[{"@context":"https:\/\/schema.org\/","@type":"Article","@id":"https:\/\/betterbones.com\/testing\/problems-with-bmd-testing\/#Article","mainEntityOfPage":"https:\/\/betterbones.com\/testing\/problems-with-bmd-testing\/","headline":"My biggest beefs with BMD testing","name":"My biggest beefs with BMD testing","description":"Print PDF eBook Facebook Twitter Gmail LinkedIn Pinterest Table of Contents Toggle   4 Minutes Read7 Problems with Bone Mineral Density (DEXA) TestingQuick Take1) Error rates are high\u2014and many are serious2) Many sources of technical error3) Bias against smaller or thinner bodies4) Bone density does not measure bone strength5) DEXA alone can\u2019t predict who will fracture6) […]","datePublished":"2025-10-13","dateModified":"2026-04-22","author":{"@type":"Person","@id":"https:\/\/betterbones.com\/author\/brownbetterbonesgmail-com\/#Person","name":"Dr. Susan E. Brown, PhD","url":"https:\/\/betterbones.com\/author\/brownbetterbonesgmail-com\/","identifier":72,"image":{"@type":"ImageObject","@id":"https:\/\/secure.gravatar.com\/avatar\/8e08d87bd45250c6616e1752933a6576aba077f335d97ee337a0cde5e435cbd3?s=96&d=mm&r=g","url":"https:\/\/secure.gravatar.com\/avatar\/8e08d87bd45250c6616e1752933a6576aba077f335d97ee337a0cde5e435cbd3?s=96&d=mm&r=g","height":96,"width":96}},"publisher":{"@type":"Organization","name":"Center for Better Bones","logo":{"@type":"ImageObject","@id":"https:\/\/betterbones.com\/wp-content\/uploads\/2018\/12\/Better-Bones-AMP.png","url":"https:\/\/betterbones.com\/wp-content\/uploads\/2018\/12\/Better-Bones-AMP.png","width":150,"height":60}},"image":{"@type":"ImageObject","@id":"https:\/\/betterbones.com\/wp-content\/uploads\/2025\/10\/bmd-testing.png","url":"https:\/\/betterbones.com\/wp-content\/uploads\/2025\/10\/bmd-testing.png","height":1109,"width":2120},"url":"https:\/\/betterbones.com\/testing\/problems-with-bmd-testing\/","video":{"@context":"http:\/\/schema.org\/","@type":"VideoObject","@id":"https:\/\/www.youtube.com\/watch?v=EvPSfn90HCE#VideoObject","contentUrl":"https:\/\/www.youtube.com\/watch?v=EvPSfn90HCE","name":"Top 7 PROBLEMS with BONE DENSITY Testing","description":"Getting a #BoneDensity test? Here\u2019s why those #DEXAscan results might not be as accurate as you think. \u2757\n\nThis video explores the common problems with #BoneMineralDensity testing, including the high rate of errors that can lead to #Misdiagnosis. Dr. Brown explains why #DEXA bone scan results can be misleading for certain body types and what this means for your #Osteoporosis testing and long-term #BoneHealth.\n\n\ud83d\udc49 Want a more reliable path forward? Check out Dr. Brown\u2019s Better Bones Solution, a natural, step-by-step program for building and maintaining strong bones: https:\/\/drbrown.cc\/bonehealthcourse\n\n#BoneHealth #OsteoporosisSupport #BetterBonesSolution #BoneStrength #DEXAScan","thumbnailUrl":["https:\/\/i.ytimg.com\/vi\/EvPSfn90HCE\/default.jpg","https:\/\/i.ytimg.com\/vi\/EvPSfn90HCE\/mqdefault.jpg","https:\/\/i.ytimg.com\/vi\/EvPSfn90HCE\/hqdefault.jpg","https:\/\/i.ytimg.com\/vi\/EvPSfn90HCE\/sddefault.jpg","https:\/\/i.ytimg.com\/vi\/EvPSfn90HCE\/maxresdefault.jpg"],"uploadDate":"2025-08-20T17:12:02+00:00","duration":"PT1M24S","embedUrl":"https:\/\/www.youtube.com\/embed\/EvPSfn90HCE","publisher":{"@type":"Organization","@id":"https:\/\/www.youtube.com\/channel\/UCm6Zry9uGdrZpm05sQLIxMw#Organization","url":"https:\/\/www.youtube.com\/channel\/UCm6Zry9uGdrZpm05sQLIxMw","name":"Dr. Susan E. Brown","description":"Dr. Susan E. Brown, PhD, is a medical anthropologist, a New York State Certified Nutritionist, and the author of Better Bones, Better Body -- the first comprehensive look at natural bone health. Dr. Brown specializes in osteoporosis, osteopenia, bone health regeneration, and auto-immune disease. She is also famous for her natural approach to bone health; check out her Better Bones programs and products.","logo":{"url":"https:\/\/yt3.ggpht.com\/ytc\/AIdro_m0l08uY9k8RO1FbN8-VsYIOa8fiq9BtocNNM_k3xw7a7s=s800-c-k-c0x00ffffff-no-rj","width":800,"height":800,"@type":"ImageObject","@id":"https:\/\/www.youtube.com\/watch?v=EvPSfn90HCE#VideoObject_publisher_logo_ImageObject"}},"potentialAction":{"@type":"SeekToAction","@id":"https:\/\/www.youtube.com\/watch?v=EvPSfn90HCE#VideoObject_potentialAction","target":"https:\/\/www.youtube.com\/watch?v=EvPSfn90HCE&t={seek_to_second_number}","startOffset-input":"required name=seek_to_second_number"},"interactionStatistic":[[{"@type":"InteractionCounter","@id":"https:\/\/www.youtube.com\/watch?v=EvPSfn90HCE#VideoObject_interactionStatistic_WatchAction","interactionType":{"@type":"WatchAction"},"userInteractionCount":5155}],{"@type":"InteractionCounter","@id":"https:\/\/www.youtube.com\/watch?v=EvPSfn90HCE#VideoObject_interactionStatistic_LikeAction","interactionType":{"@type":"LikeAction"},"userInteractionCount":217}]},"about":["Testing"],"wordCount":838,"articleBody":" Print PDF eBook\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tFacebook\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tTwitter\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tGmail\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tLinkedIn\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tPinterest\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tTable of ContentsToggle     4 Minutes Read7 Problems with Bone Mineral Density (DEXA) TestingQuick Take1) Error rates are high\u2014and many are serious2) Many sources of technical error3) Bias against smaller or thinner bodies4) Bone density does not measure bone strength5) DEXA alone can\u2019t predict who will fracture6) Machine brand & site differences distort comparisons7) Calibration and interpretation issues are commonSo\u2026what should you do instead?Related Better Bones resourcesFAQDoes low bone density mean I\u2019ll fracture?Should I start medication based on one DEXA?How often should I repeat DEXA?7 Problems with Bone Mineral Density (DEXA) Testing\u201cTake your bone density test with a grain of salt.\u201d That\u2019s how Dr. Susan Brown often opens conversations with clients\u2014because while DEXA (DXA) is a common tool, it comes with real limitations and pitfalls that can confuse patients and even lead to mistreatment.Quick TakeBone density \u2260 bone strength.Most fractures occur in people without \u201costeoporotic\u201d BMD.Technical and interpretation errors are common.Body size and machine differences skew results.1) Error rates are high\u2014and many are seriousDr. Brown notes that a large share of bone density reports contain errors, and a substantial portion of those can be clinically significant\u2014leading to misdiagnosis or overtreatment. Even small reported changes (\u00b11\u20132%) often fall within normal variability and are not worth panicking over.2) Many sources of technical errorOperator technique and analytic choices matter\u2014a lot. Misplacement on the table, incorrect region-of-interest selection, or line-drawing can all alter the result. Dr. Brown has long cautioned that DEXA\u2019s accuracy and reproducibility are imperfect (how accurate is DEXA?), so single data points shouldn\u2019t drive major treatment decisions.3) Bias against smaller or thinner bodiesDEXA can underestimate density in small, thin, or short individuals, contributing to unnecessary worry or labeling. See Dr. Brown\u2019s discussion of size-related bias in bone density testing and why \u201cthin but strong\u201d is possible when bone quality is high (Bone Quality Thinner Women).4) Bone density does not measure bone strengthBMD is a measure of mineral content\u2014not toughness, flexibility, or microarchitecture. That\u2019s why Dr. Brown emphasizes complementary ways to assess bone quality (e.g., Trabecular Bone Score) and bone turnover (NTx test).5) DEXA alone can\u2019t predict who will fractureMost so-called \u201costeoporotic\u201d fractures occur in people with osteopenic or even normal bone density. DEXA is one risk factor among many (BMD does not predict fracture; density tests aren\u2019t enough). A broader assessment of risk (history, falls, meds, inflammation, nutrition, strength, balance, etc.) is essential (3 ways to predict fracture risk).6) Machine brand & site differences distort comparisonsHologic vs. GE Lunar outputs aren\u2019t directly interchangeable. For trend tracking, try to test on the same brand, in the same facility, with the same operator whenever possible (why same machine matters; what happens when machines change).7) Calibration and interpretation issues are commonInadequate machine calibration and hurried or outdated interpretations can skew results. Dr. Brown encourages learning the basics\u2014like the difference between the T-score and Z-score\u2014so you can have an informed conversation with your provider.So\u2026what should you do instead?If you test, test smart: use the same brand\/site\/operator when possible, and don\u2019t overreact to tiny changes.Widen the lens: consider bone quality (e.g., TBS) and turnover (e.g., urine NTx), balance\/falls risk, muscle strength, medication and health history, and nutrition.Think beyond density: explore emerging tools like REMS ultrasound that may better reflect bone strength without radiation.Related Better Bones resourcesHow accurate is a DEXA bone density test?Small changes in bone density results\u2014should you worry?Bone density tests aren\u2019t enough\u2014why a fracture risk assessment is essentialBMD does not predict fractureThe infamous T-score & neglected Z-scoreDEXA scan: help for understanding your resultsBone quality in thinner womenFAQDoes low bone density mean I\u2019ll fracture?Not necessarily. Many fractures occur in people with osteopenic or normal BMD. Risk is multifactorial\u2014look at the whole picture.Should I start medication based on one DEXA?One snapshot is rarely enough. Discuss trends, other risks, and secondary testing with a knowledgeable provider.How often should I repeat DEXA?It depends on your personal risk and whether results will change management. When you do repeat, aim for the same brand\/site\/operator.SEO keywords: bone mineral density testing; DEXA scan problems; osteoporosis diagnosisSuggested URL: \/testing\/7-problems-with-bone-mineral-density-testing\/ About the AuthorDr. Susan E. Brown, PhDNew York State Certified Nutritionist & Medical Anthropologist  |  Founder, Center for Better BonesDr. Brown has dedicated more than 40 years to bone health research, clinical nutrition, and health education. She is the founder of the Center for Better Bones and the Better Bones Foundation, and author of Better Bones, Better Body \u2014 the first comprehensive guide to natural bone health. Her whole-body, alkaline-centered approach has helped thousands of women build stronger bones naturally.📖 Wikipedia📚 Amazon Author Page\u2192 Full Bio{  \"@context\": \"https:\/\/schema.org\",  \"@type\": \"Person\",  \"name\": \"Dr. Susan E. Brown\",  \"honorificSuffix\": \"PhD\",  \"jobTitle\": \"New York State Certified Nutritionist & Medical Anthropologist\",  \"description\": \"Founder of the Center for Better Bones and Better Bones Foundation. 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