Big White Bones

What does it mean when you have dense bones?

I think some of these answers need refinement. The most obvious is that even if you have “dense bones” you may weigh just a few pounds more than a person with the same BMI who has less dense bones. “I have big bones” is not an excuse for obesity.

First of all, let us define “normal bone density” medically. I will get to “denser” later.

Bone Mineral Density Levels

Normal bone mineral density (BMD) is indicated by a zero or above T-score. A T-score compares your bone mineral density to that of a healthy young adult. A score below -1.0 indicates a lower-than-normal bone density, while a score between -1.0 and -2.5 suggests osteopenia, a less severe form of low bone mineral density. A T-score of -2.5 or lower indicates osteoporosis.

High bone mineral density is typically defined as a BMD greater than two standard deviations above what is expected for age. Some sources suggest a Z-score greater than +2.5 indicates a high BMD. However, a high BMD may not always be beneficial, as it can sometimes be associated with conditions that increase fracture risk or may result from artifacts that do not affect fracture risk but can mask low BMD.

Advantages and Disadvantages of High Bone Mineral Density

High bone mineral density (BMD) generally indicates stronger, denser bones, which can offer several advantages, but also comes with potential disadvantages. Advantages of high bone mineral density include:

Reduced Fracture Risk: Higher BMD typically means bones are stronger and less likely to break, reducing the risk of fractures.
Better Support and Stability: Stronger bones provide better support for the body, improving overall stability and reducing the risk of injuries.
Enhanced Physical Performance: Strong bones contribute to better athletic performance and the ability to engage in physical activities without fear of bone-related injuries.
Protection of Internal Organs: Dense bones offer better protection for internal organs, which can be vulnerable to damage in individuals with low bone density.
Disadvantages of high bone mineral density include:

Increased Risk of Certain Conditions: High BMD can sometimes be associated with conditions like osteopathia striatae* with cranial stenosis or sclerosteosis, which can cause complications such as compression of cranial nerves and increased intracranial pressure.
Potential for Bone Pain. In some cases, high BMD can lead to bone pain, particularly if the bone density is due to a genetic condition that affects bone structure.
Risk of Complications from Genetic Conditions: Some genetic conditions that cause high BMD, such as LRP5 HBM*, can lead to complications like spinal stenosis, craniosynostosis, and other neurological issues.
Challenges in Diagnosis and Management: High BMD can sometimes be challenging to diagnose and manage, especially if it is due to an underlying genetic condition that requires specialized treatment.
Limited Treatment Options: For some genetic conditions that cause high BMD, there are limited treatment options available, making management more difficult.
Complications of Increased Bone Density

*Osteopathia striata with cranial sclerosis (OSCS) is a rare genetic entity characterized by osseous abnormalities. Symptoms and their severity vary person-to-person but generally, people with OSCS have generalized dysplasia of the distal parts of the long bones, cranial sclerosis (that is, the hardening of bones in the face and head), macrocephaly (abnormally large head), and cleft palate. Developmental delay, hearing loss, and congenital heart defects, alongside feeding and breathing (dyspnea) difficulties are common as well, although they are not seen in all cases.

The feeding and breathing difficulties that are sometimes associated with OSCS can result in starvation, nutritional deficiencies, and/or respiratory arrest if they remain untreated, which may result in early death.

Treatment

Although OSCS has no cure, it can be treated and managed. Treatment is symptom-specific, for example: avoiding areas with air pollution (e.g., big cities, smoking areas, etc.), high-altitude areas, and physically exhausting activities can reduce breathlessness episodes (breathing difficulties).

This condition is caused by X-linked dominant mutations in the AMER1 gene, in the X chromosome.

*LRP5 High Bone Mass (HBM) is an autosomal dominant disorder caused by mutations in the LRP5 gene. It is characterized by elevated bone mass due to enhanced osteoblast-mediated bone formation. Here are some key points about LRP5 HBM: Discovery and Naming: The condition was first described by Worth and Wollin in 1966 and was historically referred to as “Worth disease” or “autosomal dominant osteosclerosis.” It was later identified as being caused by mutations in the LRP5 gene in 2002.

Clinical Features: Patients with LRP5 HBM often exhibit facial changes, such as a broad jaw and torus palatinus (a bony growth on the palate). Other common features include elevated levels of serum alkaline phosphatase and cranial nerve deficits, which can lead to symptoms like headache, hypo-/anosmia, and complete mixed deafness.

Treatment and Management: Management of LRP5 HBM focuses on addressing symptoms and complications, such as neurological issues and dental problems. There is currently no specific treatment for the condition, but ongoing research may lead to new therapeutic options.

Links for more provided by Wikipedia.