men. Has a biological effect on almost all organs and tissues. … A decrease in the initial level by 2-3 ng / ml causes certain symptoms in everyone, but the level of testosterone is different. … With hypogonadotropic hypogonadism (low LH and low testosterone) and normogonadotropic hypogonadism (normal LH, low testosterone), stimulating hormonal therapy with choriogonic gonadotropin (analogue of LH) is offered in order to increase the production of endogenous (own testosterone).What foods increase testosterone in men? Testosterone is the main male sex hormone that is responsible for the development of secondary sexual characteristics, puberty and normal sexual function in men. It is present in the body of women, but in a much lower concentration. It is produced in the adrenal cortex, in the testes – in men and in the ovaries – in women. The main functions of testosterone include activation of potency and libido – sexual desire, control of sperm synthesis and maintenance of their viability, activation of metabolic processes, maintenance of optimal bone density, stimulation of muscle growth.What is the role of testosterone in men? Low testosterone levels are symptoms. How is low testosterone levels diagnosed? Low testosterone is a cure. Testosterone treatment – what tests to do? … Low testosterone is a cure. Is there a need to treat low testosterone levels? Most of the studies on testosterone treatment indicate improved libido and sexual function in men with hypogonadism or low male hormone levels. … The urologist will evaluate the effect of the therapy and determine whether to decrease or increase the testosterone dose.The optimal time of day for measuring testosterone levels depends on the form of administration. Broad shoulders and a deep voice, a beard and well-developed muscles … These, as well as a number of other masculine characteristics, are provided by the substance we know as testosterone. We are talking about him with the endocrinologist Clinic Expert Tula Makarova Oksana Viktorovna. … Testosterone is a male steroid hormone. But I will immediately make a reservation that it is produced not only in men, but also (in smaller quantities) in women. Today we are going to talk about adult men.They have it synthesized in the male gonads – the testes. … A healthy adult male has a certain range that is common to all. The situation when you can talk about an individual norm is, for example, some kind of disease. The hormone rate in men. Low testosterone: what to do and how to get tested. … A cause for alarm appears when a man has low testosterone at the age of 18-50 years, and the patient’s hormone level differs significantly from the testosterone norm in men in this age group.A decrease in the level of a substance often indicates the development of the following pathological conditions.