REMS Test for FUNCTIONAL Bone Health - A Better Evaluation than DXA and Without Radiation

#113 2025 The Rowen Report

Dear Subscriber,

Half the population of the planet has a significant concern with age. That’s because half the population are women. While this condition does affect men, it is far worse and more common in women. Women have a 50% lifetime risk of a fracture after age 50 compared to 20% in men.

An American sweetheart, Sally Fields, innocently sold out to Pharma to sell women on Boniva to “prevent” bone fractures from osteoporosis. And based on some amazing new information, you just may have been spoon fed a bunch of useless and possibly dangerous information about osteoporosis and you.

I just conducted a podcast with an orthopedic surgeon, Dr Andy Bush, whom Terri and I met some weeks ago by accident. He was conducting some testing at a dental office where Terri had an appointment. We both were invited to check it out. I was quite intrigued at a major advancement in osteoporosis assessment with technology developed in Italy which, I believes leaves the traditional American DXA scanning in the trash can.

The DXA scan is based on how well target bones block x-ray radiation. The better your bone blocks the x-ray beam, the denser your bone. That is unequivocal. But DXA scores do not translate to actual fractures or fracture risk. Furthermore, DXA does not know what is blocking the x-rays. Is it good bone? Dense but brittle bone? So many people with what appears to be porous bone never get fractures, and many with want appears to be dense bones, bust up their bones with a simple fall. What gives?

DXA looks at bone density, not bone structure. Your fracture risk is not a simple measure of density. A medical condition called Paget’s disease is one of very dense, but highly brittle and fracture prone bone. Consider a piece of chalk vs a pencil. The chalk will score high on Dexa DXA density testing, compared to the pencil. But drop both and you will see the chalk fracture and the pencil unscathed. Same thing with brittle bones when you fall. This is why hips break.

DXA comes with two scores. One, the T score, is your measure against 30-year-old woman – her height of bone density. If you score a minus, it means your density is less than the 30-year-old female ideal. Age alone will cause a diminishment. The Z score compares you to people of your own sex and age group. If you score -2 or less, you are two standard deviations below the bone density for your cohort, and your conventional doctor will interpret that as a high risk for fracture and you will likely be peddled highly dangerous drugs to “harden” your bones. But remember, chalk is harder than a pencil, but the chalk might shatter, while the pencil’s flexibility structure preserves it. So, density measure alone is not your answer to your risk.

Italian researchers have developed a far better and more relevant test. Instead of x-rays, it evaluates you by sound waves (ultrasound) sent into your bone and the echoing back to a receiver. Many, many factors go into an echo other than density alone. The richness of an echo like that of a canyon, will depend on other than the hardness of the walls. The texture of the canyon, the angle of the walls, the pitch, etc.

Likewise, in your bone, there is more than calcium. There are protein, collagen, water, other fluids and molecules. Collagen is that which keeps the bone together and grants its flexibility. All of these factors make bone resistant to fracture.

The REMS test (Radiofrequency Echographic Multi Spectrometry) collects the richness of the composite echo of your bones. It then compares your result to something quite useful – a collection of scores of people who:

1. Never got a fracture.

2. All got a fragility fracture

So, what if your bones are not dense, but your pattern matches 100% of people who never got a fracture (green zone). That is where I want to be. And you might well be concerned if your bones are very dense, but your echo falls into a pattern where all got fractures (red zone). This is not a good zone. And, you can also fall into a “yellow” area where some got fractures and some did not. To me, this information is far more useful than simply testing for mere bone density, where your bones could be dense but like chalk.) would be, what I call, a truly functional test, testing for the functional quality of my bone.

I recently had such a test after seeing it being performed in a nearby Marin County office. I fell in a mixed zone, actually overall quite good, but the final report showed minor risk. Terri also did very well. But I did not like seeing any risk. Further investigation into my report revealed that the “risk” was due to my age, NOT the scan. And, when age was removed, I fell into a quite good risk profile - a topic for a future article.

Here you can see, at first blush, that I bordered the caution (yellow) zone with the riskier (red) zone. But age is factored in as well with this graph, and as people get older, risk naturally goes up even absent the scan factor. For me, when age was removed from the risk profile, I fell into the green zone simply based on bone ultrasound results compared to the entire population irrespective of age.

I never cared for the DXA scan, but that is all we had. I like this one much better and we will be recommending it to anyone at risk, which includes most post-menopausal women. Men are more resistant to fractures due to slower decline of sex hormones.

If you have interest in this scan, please visit

http://www.osteoscanusa.com/

. There are good explanations there. And, if you schedule, you can get a discount off the cost using the discount code Rowen10, which I was able to obtain for my subscribers.

Finally, a word about how modern medicine treats “thinning” bones. Typically, if you get a low DXA score, your doctor will rush to dump in a Pharma potion into you. Sally Fields choice was Boniva, which belongs to the bisphosphonate class of drugs. These are literally poisons. They kill cells called osteoclasts which your body needs to eat up and get rid of older less robust bone, to make way for newly made and robust bone constructed by osteoblasts. There are some major downsides to these drugs. If you don’t remove old bone, the bone will become denser (looks good on DXA scan), but more brittle. Not good. Furthermore, these drugs (not infrequently) induce a very hard to treat condition in the jaw called “osteonecrosis” where areas of jawbone die and fail to heal.

Here is what AI has to say:

Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is a rare but serious condition where jawbone is exposed and fails to heal, sometimes after a dental procedure. Bisphosphonates, a class of drugs used to treat osteoporosis and bone cancers, are a primary risk factor, especially with long-term use or high doses. Symptoms include pain, swelling, and exposed bone in the jaw, and management ranges from conservative measures like mouthwashes and antibiotics to surgical intervention in more severe cases.

What it is

· A condition where bone in the jaw is exposed and does not heal for at least eight weeks.

· Associated with bisphosphonate medications, which are used to treat conditions like osteoporosis and bone cancers.

· The risk is higher for patients receiving high-dose intravenous bisphosphonates (often for cancer) compared to those taking oral bisphosphonates for osteoporosis.

· The jaw is more susceptible due to the high concentration of bisphosphonates in the area, the need for rapid bone turnover for chewing, and the thin lining of the oral mucosa.

I believe there are far better, and certainly safer, remedies for osteoporosis than cellular poisons. We construct an individualized approach for those at risk. Taking more calcium is not necessarily the answer, and may be detrimental. Above all, if you are a cola drinker, stop immediately. The phosphates in colas directly pull calcium out of your body. Also, a carnivore diet, while reportedly beneficial in other respects, creates bone loss risk by denying your body the minerals and other nutrients found in plants needed for solid and flexible bones. It also is more acid, which will leach calcium as well. You don’t need to be vegetarian. Just please eat wisely as I cover in these reports. Finally, bone responds best to stress. Stress here means torque. That, according to my research, is a most important factor in preserving your bones.

To Your Excellent Health!

Robert Jay Rowen, MD

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