Bone Health and Stairs Research

[CatharineTE]

I'm researching this area for a master's dissertation spurred on by my own osteopenia. I would be very grateful if you could complete my survey. It doesn't matter where you come from, you just need to be female over 49. And please forward it to your friends! Thank you. Catharinehw.onlinesurveys.ac.uk/hip-...

[fraid]

I started the survey but am afraid answering 7 questions re 10 previous homes got too much, nor could I see the point or remember the many homes I've lived in. Sorry, haven't the energy or patience for it, good luck though.

[CatharineTE in reply to fraid]

Hi Fraid, the point is that we know that exercise in your youth builds strong bones, and that bones become weaker after menopause. But we don’t know very much about the years in between.

The study aims to contribute to our knowledge about whether it is possible to maintain higher bone density through the middle years. We know that nutrition and exercise play a role, but what about everyday life? Could living in a house with stairs in your middle years make a difference to your hip bone health in your later years? Currently there isn’t any research to answer this question. Probably because it is quite difficult to do and relies on quanitfying people's access to stairs retrospectively. Thanks for trying anyway, most people haven't lived in that many homes!

[CatharineTE in reply to CatharineTE]

I really hope that your response won't put people off, it's the first one I've had like that out of 280 so far. Please everyone with bone health issues, do attempt the survey. It's really important that women know how to protect themselves from poor bone health with simple things, like using stairs.

[Met00 in reply to CatharineTE]

I've completed the survey. It's an interesting starting point for research in this area, but I hope you'll be able to develop it further. I would imagine most of us regularly used stairs in our homes in middle life, but many of us developed osteoporosis despite this. My personal opinion is that you'd have to go up and down stairs many times a day - maybe half an hour or more of this in total several times a week - not just a handful of times, to have any impact on bone health. Research shows that the most effective way of building healthy bones is through progressive resistance training. But there are many other factors too that contribute to bone loss, which is likely to occur regardless of exercise levels, if our diet is poor, blood vitamin D low, we smoke, drink too much alcohol, are anorexic, take certain medications (eg steroids), or have certain untreated health conditions (eg coeliac, hyperparathyroidism). Hopefully your tutors will help you adjust for such factors if you're able to do a follow up study. Good luck with your dissertation!

[CatharineTE in reply to Met00]

Thank you so much Met00, and you are right on all counts above, the situation is very complex with multiple confounds.

[strongmouse in reply to CatharineTE]

I've completed the survey.

Some of the questions asked about the time while living in the house, but it didn't allow for different periods of time. For instance, due to ill health or change of work, there may be a difference in the amount of exercise, or the amount of time using the stairs. I realise this is a first survey gathering generalised information. Good luck with it.

[Raleigh59 in reply to CatharineTE]

This is sooooooo interesting to me!!!

I’ve led a life as a stay at home mom and run up and down the stairs 10-30 x per day. My dexa came out terrible then my REMS came out excellent. In between those two tests my top endocrinologist said to me- we don’t know why your scores are so high ( bad) and you have not broken a bone yet. Then when he saw my REMS scores he said your real scores are closer to the REMS.

I lived a live of stairs and I still do to this day. I am 60 years old. I still don’t think I have good bones but I wrote poor instead of very poor that I thought I was before the REMS. Now I am wondering if I am even correctly in the poor bones level maybe I am better than that.

[CallMeSunny]

But some of us will have run up and down our stairs 20 times a day, others only three or four. Do you ask if people have worked from home (thus probably using their stairs more)? Or if they have access to a ground floor toilet? Just curious!

[CatharineTE in reply to CallMeSunny]

Hi CallmeSunny, you are so right. I couldn't ask these questions because recall on retrospective research is so rarely accurate plus the survey is already pretty complex and hard to fill in. But it may not matter... Susan Brown in the US (Better Bones) and Dr Nick Birch (spine and echolight specialist in the UK) are reporting research which suggests that it's not the frequency of exercise that drives bone remodeling, but the severity of the impact. Resistance exercise is great for muscle strength but unless it jars bones and causes microdamage, the osteoclasts don't start the process of replacement. I.e. level of impact is more important than frequency of repetition. So I'm looking to distinguish those who don't use stairs at all from those who use them in multiple contexts and are more likely to have at least high impacts on their hips.

[MyStar86]

why do you have to be over 49?? I was diagnosed with osteoporosis aged 29 and osteopenia ages 18!!

[Met00 in reply to MyStar86]

This is a study looking at the impact of activity levels in middle age.

[MyStar86 in reply to Met00]

Thank you 😊

[CatharineTE in reply to MyStar86]

Sorry to hear how early you had poor bone health, that's rotten. Met00 is correct below. The study is looking into a more general scenario, rather than your rather unusual medical one. Thank you for trying though.

[MyStar86 in reply to CatharineTE]

Ah I see

[Haz58]

Done

[Justme16]

I've lived in a top floor flat....3 flights of stairs....for 30 years. My hip scores were a lot better than spine and femur neck. So....no effect on neck of femur.

[CatharineTE]

That is really interesting, thank you. If stairs did have an effect on hip bone health I would have expected the femoral neck to the very site which would particularly benefit. Now I need to speak to an orthopedic surgeon to bottom this one out. I really appreciate that insight.

[Justme16 in reply to CatharineTE]

Hip -1.3, femur neck -2.4, spine ,-3.

[Rowan7]

Hi, started but I lived in flat for 8 years from mid 50's. Climbed 2 sets of internal stairs to front door. This is not covered, how do I answer ?

[CatharineTE in reply to Rowan7]

Thank you for asking. If you were using them every day please count them as if they were a staircase in your home.

[Rowan7 in reply to CatharineTE]

Done

[CatharineTE in reply to Rowan7]

Thank you!

[Westie63]

Hi Catherine, I’ve completed your survey thanks. I live in a 3 storey house now so hopefully this may help my bones. I worried more about heart disease prevention in the past and didn’t give much thought to my bones.

[josephinius1]

I went through menopause while living in a house that not only had stairs but it was a particularly long flight (house with high ceilings) with high risers. I remember thinking when we moved that I was losing some calorie burn, not having to do stairs multiple times per day. But I also developed hypothyroidism at menopause (Hashimotos). I'd always been a walker, went to the gym to lift weights regularly, too, but the weight I gained with hypothyroidism/menopause caused me to intensify my workouts, so I started running and regularly did workouts with a very high step to help build my leg and hip strength.

We did move to a less intense/smaller house in a flatter neighborhood, but I kept running, also joined a gym offering "functional mobility" classes that had us regularly running, jumping, walking backwards, etc. up and down two pyramid shaped staircases with an extra high riser. We also jumped onto and off of boxes of varying heights, utilized weights on strength days, and did all sorts of other things that should have been good for my bones. Unfortunately that gym was expensive and I got tired of being sooo sore every day of the week, so I only did that for 2-3 years. But I never gave up running and at least trying to strength train. I also "did the stairs" whenever possible in stores, workplaces, etc. My work for several of those years involved lifting/hauling bins of materials, often for considerable distances in hilly terrain, too. Covid slowed everything down but I still ran and did workouts sent to me in lieu of in-person workouts, but by the time covid hit, my osteoporosis was likely already well advanced.

I actually had my first bone-related injury at the gym. I knew I'd gotten a little slack, so I joined a small group class at the gym where I'd been utilizing workout machines. Right out of the gate they had us hang our feet in TRX straps, then...do a pike? I'd never done anything quite like that before, I remember that. In any event, I felt something give in my sternum--I don't know if it was a fracture but I know it didn't hurt that much when it happened, hurt like the dickens for several weeks after, convinced me my core was weak and I needed to get stronger. I broke my wrist after slipping on ice later that year; put my hand down because all I could think was "Don't land on your back!" and, I didn't. Sadly, no one mentioned osteoporosis or suggested I get checked. It took three more years and multiple injuries to learn I have osteoporosis so severe that I surely was well into the zone when I broke my arm. I now have confirmed multiple fractures, three inches of height loss and a much more limited array of activities available to me.

It truly still almost boggles my mind that someone who tried as hard as I did--maybe not to the point of being obsessed, but relative to "most people"--ended up with bones so bad I cannot, now, even consider many activities my 83 year old mom can do. My mom is active but she never strength-trained, and she only started playing pickleball ten-fifteen years ago. She also had/has osteoporosis but it it was never as bad as mine and evidently she was able, with medication, to move back into the osteopenia range. My grandma's bones were eventually really bad but she lived to be 104 and probably only really started having issues with her hip in her 80s. My grandma walked and did housework/yardwork but never intentionally strength-trained.

All to say, I had stairs in my life when it mattered, (and I still do stairs whenever there's an option,) but I don't think they helped my bones.

[CatharineTE in reply to josephinius1]

Goodness. This sounds really tough, and thank you for the detail. . I'm dropping you a message.

[CatharineTE in reply to CatharineTE]

Ah the system doesn't let me. I was going to say, have you thought of a consultation with Dr Susan Brown of Betterbones.com? I don't think anybody knows more about bones, treatment and causes.

[josephinius1 in reply to CatharineTE]

*sacrum, not sternum. Yes, I've browsed Susan Brown. There's a lot of info out there. I bought Margaret Martin's book exercise for better bones but realized I had better not even attempt what she seemed to be suggesting until I was fully fracture-free (and she did warn users to wait if we had fractures.) I seem to have found most focus with Dr Doug Lucas, Optimal Bone Health, and I'm hoping to have a consultation with him soon, but what I think I've learned is that I'm kind of in no-man's land. My impression is that my in person doctors see osteoporosis as an "old person's" condition, first, and I'm pretty sure they rarely see t-scores (especially for spine) as bad as mine even in truly old people. So they don't know what to tell me. I'm not sure the online doctors are much better. But, I really haven't looked that much into Susan Brown, who knows, maybe she does know "my kind". Thanks for responding and for the tip, and good luck with your research.

[CatharineTE in reply to josephinius1]

I don't know Dr Lucas, but good that you have found someone. I went on Dr Brown's Better Bones retreat in Massachusetts in May. Partly for my own bones but also to increase my understanding, as a number of my nutritional therapy clients have bone health issues. I learned an enormous amount. The course included osteoporosis safe yoga run by Gina. There were about 40 of us on the course, most older than me but some younger (I'm 55) and many with history of fracture. Dr Brown lectured and answered personal questions throughout. I don't think you'd be in a no man's land with her, she has seen it all bone wise!

[josephinius1 in reply to CatharineTE]

Nice! I would love to find my tribe, as it were, but unfortunately funding is an issue. I did start seeing a naturopath who supposedly specializes in thyroid issues, once I started down the "not covered by insurance" road I felt I had to at least see it through, but aside from .any tests I've never had before, she hasn't offered me anything specific to thyroid or bones. But I did suss out that I probably had "absorption issues" (per the internet, not uncommon with Hashimotos, but did any doctor in 15 years tell me that? Or ever even tell me I had Hashimotos? No. I stumbled upon that info.) so I've been doing everything I could (within the realm of practicality) to deal with those. I applaud your efforts to guide people that way. How did you learn you have/had osteopenia? I swear neither of the O words ever crossed a healthcare practitioner's lips, because, "We don't screen for osteoporosis before 65." That now seems crazy to me. Not that breast or colon cancer aren't important to catch early, but dude, you want to catch osteoporosis early, too! And I would've been deemed high risk, I think, if anyone had bothered to ask, but there's no female or colon cancer in my family. (Brain tumors, yes; skin cancer, yes. They don't screen for those either.)

Thanks for chatting.

[Br0cher]

Any research into osteoporosis is to be encouraged and applauded as this is a subject (like the menopause and endometriosis) that has has detrimental, and sometimes catastrophic consequences and been ignored for too long. Only lately are we seeing an interest. More research will lead to better understanding of the many probable complex causes and that can only lead to better diagnoses leading to beneficial and safe treatment protocols. The current drugs on offer are far from beneficial and most certainly harmful. I completed the survey within 20 minutes even though I have had multiple house moves, seven, between age 30 and 71 years. Luckily I had kept a record so made it easier. After submitting the completed survey, I emailed Catharine to explain my journey and hopefully help enhance her research. I was surprised to receive a quick reply with advice on the alternative bone density scan, Echolight, provided by Nick Birch and Osteoscan, something I was already aware of but others may not be. Please support Catharine 's study the results of which should be published mid December 2023.

[Rowan7 in reply to Br0cher]

Hello, I am booked in to have REMS scan with Mr Nick Birch in Winchester Feb 2024. Had DEXA in 2021, NHS will not support a further one so I feel I need to monitor my osteoporosis as I declined drugs (which was not well received) and was not offered any further information or advice nor signposting. Found this site purely by chance. My very good fortune.

[ScrumpyPig in reply to Rowan7]

Based on my personal experience you will find Nick Birch very helpful. He is also very approachable so you will have the time to ask lots of questions. He completely transformed the way I think about my osteoporosis - the NHS made me feel like I was on a downward spiral.

[CatharineTE]

Thank you so much! It's really wonderful that new technologies are coming to replace DEXA which has been around for a very long time.

[Southerngirl2787]

The exercise angle is good, but remember those of us who were "in good shape", ate well, I loved the Stairmaster machine! etc...but had such a nasty thing as a parathyroid tumor destroy our lives out of no where, with little help from doctors to identify and remove.