I have recently been diagnosed with a t-score in my spine of -4.2 (and -2.6 in my hip). I was referred for a DEXA scan after breaking my collarbone while skiing.
My GP has prescribed the standard alendronic acid plus calcium/vitamin D supplements but I have read that anyone with a t-score of -3.5 or worse should be referred to a specialist for possible treatment with bone building anabolic agents. I have queried this with my GP who checked with the rheumatology specialist who has advised that as I have no history of fragility fractures (the skiing accident was quite high speed) then alendronic acid is the most appropriate first treatment.
I am a little concerned that I might have to wait until I get a spinal fracture before I get a more effective treatment and am considering getting a private prescription.
I’d be very interested to hear the experiences of others with a similar t score in the spine. What medication were you prescribed? Have you managed to avoid spinal fractures with a t score of -4.2 and treatment with just anabolic acid?
Hi KateC and welcome. Not sure of your age but based on my experience I’d say this is the right treatment approach for now as you sound otherwise healthy and active. You don’t reveal your age (which is perfectly fine) but this may also be a factor in the treatment plan. I was diagnosed aged 30 (hip -2.6 spine -4.1) and did not start Alendronic acid and calcium until I was 40 as we were undergoing fertility investigations etc. I didn’t lose any further bone mass during that time and gained some once I started on alendronic. I subsequently moved onto denosumab and hoping for one of the new anabolic treatements at some point (I’m now 51). Things change especially now the consultants have a wider range of drug treatment options but one thing I have learnt is that bone building medication is a long-term treatment and is not purely based on bone desity scores. I know the system isn’t perfect and you do have to be assertive in discussions and keep up to date with developments but trust the rheumatologist for now. The risk of a spinal fracture will unfortunately always be there regardless of being on a bone building drug. You have to find your own balance between staying active and enjoying life but stopping high risk sports and activivites to reduce risk.
I am 62 years old and otherwise fit and healthy. I do lots of physical activities (cycling, sailing, hiking, skiing). I’m still trying to understand what my diagnosis means for me and my lifestyle. I suppose my initial reaction is that I want to ‘fix this’ as quickly as possible, to whatever extent it can be fixed, so that I can continue with all my usual activities (some of which might be classified as ‘high risk’).
I rolled my ankle in October 2024 and fractured a metatarsal. The fracture clinic sent me for a DXA scan. Although I chased the result continuously I didn’t get the result until 10 months later - routine so not urgent. Result was -4.4 lumber spine -2.1 hip and GP started the process for me to start a biphosphonate - risonadrate. With my foot healed I had started running again. Three weeks later my back gave way while running resulting in 3 spinal compression fractures which I wouldn’t wish on anyone. But because of the fractures I was deemed suitable to start anabolic treatment and have been injecting teraparatide for almost 6 months. In the UK it seems you have to have had fragility fractures to be considered for bone building treatment.
I can understand that yours was an impact fracture but with your T Scores and activities I would be worried about fractures occurring - mine came from nowhere. Would you be able to get a Frax Score to evaluate your risk of fracture. This could maybe help with a request for anabolic treatment.
Sorry I haven’t been much help, just giving my journey.
Thanks for sharing. Very helpful. I’ve decided to go for a private consultation as I really don’t want to wait until I get a spinal fracture. I shall see what they say.