Dexa scan referral advice

[Yetanotherproblem]

Are there any GPs or radiographers around who can help please?

I'm trying to find out if there are NICE guidelines on when a GP should refer someone for a bone density scan.

I had a dexa scan about 18 years ago (mid 40s) and was told I was in the osteopenia stage.

I have had low BMI (18.5 or under) all my life and was found to be vitamin D deficient last year so was given a prescription for 3 month to get my level back up. Mum and her mum had osteoporosis and I'm concerned I have it too and have missed out on years of treatment. I've not broken any bones but am worried about my future bone health.

Has your GP refused to refer you for a dexa scan?

I'm not a Dr but if you go on this page and click 'download guidance' it gives you the guidance from 2017. It does say that these guidelines are being updated.

https://www.nice.org.uk/guidance/cg146

It says that you should be risk assessed for fragility fractures if female and over 65, not sure if you are 65 yet but it does say to do one if other risk factors present- your GP will need to decide this but it sounds like you do. Then once your risk score is calculated, they can refer for a Dexa scan.

Have you seen your GP about this already? Hopefully one will come along to the thread shortly.

Thank you Nursemumma92. I had looked at that page but it didn't seem to state if/when it would be mandatory for a GP to refer someone.

I've not be refused, Perroi, but am trying to find out if I should have been sent years ago, eg after menopause.

I was finally referred a few months ago but only after a CT scan for something else picked up significant changes in my neck. Even then I had to push for the referral. I have now had the scan and am waiting for the report. The radiographer was surprised I'd not been checked much earlier.

As the Nice guidance states a FRAX score should be done first before referral for a DEXA scan. This indicates when a DEXA scan might be advised e.g. at 10%. Your Dr should also have discussed/ be able to discuss lifestyle measures to help - exercise, diet etc. https://theros.org.uk

Vitamin D can be bought cheaply OTC. Everyone should take this during the winter months with some people taking it all year round. This is important to help metabolise calcium, espically in menopause. Sometimes a test might be done to check it’s being absorbed or a higher dose advised. https://www.nhs.uk/conditions/vitamins-and-minerals/vitamin-d/

My GP didn't discuss anything with me when he prescribed the vitamin D but I've continued with OTC vitamin D since I finished the prescribed course.

GP referred me for the scan when a consultant (who is dealing with my other health issue) suggested that it would be a good idea. I'm just trying to understand whether the GP should have referred me a long time ago.

This would probably depend on what guidelines there were at the time. Google says that FRAX was launched in 2008 and you should be able to check online when NICE Osteoporosis guidelines were launched and changes over the years.

Maybe look at discussing future bone health with your Dr from now. Treatment options for bone health where needed have changed and improved over the years and lifestyle measures can be discussed to help

I will do that - thank you, over50andfab