The current standard of care and most widely used measure of bone density is known as dual-energy X-ray absorptiometry, or DXA. This is the best technique available for measuring bone density. However, DXA has one important drawback. It only gives a static measurement of bone density at one moment in time. It does not assess whether bone is actively being broken down. So it’s very possible that a person can have a DXA scan that shows healthy bone density while bone is actively being broken down, leading to eventual osteoporosis and/or fracture. And because these scans are generally done every two years, a person can be lead to believe that their lifestyle is supporting bone health, only to find out two years later that they are worse off than before.
As you may know, bone is living tissue that is constantly being remodeled. Cells that break down bone and cells that rebuild bone are constantly at work. For healthy bone remodeling we need more cells rebuilding bone rather than breaking it down. Unfortunately, a DXA will not reveal this information. However, there is a simple urine test that I recommend all peri- and post- menopausal women have done that can help measure the rate of bone quality and turnover. Men and those at increased risk of bone loss should also consider it.
This test is known as a urinary deoxypyridinoline (DPD) test. Dexypyridinoline is a crosslink of Type I collagen, which is found primarily in bone. The test measures how much of this compound is found in the urine. If there are elevated levels of DPD in the urine, it signifies that bone resorption (or breakdown) is occurring at too rapid a pace, leaving a person susceptible to fracture and/or bone deformation.
A urinary DPD should be considered not only for a baseline assessment, but to help determine if those undergoing treatment for lowered bone density or osteoporosis are being managed properly.
Dr. Rob D’Aquila – NYC Chiropractor – Diplomate of the International Board of Applied Kinesiology