What Conditions & Factors Affect Bone Density?

Medical conditions

Many medical and autoimmune conditions affect bone density, including:

  • Liver disease
  • Kidney disease
  • Celiac disease
  • Small bowel absorption issues
  • Rheumatoid arthritis
  • Hyperthyroidism
  • Hyperparathyroidism


Our genetics, diet, and sex hormones allow us to achieve the greatest density in our mid-twenties. After that time, the density decreases over time. We can see the most significant changes in women's density after menopause because their hormones are much lower. Men exhibit the most significant decrease in density after age 50 when testosterone decreases. Our diet and nutritional access play a substantial role in developing peak bone density and can help maintain normal bone mass. A diet rich in calcium is essential at all age levels. Foods that are rich in calcium include:

  • Milk products
  • Most vegetables
  • And most supplemented foods


The average American has an adequate calcium intake until they become older. The elderly have several obstacles to overcome in meeting adequate dietary calcium intake. For example, as we age, we lose our sense of taste and have other medical problems. Medication may make it harder to maintain adequate food intake. Thus, many patients who struggle with nutrition supplement with over-the-counter calcium. We do not make our own active Vitamin 3 — either we can get enough sun exposure to allow our skin to convert the inactive to the active form, or we can consume supplemental vitamin D3. Vitamin D3 levels are not routinely tested, but for some conditions, it may be recommended, such as:

  • Underlying renal
  • Liver
  • Small bowel absorption problems
  • Or thyroid conditions

Family history

We know that family history is a significant risk factor for osteoporosis. If your first-degree relatives have been diagnosed with osteoporosis, you may be at risk. For example, if a close relative suffered an osteoporotic fracture, that is considered an even stronger indication of your future fracture risk. The opposite is also true. If your immediate family members had excellent bone density, you may too.

Hereditary factors also influence peak bone density. Your body weight and height affect the stimulation of bone cortical thickening. A thicker bone cortex is necessary to hold a heavier frame. But, low body weight is a significant risk factor for low bone density. A loss of height of greater than 1/2 inch over a one-year interval is also considered a significant risk factor. 

Prior fractures

Your history of prior fractures may influence your future risk for fracture. It depends on the circumstances that caused the fracture in the first place. If you suffered a fracture from minor trauma, your fracture might be considered a "fragility" or "insufficiency" fracture. If you had a traumatic injury such as a car accident, then this history should not be used to predict your future risk.

Other factors

Some medicines, like corticosteroids and overtreatment with thyroid supplements, can affect bone density. Smoking and excess alcohol consumption also affect bone density.

What to Expect With a DEXA Bone Density Scan

We want to make you as comfortable as possible during your DEXA bone density scan. Here’s what you can expect for your procedure.

Preparing for the DEXA Scan
  • Do not take calcium tablets or other large mineral tablets. The tablets may still be in the bowel and overlap on spine images.
  • Avoid wearing clothes with metal buttons or naval jewelry. A two-piece outfit with an elastic band is optimal.
  • Download the BONE DENSITY Forms under the Resources tab within "Patients forms." 
    • Please bring the completed forms to your appointment and wear an appropriate outfit for your visit. If you cannot prepare for this, don't worry. Come at least 15 minutes early, and we will have you complete the questionnaire onsite and change you into comfortable medical scrubs.


During the DEXA Scan

You will lie on a soft paddled table starting on your back. The technologic will position you in the middle of the beam. The medical x-ray tube moves across your spine. Another scanning device in the table, called a photo generator, passes beneath you. "Dual Energy" in the name DEXA comes from using these two types of energy. After the lumbar spine bone density image is acquired, you will be positioned on your side to obtain the Lateral Vertebral Assessment (LVA).

Historically, the left hip is typically selected to measure bone density. If there is a reason that your hip densities would not be symmetrical (such as one leg being much shorter than the other), let the technologist know so she can measure both hips. The exam will only take 10 - 15 minutes to complete. 

We can scan the opposite hip if you have had a hip joint replacement. If you have had both hips replaced, we can omit that score and select the forearm instead. 

We will scan your forearm if you have an underlying medical problem with your serum calcium. Hyperparathyroidism also applies here, and we need to scan your forearm.

Please let your technologists know in advance if you cannot assume these positions. They will be able to alter the examination to accommodate your needs.  

After the DEXA Scan

Once the exam is complete, the results will be determined by a specialized radiologist. Once complete, the results will be sent via letter to the patient and their desired physician.


What Do The Bone Density Results Mean?

  • A T-Score of -1.0 or higher is normal.
  • A T-score -1.0 to -2.5 is low bone density (osteopenia).
  • A T-score -2.5 or greater (more negative) is osteoporosis.


Find a DEXA Bone Density in Denver

Meet Our Specialists

The Women’s Imaging Center uses a unique patient-centric model you won’t find anywhere elsewhere. Our highly qualified team is composed of technologists, radiologists, doctors, and staff who are dedicated to ensuring you have an exceptional experience. Discover the difference with our specialists, who elevate women's care in Denver and beyond.

Kelly McAleese, M.D.

Timothy Colt, M.D.

Barbara Jaegar, M.D.

John Lewin, M.D.


Frequently Asked Questions About Bone Density Scans

What is a Bone Density Scan?

A Bone Density Scan is technically called Dual Energy X-ray Absorptiometry (DEXA). It uses low-dose X-rays from different angles projected at bones in the spine, hip, or wrist to measure the density or mass of the bones and test for osteoporosis, a condition that causes bones to become weak and brittle. Other names for this test are Bone Mineral Density (BMD) or Dual X-ray absorptiometry (DXA). 

How is a Bone Density Scan (DEXA) done?

A bone density scan, or dual-energy X-ray absorptiometry (DEXA), is a simple and painless test that measures bone mineral density. For the test, we will ask you to lie on a padded table and remove any jewelry, metal objects, or clothing that might interfere with the scan. The technician will position you carefully so that the part of your body being scanned is between two X-ray machines. These machines emit low-level X-rays that are absorbed differently by bone and soft tissue.

You will need to lie still and hold your breath for a few seconds while the X-rays are taken. The process is painless and only takes a few minutes. After the scan is complete, the technician will review the images and ensure they are high enough quality to accurately measure your bone density.

How Can I Treat Osteopenia or Osteoporosis?

At the very least, increase your weight-bearing or resistive exercises. Not all exercise is capable of achieving this. Walking up a hill carrying a backpack will improve bone density, while biking will decrease your density. Biking is not resistive since you use a machine to decrease your work. The muscles are not resisting a force.

Also, be sure to take enough Vitamin D3. Taking 1,000 IU/day is enough for most healthy adults, but some may need more. If there is a medical reason why you may not be able to absorb Vitamin D appropriately (like with celiac disease) or convert it to its active form (liver disease), you may want to have your vitamin D3 level measured. 

Are There Any Medications That Can Help Treat Osteopenia or Osteoporosis?

Many medications are available today that improve bone density. These medications work by reversing the proportion of bone turnover or anabolic building new bone (PTH). Bone is a dynamic organ — it is constantly building up by osteoblasts or breaking down (called remodeling) by osteoclasts. The balance of building and breaking down is normal. Specialists have discovered that by slowing the caustic activity, the blastic activity wins. This results in increased bone density.

Medicines called bisphosphonates are common for treating low bone mass. Bisphosphonates help decrease the rate of bone loss. This process can take around five years to see an increase in bone density. The most common bisphosphonates include Fosamax and Actonel. Other medicines like Boniva can be given as a pill or IV infusion quarterly. Prolia can be used in people with decreased kidney function or in patients who can't take oral medications. Another drug, Reclast, uses IV infusion once yearly. Other anabolic medicines help "build new bone," like Forteo. We recommend all patients speak with their radiologist or primary doctor before taking a new medication. 

Insurances we honor

At the Women's Imaging Center, we accept most major insurance providers and provide affordable self-pay options. If you have any questions about whether we accept your insurance, please contact us at 303-321-2273.


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Find a DEXA Bone Density Scan in Denver

We serve patients in the Greater Denver area, with multiple locations for your convenience. Discover how our fellowship-trained radiologists use bone density exams to provide an accurate diagnosis for bone conditions.