Key Takeaways
- T-Score compares your bone density to a healthy 30-year-old adult
- Normal: T-Score of -1.0 or higher
- Osteopenia: T-Score between -1.0 and -2.5 (low bone mass)
- Osteoporosis: T-Score of -2.5 or lower (high fracture risk)
- Early detection and lifestyle changes can help prevent bone loss
What Is a Bone Density T-Score?
A T-Score is a measurement from a DEXA (Dual-Energy X-ray Absorptiometry) scan that compares your bone mineral density (BMD) to the peak bone density of a healthy 30-year-old adult of the same sex. This comparison helps determine if you have normal bone density, low bone mass (osteopenia), or osteoporosis.
The T-Score is expressed as a standard deviation from the reference value. A score of 0 means your bone density is exactly average for a young adult. Negative numbers indicate lower-than-average density, while positive numbers indicate higher-than-average density.
Understanding T-Score Ranges
What Each Range Means
- Normal (-1.0 or higher): Your bones are strong and healthy. Continue maintaining good bone health through diet and exercise.
- Osteopenia (-1.0 to -2.5): You have lower-than-normal bone density but not low enough to be classified as osteoporosis. This is a warning sign that action should be taken.
- Osteoporosis (-2.5 or lower): Your bones are significantly weakened and at high risk for fractures. Medical treatment and lifestyle modifications are typically recommended.
Important Medical Disclaimer
This calculator is for educational purposes only. Always consult with a healthcare professional for proper interpretation of your DEXA scan results and personalized treatment recommendations. T-Scores should be evaluated alongside other risk factors including age, family history, and overall health.
Who Should Get a Bone Density Test?
The National Osteoporosis Foundation and major medical organizations recommend bone density testing for:
- Women age 65 and older
- Men age 70 and older
- Postmenopausal women under 65 with risk factors
- Adults with a fracture after age 50
- People taking medications that cause bone loss (corticosteroids, etc.)
- Anyone with conditions associated with bone loss (rheumatoid arthritis, celiac disease, etc.)
Pro Tip: Prevention is Key
Even if your T-Score is normal, you can take steps to maintain bone health: ensure adequate calcium (1,000-1,200mg daily) and vitamin D (600-800 IU daily), perform weight-bearing exercises, avoid smoking, and limit alcohol consumption.
T-Score vs. Z-Score: What's the Difference?
While T-Scores compare your bone density to young adults, Z-Scores compare your density to people of your same age, sex, weight, and ethnicity. Z-Scores are typically used for:
- Premenopausal women
- Men under age 50
- Children and adolescents
A Z-Score below -2.0 is considered "below the expected range for age" and may indicate a secondary cause of bone loss that requires further investigation.
How to Improve Your Bone Density
Lifestyle Modifications
- Weight-bearing exercise: Walking, jogging, tennis, dancing, climbing stairs
- Resistance training: Lifting weights, using resistance bands
- Balance exercises: Tai chi, yoga to prevent falls
- Quit smoking: Smoking accelerates bone loss
- Limit alcohol: Excessive drinking weakens bones
Nutritional Support
- Calcium: Dairy products, leafy greens, fortified foods
- Vitamin D: Sunlight, fatty fish, supplements if deficient
- Protein: Essential for bone structure and repair
- Vitamin K: Found in leafy greens, helps with calcium regulation
Frequently Asked Questions
For those with normal bone density, testing every 2-5 years may be sufficient. If you have osteopenia or osteoporosis, your doctor may recommend testing every 1-2 years to monitor response to treatment. Medicare typically covers DEXA scans every 2 years for qualifying individuals.
Yes, bone density can be improved through a combination of weight-bearing exercise, adequate calcium and vitamin D intake, and in some cases, medication. Studies show that proper treatment can increase bone density by 1-3% per year and significantly reduce fracture risk.
Common osteoporosis medications include bisphosphonates (Fosamax, Boniva, Reclast), denosumab (Prolia), hormone therapy, and bone-building medications like teriparatide (Forteo) and romosozumab (Evenity). Your doctor will recommend the best option based on your specific situation, risk factors, and medical history.
DEXA scans are very safe. The radiation exposure is minimal - about 1/10th of a standard chest X-ray. The scan is painless, non-invasive, and takes only 10-20 minutes. It's one of the lowest radiation medical imaging procedures available.
A standard DEXA scan measures bone density at the hip and spine, as these are common sites for osteoporotic fractures. Sometimes the forearm is also measured. The results from different sites may vary, and the lowest T-Score is typically used for diagnosis.