Do I Really Need A Dexa Scan?

Updated: September 25, 2024

woman taking dexa scan

Yes, you do! If your healthcare provider has recommended a DEXA scan, that means he’s worried about your bones—and here’s why…

When we’re young, our bones are packed with minerals. That’s what makes them strong. But sometime after our 40th birthday, we start to lose these minerals. And every year, we lose more and more. Which makes our bones weaker and weaker

That’s why half of all women over the age can expect to break a bone due to low bone density, according to the National Osteoporosis Foundation, all because we’re losing the minerals that make our bones healthy and strong. 

A DEXA scan measures the density of these minerals in your bones, allowing your healthcare provider to determine your osteoporosis risk.

What Is a DEXA Scan?

The acronym DEXA stands for Dual Energy X-Ray Absorptiometry, and here’s how it works…

DEXAs use two X-ray beams with different energy levels that are aimed at your bones. One beam passes through soft tissue, while the other passes through your bone. The amount of radiation that passes through your soft tissue is then subtracted from the total to determine your bone mineral density. Thus, DEXA uses a “Dual Energy X-Ray [1].” 

The word absorptiometry describes the amount of radiation absorbed.

Denser bones will absorb more X-ray energy as it tries to pass through, which means that if your bones have lost density, the amount of X-ray energy that passes through will be higher.

Are DEXA Scans Safe?

Bone density scans are very safe. They use a low radiation dose, so it’s not harmful. In fact, it’s about the same as the background radiation that you’d expect flying from New York to London! 

Who Should Get a DEXA Scan?

The National Osteoporosis Foundation recommends that you should a DEXA scan if [2]:

  • You are a woman age 65 or older
  • You are a man age 70 or older
  • You break a bone after age 50
  • You are a woman of menopausal age with risk factors
  • You are a postmenopausal woman under age 65 with risk factors
  • You are a man age 50-69 with risk factors
woman watering plants

Am I At Risk For Osteoporosis?

There are many factors that contribute to bone loss and osteoporosis. Some of these are outside your control.

Gender:  Osteoporosis is more common among women because they have smaller bones and lose estrogen during menopause. Estrogen is key in maintaining bone density, so when its levels fall, the rate of bone loss increases. In fact, studies show that in the five to seven years following menopause, a woman can lose up to 20% of her bone density [3]. 

Age: By the time most people celebrate their 40th birthday, they’ve already begun to lose minerals from their bones. In fact, most people lose around 1% of their bone mineral density per year. This doesn’t sound like much, but it really adds up. By the time you’re 50, you’ve already lost at least 10% of your bone-strengthening minerals. Imagine a house that was missing 10% of its bricks! [4]. 

Family History: You’re more likely to have osteoporosis if you have a family history of osteoporosis or if one of your parents has broken a hip[5].

Osteoporosis is Underdiagnosed

About 10 million Americans have osteoporosis, and 34 million more are at risk, but the weak bones that characterize the condition often go unnoticed until they fracture, most frequently in the hip, spine or wrist. Among the older people most susceptible to osteoporosis, this can present major problems. “The gravity of fractures is often underappreciated when in fact, patients with hip fractures go on to have deterioration in their health linked directly to their fractures, with a high probability of death or nursing home placement,” according to a report from Stanford University School of Medicine.

And yet, despite the serious implications, osteoporosis is woefully underdiagnosed [6,7]. This underdiagnosis was highlighted in a 2021 study involving 235 subjects who had suffered vertebral fractures. Astonishingly, nearly 29% of these people had not been diagnosed with osteoporosis before their fracture occurred. This finding underscores the gap in early detection and diagnosis of osteoporosis, which is crucial for preventing such fractures.[14]

Despite the clear link between fractures and osteoporosis, many patients don’t receive a diagnosis for the latter, even after suffering a fracture. [8] The main reason for this is a lack of follow-up testing by healthcare providers. For instance, a study revealed that only 9% of women underwent bone mineral density tests six months after experiencing a fracture. [9
This underscores the need to advocate for your own bone health. If you believe you might be at risk for osteoporosis or have suffered a fracture, it’s important to discuss the possibility of a DEXA bone density scan with your doctor.

Please Don’t Wait Till You’re 65 For A Scan!

At AlgaeCal, we meet many people in their 50s, 40s, and even 30s who waited too long for a DEXA scan and are surprised to discover they have low bone density. Why wait until 65 to find out? DEXA scans, a critical tool for assessing bone health, are affordable and accessible, typically ranging from $70 to $200. And many clinics offer them without requiring a doctor’s prescription. Investing in your health sooner rather than later allows you to take proactive steps toward bone strength and longevity. Don’t wait for a fracture to tell you what a simple test could have revealed.

What Happens During a DEXA Scan?

DEXA scans are painless, non-invasive procedures. When you go in for your scan, the radiographer ( a specialist taking X-ray images) will have you lay on your back on a flat, open X-ray table. During the scan, you’ll want to be as still as possible to ensure the clarity of the images, with most scans only lasting between 10 and 20 minutes. 

As you lay on the table, a large scanning arm will be passed over your body to measure bone density in various areas. In most cases, your hips and lower spine will be evaluated for density if you’re checking for osteoporosis [10].

What Do My DEXA Results Mean?

Your T-Score represents the difference between your current bone mineral density and that of a healthy young adult. Simply put, it measures your current bone mineral density against someone in the prime of their bone health. This score allows your doctor to determine if your bones are still in good shape if they’re beginning to lose density and you’re entering a phase of osteopenia, or if you are already dealing with osteoporosis [11].

  • If your T-score is greater than -1.0, your bones are considered normal. 
  • If your T-score is between -1.0 and -2.5, your bone mineral density is below normal, and you are diagnosed with osteopenia. Left untreated, osteopenia may lead to osteoporosis. 
  • If your T-score is -2.5 or less, then you will be diagnosed with osteoporosis. 
Dexa results

In addition to your T-score, your report will also provide a Z-score. The Z-score measures your bone mineral density against the average bone mineral density of someone your age and gender. This number helps you see how you’re doing compared to others in your age range. Generally speaking, a T-score is more useful for older folks, while a Z-score is used to determine bone health in children and young adults.

I Take Calcium! Do I Still Need A DEXA Scan?

Many people assume calcium protects them from bone loss. So they load up on calcium-rich foods, stock their refrigerator with calcium-fortified drinks, and even take a good-quality calcium supplement. But it doesn’t work…

That’s because bone loss isn’t a loss of calcium – it’s a loss of all the minerals that collectively hold your bone together. In fact, clinical studies show that it takes a total of 13 minerals and 3 vitamins to make your bones stronger.

So if your calcium supplement contains only calcium, you’re getting just one of the 16 nutrients needed for bone health— you’re 15 nutrients short! And without those missing ingredients, you can’t increase the density of your bones. It’s like trying to bake a cake with nothing but flour!

Remember, the technicians at your DEXA scan aren’t testing your bone calcium density – they’re testing your bone mineral density. 

You don’t need more calcium. You need more minerals. 

In fact, your bones need a precise combination of 13 different minerals. A combination shown in clinical trials to increase bone mineral density– even for people in their mid-80s! 

In addition to calcium, she needed magnesium, boron, copper, manganese, silicon, strontium, nickel, phosphorus, potassium, selenium, vanadium, and zinc.

And if you’re going to protect and rejuvenate your weakening bones, you’ll need all these minerals – not some of them. 

Besides these minerals, you also need specific amounts of vitamin D3, vitamin C, and vitamin K2-7. 

That’s a lot of ingredients! But lacking even a single one of these nutrients can lower your bones’ mineral density. Leaving you weak and vulnerable to a fracture. A fracture that could cause unnecessary pain and expense laid up in the hospital … force you to give up your favorite hobbies … and even land you in a nursing home.

So What Makes A Good Calcium Supplement?

Made From Plants, Not Rocks.

Plant-based calcium is easier on your digestive system. It gives your body the calcium it needs in a form it understands – food.

Contains All The Bone-Building Nutrients, Not Some Of Them

The best calcium supplements contain all the minerals and vitamins needed to build up your bones’ mineral density.

Clinically Supported To Improve Bone Health

You can’t afford to waste time or money on something that won’t work. So only take calcium supplements that have been shown to work in published clinical trials.  Now, there is only one nutritional supplement in the world that ticks all those boxes. It’s the AlgaeCal Bone Builder Pack, and it’s the only natural way to stop bone loss for good.

AlgaeCal Bone Builder Pack

Takeaway

With a silent disease like osteoporosis, it can be hard to catch the signs that something isn’t quite right with your bones. Mostly because there often aren’t any signs. 

That’s why diagnostic testing is the best way to ensure that your bone health is where it needs to be. Keep in mind that osteoporosis is significantly underdiagnosed, and many people don’t realize they’re dealing with weak bones until they have a fracture. Even still, some people with a fracture may remain undiagnosed, setting them up for future breaks. 

Talk to your doctor about whether or not a DEXA scan is right for you, and trust your gut if you think it’s time to look at your bones. Self-advocating may be the difference between undiagnosed osteoporosis and healthy, strong bones as you age. 
Sign up for the AlgaeCal Newsletter to stay updated on all things bone health and healthy aging.

FAQs

Does a DEXA scan show arthritis?

Arthritis won’t show up on a DEXA scan; instead, regular X-rays are used to diagnose arthritis. With that said, advanced osteoarthritis may appear as higher density on a DEXA scan due to potential disc narrowing.

Who should not have a DEXA scan?

While DEXA scans are generally safe, caution is advised for pregnant women or anyone who has received gastrointestinal contrast or radionuclides.

What else do healthcare providers use DEXA scans for?

In addition to bone density, DEXA scans can be used to measure body composition, such as fat and muscle mass.

Article Sources

  1. https://my.clevelandclinic.org/health/diagnostics/10683-dexa-dxa-scan-bone-density-test
  2. https://www.nof.org/patients/diagnosis-information/bone-density-examtesting/
  3. https://www.nof.org/preventing-fractures/general-facts/what-women-need-to-know/#menopause
  4. Demontiero, O., Vidal, C., & Duque, G. (2012). Aging and bone loss: new insights for the clinician. Therapeutic advances in musculoskeletal disease, 4(2), 61-76.
  5. Stewart, T. L., & Ralston, S. H. (2000). Role of genetic factors in the pathogenesis of osteoporosis. Journal of Endocrinology, 166(2), 235-246.
  6. Nguyen, T. V., Center, J. R., & Eisman, J. A. (2004). Osteoporosis: underrated, underdiagnosed and undertreated. Medical Journal of Australia, 180(5), S18.
  7. Siris, E. S., Miller, P. D., Barrett-Connor, E., Faulkner, K. G., Wehren, L. E., Abbott, T. A., ... & Sherwood, L. M. (2001). Identification and fracture outcomes of undiagnosed low bone mineral density in postmenopausal women: results from the National Osteoporosis Risk Assessment. Jama, 286(22), 2815-2822.
  8. Delmas, P. D., van de Langerijt, L., Watts, N. B., Eastell, R., Genant, H., Grauer, A., & Cahall, D. L. (2005). Underdiagnosis of vertebral fractures is a worldwide problem: the IMPACT study. Journal of bone and mineral research, 20(4), 557-563.
  9. https://www.milliman.com/en/insight/medicare-cost-of-osteoporotic-fractures-2021-updated-report
  10. https://www.nhs.uk/conditions/dexa-scan/what-happens/
  11. https://health.ucsd.edu/care/imaging/dexa/
  12. Shanb, A. A., & Youssef, E. F. (2014). The impact of adding weight-bearing exercise versus nonweight bearing programs to the medical treatment of elderly patients with osteoporosis. Journal of family & community medicine, 21(3), 176.
  13. Wang, Z., Zan, X., Li, Y., Lu, Y., Xia, Y., & Pan, X. (2023). Comparative efficacy different resistance training protocols on bone mineral density in postmenopausal women: A systematic review and network meta-analysis. Frontiers in Physiology, 14, 1105303
  14. Casella M, Becciolini A, Di Donato E, Basaglia M, Zardo M, Lucchini G, Riva M, Ariani A, Magalini F. Internal medicine inpatients' prevalence of misdiagnosed severe osteoporosis. Osteoporos Int. 2021 Nov;32(11):2361-2364. doi: 10.1007/s00198-021-05976-6. Epub 2021 May 5. PMID: 33950266.

Article Comments

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  1. Zita Marisa Mendes

    July 25, 2024 , 6:59 pm

    my T-score -2.7im 65yo.

  2. Samantha AlgaeCal

    July 26, 2024 , 10:43 am

    We’re sorry to hear this, Zita! If you’re interested in a safe and natural approach to increasing your bone density, AlgaeCal is the only calcium supplement that is clinically supported to do so! You can always call our Bone Health Consultants at 1-800-820-0184 (USA & Canada toll-free) who would be happy to answer any questions you may have.
    – Sam

  3. Angela

    September 27, 2024 , 10:32 am

    Is there anything to rebuild bones and have osteoarthritis?

  4. Yoori AlgaeCal

    September 30, 2024 , 5:44 pm

    Thank you for reaching out, Angela. AlgaeCal’s Bone Builder Pack has been studied specifically for improving bone mineral density. As for osteoarthritis, you may benefit from our product called Triple Power Fish Oil! It eases oxidative stress through a combination of EPA + DHA omega 3s, turmeric, and astaxanthin. You can learn more about our Bone Builder Pack HERE, and Triple Power Fish Oil HERE.

    Please feel free to give us a call at 1-800-820-0184 (US & Canada Toll-free) or email [email protected] for personalized recommendations! 🙂

    – Yoori

  5. Teri

    August 7, 2024 , 1:16 pm

    Can an HSA be used to pay for your products?

  6. Yoori AlgaeCal

    August 7, 2024 , 3:14 pm

    Thank you for reaching out, Teri!

    Teri, although we accept VISA, Mastercard, Discover, and American Express cards, our system sometimes does not accept payments via a Health Savings Account. We apologize for any inconveniences.

    To our knowledge, some of our community members have been able to get reimbursed for their AlgaeCal supplements through the flex portion of their insurance or their HSA as long as they have a note or “prescription” from their doctor. This would definitely be worth looking into directly through your HSA and seeing if your doctor can provide you with this written note for our supplements!

    Essentially, you would place your order with us and pay, and then submit your receipt and doctor’s note to your HSA for reimbursement. Your doctor would simply have to provide you with something saying that you need these supplements to help with your bone loss, and that should do the trick! Again we do recommend checking in directly with your HSA to see exactly what they would need to be able to provide a reimbursement. 🙂 I hope this helps!

    – Yoori

  7. Catherine A. Greene

    August 18, 2024 , 9:40 am

    Do you know if HSAs cover Algae Cal?

  8. Cheryl

    September 5, 2024 , 2:55 pm

    Do i still need to take my daily calcium and vit d supplements along with this product.
    What are the side effects of your product?

  9. Samantha AlgaeCal

    September 6, 2024 , 6:42 am

    Great questions, Cheryl! The daily dosage of AlgaeCal Plus takes into account dietary calcium to avoid excessive levels of supplementation. The average diet provides at least 500mg and AlgaeCal makes up for the rest! This means you are reaching the recommended 1200mg per day, with all of it coming from body-friendly, whole-food sources.
    Additionally, Vitamin D3 requirements vary greatly from person to person. AlgaeCal Plus provides 1600 IU and the best way to determine if you need additional D3 to have a blood test done.
    Lastly, along with being clinically supported to increase bone density, AlgaeCal showed no adverse side effects in clinical research! The results of our studies demonstrated extraordinary safety via a panel of 45 blood chemistries and a quality of life questionnaire. To review the research, visit our website here! I hope this helps. 🙂
    – Sam

  10. Anne-Marie Hamilton

    September 26, 2024 , 7:34 am

    Can you comment on the special bone density ultrasound scans. I have been told they are more accurate than the Dexa scan and are used exclusively in some European countries, Italy being an example.

  11. B

    September 26, 2024 , 9:25 am

    Does AlgaeCal have any negative impacts on the liver?

  12. Samantha AlgaeCal

    September 26, 2024 , 9:59 am

    B, along with being clinically supported to increase bone density, AlgaeCal showed no adverse side effects in clinical research! The results of our studies demonstrated extraordinary safety via a panel of 45 blood chemistries and a quality of life questionnaire. To review the research, visit our website HERE. Please let us know if you have any questions!
    – Sam

  13. Lorraine Huntley

    September 26, 2024 , 12:46 pm

    Why do you mention only plant and rock sources of calcium and not animal sources like meat, fish and dairy?

  14. Samantha AlgaeCal

    September 27, 2024 , 9:31 am

    Great question, Lorraine! We focus on plant and rock sources of calcium in our article because many traditional calcium supplements come from rock-derived sources. This section was specifically about calcium supplements rather than general food sources. I hope this clarifies this! 🙂
    – Sam

  15. Laurel

    September 26, 2024 , 1:34 pm

    Very good and very understandable article. 😊

  16. Samantha AlgaeCal

    September 27, 2024 , 9:09 am

    We’re glad you’ve found this helpful, Laurel! 🙂
    – Sam

  17. Sally Buehler

    September 26, 2024 , 5:52 pm

    I am disabled and have to use a walker or wheelchair to get around. I am not as mobile as I once was. I use a stationary bike for exercise. I also do leg exercises in a pool. I am doing my best to stay active but I have a neuromuscular disease that causes me to tire easily

  18. Samantha AlgaeCal

    September 27, 2024 , 12:36 pm

    Sally, thank you for sharing this information with us! It’s inspiring to hear how you’re staying active despite the challenges you face. Using a stationary bike and doing leg exercises in the pool are great ways to keep moving! Your determination is truly commendable! If you have any questions, please don’t hesitate to let us know. 🙂
    – Sam

  19. Jacqueline Formato

    September 27, 2024 , 8:58 am

    Great article. Am going to forward to my new doctor.

  20. Yoori AlgaeCal

    September 30, 2024 , 5:37 pm

    Thanks so much for your comment, Jacqueline! We’re so happy you have found this information helpful! 🙂
    – Yoori

  21. Angela

    September 27, 2024 , 10:32 am

    Is there anything to rebuild bones and have osteoarthritis?

  22. Yoori AlgaeCal

    September 30, 2024 , 5:44 pm

    Thank you for reaching out, Angela. AlgaeCal’s Bone Builder Pack has been studied specifically for improving bone mineral density. As for osteoarthritis, you may benefit from our product called Triple Power Fish Oil! It eases oxidative stress through a combination of EPA + DHA omega 3s, turmeric, and astaxanthin. You can learn more about our Bone Builder Pack HERE, and Triple Power Fish Oil HERE.

    Please feel free to give us a call at 1-800-820-0184 (US & Canada Toll-free) or email [email protected] for personalized recommendations! 🙂

    – Yoori

  23. JIll Norair

    September 27, 2024 , 11:08 am

    I dont quite get why you say get Dexa- I have had many and my last one was in 2021 as I ws Osteoporosis but I dont want to get another as I won’t take the drugs. I do take the algae cal plus tho not strontium as it gives me headaches .. not sure what else I can do if my scores are still bad..

  24. Yoori AlgaeCal

    September 30, 2024 , 5:50 pm

    Thank you for your question, Jill! Regular DEXA scans are suggested for tracking changes in bone density over time, and a follow-up scan can help assess how well the AlgaeCal program is working for you!

    We’re sorry to hear that you’ve experienced headaches while taking our Strontium Boost. While this is quite unusual, we understand that everyone’s body is unique, and we want to ensure you’re feeling your best. We would love to assist you in determining what might be causing this and finding a suitable solution.

    Please feel free to reach out to our friendly Bone Health Consultants at 1-800-820-0184 (US & Canada Toll-free) or email us at [email protected]. We look forward to hearing from you!

    – Yoori

  25. Maureen Strathmann

    September 27, 2024 , 11:15 am

    I have osteoporosis and arthritis. I have osteo-arthritis in my knee. I’ve been taking Algaecal plus and strontium for over a year. My next DEXA scan will be in February. My question is can your products help my arthritis?

  26. Yoori AlgaeCal

    September 30, 2024 , 5:52 pm

    Thank you for reaching out, Maureen. We are sorry to hear you have bone loss and arthritis. AlgaeCal has been studied specifically for improving bone mineral density and not osteoarthritis. You may benefit from our product called Triple Power Fish Oil! It eases oxidative stress through a combination of EPA + DHA omega 3s, turmeric, and astaxanthin. You can learn more HERE. We also have an article on natural remedies for arthritis you may find helpful HERE.

    I hope this helps! We hope you’ll keep us updated on your progress once you get your results in for your next DEXA scan! 🙂

    – Yoori

  27. Barbara Zapinski

    September 27, 2024 , 11:36 am

    Thank you Lara for explaining what a DEXA scan is all about. It’s very clear to me now. Iv had 4 scans in the past and didn’t know how to read them. I’m 84 years old and have been on the AlgaeCal program since 2016.That was the best move I made in protecting my bone health! I believe the AlgaeCal Company is the best out there and all the products they offer for women .I will continue to order these wonderful products till I’m no longer on this earth. Thank you again.

  28. Yoori AlgaeCal

    September 30, 2024 , 5:54 pm

    Thanks so much for your kind words, Barbara! We’re so happy you have found this information helpful. 🙂

    In case you’d like to review your previous DEXA scans with one of our Bone Health Consultants, please feel free to give us a call at 1-800-820-0184 (US & Canada Toll-free) or email [email protected]. We are happy to help!

    – Yoori

  29. Susan Stephens

    September 27, 2024 , 2:16 pm

    Based on Published data on Pub Med originally published in 2021REMS (radiofrequency Echographic Multi Spectrometry) testing is much more accurate when compared to DEXA scanning. This technology is widely used and accepted in other countries. We need more providers and availability in this country. Please feature an article on this technology.
    Thank you!

  30. Yoori AlgaeCal

    September 30, 2024 , 5:58 pm

    Thank you for sharing, Susan! REMS provide a DEXA-equivalent BMD value along with valuable insights into bone quality. We agree that having an article on this new technology would be beneficial, and I’ll be sure to pass your constructive feedback along to our team. We truly appreciate your input!

    – Yoori

  31. Julrne Jardine Hymer

    September 27, 2024 , 7:43 pm

    Thanks for all your information…. I had no idea that it was so complex I appreciate all the information

  32. Yoori AlgaeCal

    September 30, 2024 , 5:59 pm

    Happy you liked our post, Julrne! Feel free to let us know if you have any follow-up questions! We are happy to help. 🙂

    – Yoori

  33. Arantza

    September 27, 2024 , 9:19 pm

    Do you send Algae cal to Spain easily? Ee have problems yo get products fron USA. Do you sell Algae cal in any other countries in Europe?

  34. Yoori AlgaeCal

    September 30, 2024 , 6:04 pm

    Thank you for your interest in AlgaeCal, Arantza. We’re sorry that we do not ship to Spain at this time due to continuous problems in trying to send products to Spain and customers receiving the product.

    Do you have friends or family in any of the ten international countries where we can ship, or anywhere within North America? If you do, we would be pleased to assist you in placing the order to them, and you are free to have them forward the order to you in Spain. 🙂 For the list of countries we ship to, please click HERE, and scroll down to “Shipping & Handling”.

    I hope this helps! Please feel free to give us a call at 1-510-564-7192 (international charges apply) or email [email protected] for any additional questions!

    – Yoori

  35. Josefina Uribe Juarez

    October 1, 2024 , 11:55 am

    I was diagnosed with Osteopenia, and I returned it to normal in two years following the Alkaline diet. This year I will visit DEXA to find out, but I would like to try the Algae Cal

  36. Manja AlgaeCal

    October 2, 2024 , 2:31 am

    Hi Josefina, congratulations on your improvements! That’s amazing to hear about your journey back to normal bone health through the alkaline diet. We appreciate your interest in our products, and we’d love to help you further! Please feel free to reach out to our Bone Health Consultants at 1-800-820-0184 (USA & Canada toll-free) or email us at [email protected]. They can discuss your goals and help you find the best product for your needs. Best of luck with your upcoming DEXA scan!
    – Manja

  37. Mahin

    October 4, 2024 , 10:03 am

    Thanks , for this informative article

This article features advice based on cutting-edge research from our industry experts to give you the best possible information to support your bone-building journey.

Lara Pizzorno
MDiv, MA, LMT - Best-selling author of Healthy Bones Healthy You! and Your Bones; Editor of Longevity Medicine Review, and Senior Medical Editor for Integrative Medicine Advisors.,
Dr. Liz Lipski
PhD, CNS, FACN, IFMP, BCHN, LDN - Professor and Director of Academic Development, Nutrition programs in Clinical Nutrition at Maryland University of Integrative Health.,
Dr. Emma Gasinski
PT, DPT, RYT - Physical therapist and certified yoga teacher with a Doctorate in Physical Therapy from Rocky Mountain University of Health Professionals,
Dr. Lawrence (Larry) A. May
MD, FACP, Harvard Medical School Graduate, Physician, Author, Public Speaker - Doctor of Internal Medicine at Providence Cedars-Sinai Tarzana Medical Center and author of several articles and books, including the widely utilized and best selling medical textbook Primary Care Medicine,