Bone Density Test: What Your Osteoporosis T-Score Means for Your Bone Health

When you have a bone density test, your result comes back as a T-score. A T-score of minus 2.5 means osteoporosis.

osteoporosis -3.0

A bone density scan uses as a baseline the T-score of a normal, healthy-boned 30-year-old.

© Sebastian Kaulitzki | Dreamstime.com

A bone mineral density test is the best way to measure your bone health. It can tell you if you have osteoporosis and predict your risk for a bone fracture. If you are being treated for osteoporosis, a bone density test can tell your doctor how your bones are responding to treatment. [1-3]

Osteoporosis causes your bones to become thin, weak, and brittle. Osteoporosis is a common cause of fractures that can lead to disability. A fractured hip or wrist may be the first sign of osteoporosis. Osteoporosis is five times more common in women than men. The reason is the female hormone estrogen. Estrogen helps prevent bone loss in women. But when estrogen starts to drop around the time of menopause, there is a rapid loss of bone that lasts about three years. [2]

The most common bone density test is called a DEXA scan. This test is a painless imaging study that scans your bones while you lay still for several minutes. Radiation exposure from the test is less than a chest x-ray. [2] DXA usually measure bone density in your hip and lower spine. Other bone density tests measure density of your arm, wrist, finger, or heel. These tests can’t diagnose osteoporosis, but they can suggest the need for a DXA scan if they are abnormal. [1]

What Is a T-Score?

osteoporosis dxa scan

Osteopenia (middle) and osteoporosis (right) occur when we lose more bone than we are able to make during normal bone remodeling as we age.

DXA reports your results as a T-score. Your bone density is compared to the normal bone density of a healthy young adult. Differences between your bone density and the normal density is measured in units called standard deviations: [1]

  • A T-score of 0 means your score is the same as the healthy adult.
  • A T-score 1 unit below normal (-1) is still considered within the normal range.
  • A T-score between 1 and 2.5 units below normal (-1 to -2.5) is low bone mass, also called osteopenia.
  • A T-score more than 2.5 units below normal (-2.5) means osteoporosis and an increased risk for bone fracture.

Who Should Get a DXA Scan?

DXA testing is recommended for all women age 65 and older. If you are postmenopausal, but under age 65, bone density testing may be recommended if you have risk factors for osteoporosis. These risk factors include: [2]

  • A history of a bone fracture due to fragile bone
  • A diagnosis of rheumatoid arthritis
  • Body weight less than 127 pounds
  • A history of smoking or alcohol abuse
  • A history of hip fracture in a parent

If you have a normal DXA scan, you do not need to have another scan for up to 15 years. If you have an abnormal scan, your doctor may order testing more frequently to check for more bone loss. [2]

Do Men Need Bone Density Testing?

There is not enough evidence to recommend routine bone density testing in men. [1] Although osteoporosis is thought of as a woman’ disease, it can also occur in men, especially men over age 70. Just like women, the first sign in men may be a bone fracture of the hip, wrist, or spine. Men have larger and stronger bones than women and they do not have rapid bone loss like women do around menopause. However, by age 70 men are losing bone at the same rate as women. [3]

Bone density testing with DXA is the same for men as women, with the same T-score interpretation. Bone density testing for older men may be recommended if a physical exam shows that they are losing height or having a change in posture. A sudden fracture is another reason for treating. Testing is also done for men with these risk factors:

  • Long-term disease of the kidneys, lungs, or stomach
  • Use of steroid medication
  • Signs of low testosterone
  • Lack of physical activity
  • Smoking or alcohol abuse [3]

How Is Osteopenia and Osteoporosis Treated in Men and Women?

If you have osteopenia, you may be able to prevent osteoporosis and a future fracture by increasing calcium and vitamin D in your diet. Calcium helps build bones and vitamin D helps you absorb calcium from your diet. You can also strengthen your bones with weight-bearing exercises like walking or jogging. [1]

how to increase bone density

How to increase bone density? Exercise is a key aspect in keeping bones strong.

Exercise helps because bone is living tissue that responds to exercise by adding more calcium. Recommendations for exercise are about 30 minutes on most days of the week. Weight-bearing exercise is any activity that that you do while standing, requiring your muscles and bones to work against gravity. [2]

Diet sources for calcium include leafy green vegetables, dairy foods, and canned fish with bones (like sardines). Vitamin D is not present in many foods so it is added to milk, juice, and cereal, fortified with vitamin D. To make vitamin D in your body, you need to be exposed to sunshine. Try to get outdoor sun exposure for about 15 minutes a few days each week. [2]

If you have osteoporosis, you should do all the same things you do for osteopenia, but your doctor may start you on a medication to treat osteoporosis. [1] Supplements for calcium and vitamin D may also be recommended by your doctor. [3]

RECOMMENDED FOR YOU

SOURCES

  1. NIH, Bone Mass Measurement: What the Numbers Mean, https://www.bones.nih.gov/health-info/bone/bone-health/bone-mass-measure
  2. ACOG, Osteoporosis, https://www.acog.org/en/Womens%20Health/FAQs/Osteoporosis
  3. NIH, Osteoporosis in Men, https://www.bones.nih.gov/health-info/bone/osteoporosis/men

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Chris Iliades, MD

Chris Iliades has an MD degree and 15 years of experience as a freelance writer. Based in Boothbay Harbor, Maine, his byline has appeared regularly on many health and medicine … Read More

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Comments Comments Policy
  • My endocrinologist tracks my bone density with an “NTX” blood test – current level at 23, down (with Boniva tablets over 1 year) from 30.9. How does this rating line up against “DEXA” scan numbers?

  • I had a dexa scan, my t-score was a -0.3 for my lumbar spine L1-L2, and my femoral necks tscore was -0.7. What does this mean for me. Can you send me some information on this matter. Thank you.

  • My t-score is-0.3 left femoral neck BMD is 0.693 gm/cm squared with at-score of -2.9 ! RIGHT femorelneck BMD is 0.720gm/cm squared with a T-score of-2’7 !! Can You send me information on this Matter I am 90 years old in good Health Thank You !!!!

  • My t-score is-0.3 left femoral neck BMD is 0.693 gm/cm squared with at-score of -2.9 ! RIGHT femorelneck BMD is 0.720gm/cm squared with a T-score of-2’7 !! Can You send me information on this Matter I am 90 years old in good Health Thank You !!!!

  • I am 51 years old. My DEXA scan showed alarming results! My both hips scored 3.9 and my lumbar is 4.0 I am really worried,for I have done everything possible to slow it or prevent it! What does this mean for me, other than another fall could result in death.

  • My worst T score was -3. in the lumbar spine, the rest of my scores were T -2.3 and -1.9 and -1.7. I am extremely active, swim, bike, walk, pilates, tai chi, yoga and am 65…. what’s a girl to do? I am not interested in taking any meds, is this unwise? given the -3.0. thank you

  • just had my DEXA test,,,,left femoral neck is -2.4, and my L1 through L4 is -3.8…my dr. just put me on Alondrate?sp…..I am a little scare…i’m 62 what else could be done

  • I am 59 and just received my bone density results.
    L1-L3: BMD: 0.15 gm/cm2 T-Score: -7.9 Z-score: -6.5 prior T -1.0

    Femoral neck: BMD: 0.77 gm/cm2 T-Score: -0.7 Z-score: 0.5 prior
    T -0.7

    Trabecular forearm: BMD 0.38 gm/cm2 T-Score -1.0 Z-score: -0.1
    prior T -0.5

    I was told that a -7.9 result on L1-L3 was not possible…
    Any thoughts?

  • The bone density image in the spine is satisfactory. The measured value in the spine (L1-L4) is below the expected range of values and reflects osteoporosis with a T-score of -2.8.
    My left hip image is satisfactory. The hip density is below the range expected and reflects low bone density with a T-score of -2.4 at the femoral neck. The total hip T-score is -2.2.

    My right hip image is satisfactory. The bone density measurement is also below the expected range and reflects low bone mineral density with a femoral neck T-score of -2.2. The total hip T-score is -1.9.

    My question is about micro fractures on my spine. Can I get those now from simply bending forward and washing my hair in the kitchen sink? Or are my numbers too low for such a thing. I’m a 59 year old woman. Any thoughts, the more I read about this the more fear is generated. Thanks.

  • My T score is -2.8. I am 80 years old, very active. I just tripped and took a hard fall landing hard on my upper thigh and lower hip. I had a dark purple scare covering most of my thigh. I am very sceptical about taking medications.

  • -3 on dexa hips taking Fosamax & 2 Citracal per day will this improve any bone regrowth at all within 7 months when I have my next dexa Im 56 with MS hips are my major problem with walking to keep moving. Any advice Thank-you

  • HERBAL FORMULA

    Best Health Herbal Centre osteoporosis herbal remedy is not a joke, is real. My mother had severe osteoporosis for 10 years. 5 of which she was on medication. In the past 2 years, she have had 7 fx ribs, and it was revealed on x ray that she have a t-6 compressed disc. Luckily for me i saw many discussions in a group, discussing how they reversed osteoporosis with osteoporosis herbal remedy ordered online from Best Health Herbal Centre. I was Very shocked to see that, but i don’t hesitate to order for my mother. My mother osteoporosis was total reversed after one month of usage. Her bone density in now normal..

  • Please could you let me know the name of the herbal remedy the last person in the conversation had for his mother please.

  • What is the name please of that herbal that helped the mother ‘s osteoporosis on that publication of April 23 2018. Thank you

  • Please advise the name of herbal remedy which reversed her mother’s osteoporosis on that publication of 4/23/2018

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