Should I Get a DEXA Scan?

A doctor’s advice about getting a test to measure the thickness of your bones

Adam Rosenbluth, M.D.,

AARP

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Published November 11, 2024

Video: Dr. Adam, How Do I Know if My Bones Are Healthy?

Should I get a DEXA scan to see if my bones are healthy?

Definitely. But like a lot of things in life, timing matters. When you get your first baseline scan will depend on your age, family history, personal lifestyle and medical conditions.

A DEXA scan (short for dual-energy X-ray absorptiometry) is a bone density test that measures the thickness and strength of your bones. A fast and painless procedure, it’s similar to a regular X-ray that uses low-dose radiation. From start to finish, the scan is likely to take less than 20 minutes.

The U.S. Preventive Services Task Force recommends women get their first routine DEXA scan at 65 years or older. But many health care providers, including myself, recommend you take one sooner — as early or even earlier than age 50 —regardless of your sex. This is particularly true for both men and women who have one or more risk factors for fractures.

Your family history matters. I’ll ask my patients: “Did your mother or father have an unexpected fracture?” If I hear something like “You know what Adam? I remember my mother was just turning around to grab something and she broke her ankle.” Or “My dad fell when his hip spontaneously fractured.” These answers tell me there’s bone weakness in the family.

The second question is: “Did either of your parents lose considerable height as they aged?” If my patient answers yes to either or both of these questions, I’ll ask “When did this happen?” Then I back up between 5 to 10 years and calculate the age I recommend scheduling their first DEXA scan.

Other risk factors that point to an earlier scan include sudden back pain, your own loss of height or increasing stooped posture, as well as taking certain medications that can thin bones. Alcohol and tobacco use and medical conditions such as diabetes, rheumatoid arthritis, gastrointestinal diseases and cancer can increase your chance of fractures.

For women, perimenopause and the early years of menopause play a role in the development of osteoporosis, because bone density starts to decrease with lowered levels of estrogen. It’s a good idea to schedule routine DEXA scans during this time of life.

It’s crucial that we detect weakening bones early, because fractures in older people can often lead to a cascade of health problems. As many as 24 percent of people age 50 and older die within a year of a hip fracture, and an estimated 12 percent of elderly people die within a year of an ankle fracture. The risks of complications from broken bones increase with age, and men are more likely to have serious problems than women. Luckily, there are things we can do to strengthen your bones.

Let’s say you have a DEXA scan in your early 50s and discover you have osteopenia. This means you have a condition where your bone density is lower than average, but not so low that it’s considered osteoporosis, which is a more advanced stage of bone loss. I suggest you look at your diagnosis as a warning sign and use natural ways to strengthen your bones.

Regular impact or weight-bearing exercises such as walking, running, playing tennis, dancing and yoga will help to strengthen your bones and your balance. One study involving 741 participants found that 12 minutes of daily yoga can reverse bone loss.

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You might want to speak with your doctor about taking vitamin D supplements and bisphosphonates or denosumab to slow down bone loss. You’ll also want to pay attention to your diet to perhaps add more calcium and protein.

Dairy products like yogurt, milk and cottage cheese, green leafy vegetables, fortified juices and legumes are excellent choices. If you’re diagnosed with osteoporosis, some medications can help to stop the disease and even increase your bone density. In the past, these drugs had to be taken for the rest of your life. But recent advances have shortened the frequency and duration you need to take medications. Speak with your doctor about the best treatment for you.

There should be no bone of contention around getting a DEXA scan. A strong skeletal system provides a sturdy framework for your body, aids muscles when you move, protects organs and even helps you to breathe. Make bone health a priority. After your first baseline scan, schedule follow-ups every two years.

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