Is It Necessary To Have A Bone Density Test If Blood Work Is Normal?

[BelleVie]

My calcium and vitamin D levels were normal on my blood work last month, so my doctor said that I don't need to do any sort of bone density tests. What's been your experience with this? Do you think a bone density test is necessary? I'm 25. 

[kareng]

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[moosemalibu]

It is my understanding that your body will take from the bones in calcium in order to maintain a normal level of calcium in the blood, so your blood levels do not necessarily reflect what your bones are doing. 

[cyclinglady]

(Conversation in Doctor's office)

 

GP (or PCP), "I see you're here for a follow-up visit after your hospital stay."

 

I say, "Before we get into that, I have this sheet of items that I should be tested on.  I belong to this Celiac forum.  One of the bloggers is a Pediatrician and has Celiac Disease.  She subscribes to a doctor's website that sends her the latest and greatest in the medical field.  I probably will need a bone density test......."

 

GP says, "I get the same news, but this is Celiac related.  You should follow-up with your Gastro."  

 

I say, "But you guys are in the same medical practice.  What difference does it make?"

 

GP says, "Let's look at your hospital chart.  Oh my, you have fractured your vertabrae.  Did you fall?"

 

I say, "Nope.  I did nothing except to try to get off my bathroom floor." 

 

GP says, "Oh, we should order a bone density scan."

 

I KID YOU NOT!  

 

My blood tests were all fine at diagnosis (March 2013) except for low Ferritin.  I strongly recommend a bone scan even though the pediatrician (Jebby's blog) on this forum said her own insurance refused to pay for it.  In my research there are plenty of celiac disease patients who have poor bone density and that includes children and young adults.  

[nora-n]

over at a hyperparathyroid gb page, several are celiacs. They found some info and studies that also found some correlation. PTH draws the calcium out of your bones to keep blood calcium within tight ranges.

 

But sometimes the parathyroids get stuck somehow and send out PTH without stopping.

[BelleVie]

Thank you, folks. 

[TGK112]

I went in reverse. My bone density problems were discovered before celiac. I was seeing a bone density specialist - because I was losing - and he ran blood tests on me ( "to rule things out") - which showed celiac, confirmed with an endoscopy. I was pretty asymptomatic and my other blood tests showed normal ranges of calcium, Vitamin D and iron. I posed the question to my doctor - If it does not appear that I have a malabsorption issue going on -  is celiac even contributing to the osteoporosis? His response was that ANY inflammation is bad for bones - and yes the inflammation of the small intestine can contribute to osteoporosis - even with normal Vitamin D levels.

[1desperateladysaved]

A question I have:  "What do you do about poor density when you find it? "

 

My thoughts about it: 

 

My answer " I would make sure that my nutrient levels were good.  "

 

self:  "Oh, I am doing that, so why do I need to test my bone density?" 

 

...If anyone has thoughts on my thoughts, or on my question go ahead. 

[TGK112]

  On 9/8/2013 at 4:09 PM, 1desperateladysaved said:

A question I have:  "What do you do about poor density when you find it? "

 

My thoughts about it: 

 

My answer " I would make sure that my nutrient levels were good.  "

 

self:  "Oh, I am doing that, so why do I need to test my bone density?" 

 

...If anyone has thoughts on my thoughts, or on my question go ahead. 

I also do weight bearing exercises and I am on Alendronate (Fosamax) - to strengthen the bones.

[1desperateladysaved]

  On 9/8/2013 at 4:14 PM, TGK112 said:

I also do weight bearing exercises and I am on Alendronate (Fosamax) - to strengthen the bones.

What's Fosamax?

[kareng]

  On 9/8/2013 at 4:09 PM, 1desperateladysaved said:

A question I have:  "What do you do about poor density when you find it? "

 

My thoughts about it: 

 

My answer " I would make sure that my nutrient levels were good.  "

 

self:  "Oh, I am doing that, so why do I need to test my bone density?" 

 

...If anyone has thoughts on my thoughts, or on my question go ahead. 

 

 

What people have been trying to say is that, years of Celiac have caused you to either loose calcium from your bones or you have never been able to build "filled in" bones because you couldn't absorb calcium.  Your bones don't magically fill in if they start to get calcium.  It takes calcium, weight bearing exercises and sometimes medications like Fosamax to start to fix the damage.  Just having good calcium levels in your blood now, does not mean your bones have good density.  Your doctor should have discussed this with you, especially for you and I who are a little bit over 40. 

[cyclinglady]

  On 9/8/2013 at 4:09 PM, 1desperateladysaved said:

A question I have:  "What do you do about poor density when you find it? "

 

My thoughts about it: 

 

My answer " I would make sure that my nutrient levels were good.  "

 

self:  "Oh, I am doing that, so why do I need to test my bone density?" 

 

...If anyone has thoughts on my thoughts, or on my question go ahead. 

That's fine, if you're going to take supplements, avoid gluten, and do weight bearing exercises.  That's exactly what my Gastro prescribed upon my diagnosis.  But what if you need to modify your activities to prevent fractures?   Like giving up gluten, it's easier to stick to it if you have been diagnosed with celiac disease or an intolerance.  If I'm going to stay off my bike, stop running or rollerskating at the rink I needed to know that it was medically necessary for my health.  

[TGK112]

  On 9/8/2013 at 9:54 PM, 1desperateladysaved said:

What's Fosamax?

It is a prescription medication given to people with osteopenia or osteoporosis to strengthen bones in order to prevent fractures.

 

My celiac and osteoporosis go hand in hand - I am equally concerned about both of them

[eers03]

I have taken my gluten-free diet quite seriously but need to be as aggressive with my bone density.  I'm taking a combo OTC supplement that contains both Vitamin D and Calcium.  Hope it does its job!  How much calcium should I be consuming per day?  

[cyclinglady]

  On 9/10/2013 at 1:11 AM, eers03 said:

I have taken my gluten-free diet quite seriously but need to be as aggressive with my bone density.  I'm taking a combo OTC supplement that contains both Vitamin D and Calcium.  Hope it does its job!  How much calcium should I be consuming per day?  

My doctor prescribed 1500 mg of calcium.  I use the Costco brand (Calicum Citrate) that contains vitamin D, Magnesium  and few other minerals.  Ugh!  It's six pills a day!  

[Piccolo]

I say yes to the bone scan.

 

Here is my story.  I was 50+ when I was at a health fair.  A heal scan already was -3.  I had done nothing to stop it.  I looked up an osteoporosis doctor.  My first scan confirmed I was a -3.  I was started on Forteo and began calcium and vitamin D.  I began to gain in bone density slowly.  The whole time I am having malabsorbtion issues as I did for 20 years prior.

 

I am currently on Prolia, probiotics, calcium and vitamin D and exercise (weight bearing) and I have finally stopped loosing bone.  I still have osteoporosis but it is better.

 

Susan

[frieze]

be careful of too much Ca++, my GYN doesn't recommend supplementing any more, r/t cardiac issues.  Vit D + K are big issues with bones.

read up on any  of the bone building meds, before you take!

[1desperateladysaved]

When I was 25 the doctor prescribed calcium forever.  However, it hurt my tummy and made me feel sick.  my Functional Medicine nurse has since told me that it could make untreated celiac worse. That likely was my difficulty.  I redoubled my efforts to  take milk!  I had my calcium levels checked recently and I have enough calcium.  My absorption is now quite well, though.

 

I think it would be a good idea to have one's calcium level checked before supplementing much.

 

D

[frieze]

remember, the blood levels are the last place the def is going to show.  Homeostasis needs to be maintained or you will die.