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I would be careful using BMD in this case. It's a funny metric, so-called aereal density, grams per centimeter squared versus grams per centimeter cubed you'd n

by gleb 8y ago

I would be careful using BMD in this case. It's a funny metric, so-called aereal density, grams per centimeter squared versus grams per centimeter cubed you'd normally think of as density. Given perfectly normal bone structure the BMD is gonna be smaller on a smaller person. It's not clear that the linked study controls for this. Consider seeking out a facility with HRPQCT machine to better evaluate bone microarchitecture. Also, any particular reason they're not using a newer anabolic osteoporosis drug on you? Meaning teriparatide or abaloparatide.

Abishek_Muthian 8y ago
(OP) You have raised some interesting questions, are you in medical field? >grams per centimeter squared versus grams per centimeter cubed you'd normally think of as density. BMD results are measured as differences with normal healthy 30 year old (T-score) in Standard deviations (SD). >Given perfectly normal bone structure the BMD is gonna be smaller on a smaller person Density should be within acceptable range for a smaller person & a healthy person of same age right? > they're not using a newer anabolic osteoporosis drug on you? Meaning teriparatide or abaloparatide. As soon as it was found that I was suffering from osteoporosis (from BMD), I underwent zoldronic acid treatment along with calcium, vitamin-D supplements with the orthopedic. During diagnosis by spine surgeon, I was asked to take BMD again as the results I had was equal to that of an 85 year old (in his words). New results showed similar values & I was referred to an endocrinologist. The endocrinologist did mention that there were powerful medications than zoledronic, but since I had already administered it just a couple of weeks earlier & that my spine surgery was to be held in next week; he asked me to continue with the present treatment for osteoporosis. After surgery, I did visit him again; he increased the dosage of calcium(500mg - daily) & vitamin-D3 (Cholecalciferol 60,000 I.U - monthly) supplements for a year and continue with zoledronic treatment for next 2 years.
- gleb 8y ago
  Consider watching lectures by Dr. John Bilezikian on YouTube. He is one of the top osteoporosis doctors in the world. Here's a link to the first one in the latest series, but all his stuff on YouTube is great: https://www.youtube.com/watch?v=vnOQsYYalyQ https://www.youtube.com/watch?v=vnOQsYYalyQ To your question, no, you would expect BMD to be a function of person size. Because it's not actually density. The bigger the person bones are the larger BMD you would see given the same volumetric density. DEXA measures how many grams of calcium fall on a square centimeter, and bigger bones will result in higher numbers. For people close to mean in size the difference is academic, for somebody 3-4 standard deviations below the mean in size not so much. This is covered in Dr. Bilezikian’s lectures. You can also Google [BMD areal volumetric]. In any case, this may not matter, BMD is predictive of fracture risk regardless of size. There seems to be some but not much science there on achondroplasia and osteoporosis. The few papers that pop up do suggest a link. Since you are an outlier I'd consider doing this: -learn more about osteoporosis from these lectures on YouTube -find a facility with a HRPQCT which is a gold standard for diagnosing bone density issues -the doctor who owns this machine is going to be a researcher who should find this case interesting, and will be able to reason from first principles not just follow guidelines, the guidelines that may not be applicable to somebody of an outlier size. Consult with his doctor Feel free to friend me on LinkedIn if you want to talk more.

by gleb 8y ago

Abishek_Muthian 8y ago

(OP) You have raised some interesting questions, are you in medical field? >grams per centimeter squared versus grams per centimeter cubed you'd normally think of as density. BMD results are measured as differences with normal healthy 30 year old (T-score) in Standard deviations (SD). >Given perfectly normal bone structure the BMD is gonna be smaller on a smaller person Density should be within acceptable range for a smaller person & a healthy person of same age right? > they're not using a newer anabolic osteoporosis drug on you? Meaning teriparatide or abaloparatide. As soon as it was found that I was suffering from osteoporosis (from BMD), I underwent zoldronic acid treatment along with calcium, vitamin-D supplements with the orthopedic. During diagnosis by spine surgeon, I was asked to take BMD again as the results I had was equal to that of an 85 year old (in his words). New results showed similar values & I was referred to an endocrinologist. The endocrinologist did mention that there were powerful medications than zoledronic, but since I had already administered it just a couple of weeks earlier & that my spine surgery was to be held in next week; he asked me to continue with the present treatment for osteoporosis. After surgery, I did visit him again; he increased the dosage of calcium(500mg - daily) & vitamin-D3 (Cholecalciferol 60,000 I.U - monthly) supplements for a year and continue with zoledronic treatment for next 2 years.

gleb 8y ago
Consider watching lectures by Dr. John Bilezikian on YouTube. He is one of the top osteoporosis doctors in the world. Here's a link to the first one in the latest series, but all his stuff on YouTube is great: https://www.youtube.com/watch?v=vnOQsYYalyQ https://www.youtube.com/watch?v=vnOQsYYalyQ To your question, no, you would expect BMD to be a function of person size. Because it's not actually density. The bigger the person bones are the larger BMD you would see given the same volumetric density. DEXA measures how many grams of calcium fall on a square centimeter, and bigger bones will result in higher numbers. For people close to mean in size the difference is academic, for somebody 3-4 standard deviations below the mean in size not so much. This is covered in Dr. Bilezikian’s lectures. You can also Google [BMD areal volumetric]. In any case, this may not matter, BMD is predictive of fracture risk regardless of size. There seems to be some but not much science there on achondroplasia and osteoporosis. The few papers that pop up do suggest a link. Since you are an outlier I'd consider doing this: -learn more about osteoporosis from these lectures on YouTube -find a facility with a HRPQCT which is a gold standard for diagnosing bone density issues -the doctor who owns this machine is going to be a researcher who should find this case interesting, and will be able to reason from first principles not just follow guidelines, the guidelines that may not be applicable to somebody of an outlier size. Consult with his doctor Feel free to friend me on LinkedIn if you want to talk more.