Hi Reader,

If you are new here, welcome! Last week, I sent an email with the results of my DEXA scan T-scores . This week, I want to take a closer look at another part of the report. It may be part of your DEXA report as well. Let's look at and interpret the TBS scores.

What is TBS?
TBS stands for trabecular bone score. It is a way to assess the quality of your bone structure, not just the density. The T-score tells us about the density of our bone, but the TBS numbers provide insight into the quality of the bone, specifically its microarchitecture.

I had my DEXA, and my T-scores indicated osteopenia. Here is what my TBS report looked like:

In this color-coded chart on the right (not the mapping image):

• Green = normal bone microarchitecture
• Yellow = slightly degraded
• Red = degraded

You’ll see my little dot lands in the green zone—above average for my age (56), which is encouraging. The dot indicates my combined average TBS at L1-L4, which is 1.383.

In addition to the color chart, there is also a Results by region section, which includes my TBS score, the T-score, and the Z-score . Go ahead and ignore the Z-score. We are looking at the TBS numbers today.

In my experience, DEXA reports do a poor job of indicating which numbers you should be looking for. My research suggests a TBS of 1.350 or higher is considered good bone quality.
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If you look at my TBS row:

• L1 = 1.292 (lowest for me)
• L2 = 1.333
• L3 = 1.445
• L4 - 1.459
  Add them up and divide by four = 1.383.​
  The average TBS of my Lumbar Spine is ABOVE 1.350

These numbers tell me that even though my T-scores indicate I have osteopenia, my TBS suggests my bone quality is still relativ ly strong. That matters!

The takeaway?

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You are not your T-score! The TBS adds a bit of nuance to the big picture, and provides addiitonal information you can use as you make decsions about how to address your bone health.

For me, I have at least 2 days a week of specific weight training, 2 days of osteopenia-friendly specific yoga, 2 days of spin class, at least 2 long walks, and whatever else feels good. Sometimes a hike, sometimes an ebike ride, last week 9 holes of golf. You ge the picture, there is not much I am not doing.

I'll talk a bit more about the FRAX tool next week. Stay tuned and for now, if you’ve had a DEXA scan and want to know more about what your numbers mean, you’re in the right place

If you would like to get started with me this fall and join a group of strong women as we lift, balance, and stretch, I invite you to sign up for my waitlist now (see below). Fall dates will be coming to you next month!

All my best,

If you’re looking for a structured plan to keep your bones strong, join the waitlist for Strong Women, Strong Bones. We’ll work together to build strength, balance, and confidence—all in a way that feels good and works for you. I will get the specific dates out to you next month, but by being on the waitlist, you will receive the information first, along with additional details on bone health and staying strong.

🔗 Join the Waitlist Here​

The information provided is for general educational purposes only and is not intended to serve as medical or physical therapy advice to any individual. Please consult with your physician before starting any new exercise program. Any exercise has the potential to cause injury or physical problems.

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