iDexa Scan

Hi, I had an iDexa scan pre-op.  It showed my percent body fat, lean tissue and that my bones weighed something like 6 pounds for my entire skeleton.  I'm newly menopausal and I'm wondering if this scan is good as an initial bone density benchmark.  I'm concerned about preventing osteoporosis.   Or should I request a referral for a bone density test? 


Cheryl

Actually, I'd say the person to ask this to is Gina.  She has(had) Osteopenia and had the various scans.  i'm sure someone else will chime in, but if you don't get the answer you're looking for, send her a PM. 

Wish I could help.  I had a bone density test and the results were just "good"....

From what I have seen Nutritionists are more apt to order the iDEXA Scans because they are more about weight loss - body fat, lean tissue and weight of bones vs the rest of your body.  In order to determine if you are at risk for Osteopenia or worse off, Osteoporosis - you need a regular DEXA scan which gives you a T-score and Z-score to measure your bone density.  You should definitely get one preop, if you haven't already gotten one.  The fact that you are newly menopausal makes it more important that you get the DEXA scan.   After menopause, you start to lose bone density and one very important thing other then testing is to take the proper amounts of calcium citrate and Dry D3.  After WLS surgery, we develop malabsorbtion, putting us at higher risk for osteopenia and osteoporosis so you need to have scans to compare to

I'm already post op, 10 weeks, RNY.  I wasn't certain if there was any value to the iDexa scan as far as bone density is concerned.   If I understand what you said the iDexa only measures the weight of bones, not density (although I would think they would be somewhat related).  I don't want to order an extra test for nothing, as my insurance isn't that great at covering stuff (it didn't cover the iDexa).  I take calcium citrate (500 mg 2x daily) and dry D3 (1500 IUC 2x daily) , plus theres additional calcium and D3 in my multi.  I do weight bearing exercises and cardio (jogging, elliptical and biking).  I'm probably a low risk, but don't want to be stupid and ignor the possible.  

Thanks for the response.   

I can't swear that the iDEXA doesn't do the bone density I just know my Endocrinologist told me not to bother with it, the most important test to do to determine your risk or your actual status of osteopenia or osteoporosis is the regular DEXA scan.  They scan your hip and spine, in some cases they do your wrist.  For me they just do my hip and spine.  The most important reason to get the DEXA scan at the beginning is for baseline, so you can see how much things change over time.  We need to get them atleast every 2 years and some doctors prefer yearly after gastric bypass surgery due to our malabsorbtion.

As far as your supplementation, you aren't taking enough calcium and probably not enough vitamin D3. For calcium - it is recommended to take a minimum of 1500-1800mg per day of calcium citrate. So, if you are taking 500mg at a time - you need to take 3 doses.  What type of calcium citrate are you taking - citrical or chewables?  As far as your vitamin D3 - do you know your vitamin D level?  75% of the population are vitamin D deficient and WLS patients, that number is even higher, making necessary supplementation dosage to be pretty high.  2,000-3,000 units per day is great for a non-surgical patient that is trying to keep good levels stable.  If you are low to begin with, you need a great deal more.  I can't just the exact dosage without knowing your vitamin D level though.

You can't count the calcium and vitamin D in your multi - the calcium is most likely calcium carbonate which we can't absorb and the vitamin D is D2, which we can't absorb either.

At 3 months which is very soon for you, you need a full blood workup - make sure they do calcium, vitamin D 25hydroxy and PTH.  If you need the full list for the workup, feel free to ask and I will gladly send it to you.

I agree with Randi. Your GYN should be able to order a baseline DEXA Scan if you are close to menopause and now you're at even more risk as you lose weight this year. Even if your labs are perfect and you take 1,800 - 2,400mgs of calcium citrate and 20,000IUs of dry D3 a day, you could end up with some bone lose just because you're dropping a lot of weight. That's what happened to me. There's recent article just published about WLS patients and unexpected bone loss. You, your PCP and GYN might need to read it. I'll post the link as soon as I find it again.

--gina
  

Here's the link to the article. You can click on the download full pdf article in the upper right hand block.
http://www.hindawi.com/journals/jobes/2011/634614.html

--g

ETA: I'm currently getting an error when I use the link. I don't know if it's a bad link or they just know I've downloaded the paper. Give it a try and if it doesn't work for you, PM me with an email addy and I'll send you the paper as an attachment.