I have a friend who has been given a bone scan by her doctor and was told her bone density has become rather low, although it is not osteoporosis yet.
What can she do in terms of self help to try and get her bone density up again?
She is a vegetarian, and has a very healthy lifestyle in terms of a healthy and varied diet, exercise, fresh air, good sleep, no alcohol, no smoking/drugs, and a good BMI.
I don't know if increasing dairy is a good idea, taking a D and K supplement, or lifting weights?
Many thanks for any suggestions.
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Carrie234
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Can I ask how old your friend is? It's normal to lose bone density as we get older, so having osteopenia (bone density that is reduced, but not osteoporosis) may be perfectly normal for her. If your friend is willing for you to share her t-scores (compare her bone density to an average 30 year old), z-scores (compare her bone density to average for age) and fracture risk (eg 10% risk of fracture in the next 10 years), that would give a clearer picture of her bone health. However, having said all that, bone density is only a very small part of bone health and not necessarily directly related to bone strength. In addition, if her doctor is concerned about her loss of bone density, he should be running blood tests to check for underlying causes - Vitamin D, calcium and parathyroid (not the same as thyroid) in the same blood draw, coeliac, thyroid and a full blood count. If your friend hasn't had these tests done, I would recommend that she goes back to her doctor and asks for them.
As far as what she can do to maintain bone health, exercise is really important - as high impact as is safe for her (eg jogging, dancing, jumping, hopping, skipping), together with strength training (using body weight, weights and resistance bands) and balance exercises. It's important to have a healthy diet to ensure her bones are getting all the nutrients they need, including plenty of calcium, magnesium and protein. A Vitamin D supplement is recommended, but how much to take depends on an individual's own blood level. Many rheumatologists recommend that your blood level should be at least 75nmol/litre (assuming you're in the UK, the US uses different measurements), some say 100 or even higher (100 is in the middle of the normal range). Doctors usually prescribe (or ask you to buy!) 800iu Vit D supplement, but many of us need 2000iu or more. I always recommend regular monitoring of this, following my own experience when my blood level shot up unexpectedly on a couple of occasions - without monitoring, I wouldn't have known to reduce my supplement at that point. Vitamin K2-MK7 (or the much more expensive K2-MK4) is also a good idea, as it helps send calcium to the bones. Many people also supplement with magnesium, as it's hard to get sufficient from diet.
She is in her 50s - I didn't realise that is actually normal to have osteopenia as we get older, so maybe it's OK to have less bone density for her, and perhaps she does not need to do too much.
I will ask her if she knows her t-scores, z-scores, and fracture risk. I'm not sure if the doctor was concerned about the bone loss, or whether the doctor just told her that her scores were low. I think her vitamin D, iron, and b12 levels were also a bit low. I can't see how, but can low iron and low B12 also affect bone density at all?
With high impact exercise, can it be hard on the joints if your bones are already lower density? She has a varied and healthy unprocessed diet, with protein from beans/lentils, and some eggs/cheese/milk, but I'm not sure how much calcium she gets from the diet. She doesn't take any supplements yet but she is thinking of starting D, K, iron and b12.
Are you in the UK? If so, do you know why she was referred for a DEXA scan, as that doesn't usually happen here unless someone's had an unexplained fracture or is known to be at high risk of osteoporosis (for example, due to certain health conditions and/or medications).
I don't know whether low iron and B12 affect bone density, but low D definitely can do, as vitamin D plays a major role in calcium absorption. I'm really surprised her doctor didn't either prescribe a D supplement or tell her to buy one! Make sure it's K2 she's considering buying, as if it's sold as Vitamin K, that will almost certainly be K1, not K2. It's possible to get enough K1 through diet, but very difficult to get K2 that way, unless you eat a lot of natto (fermented soya)! I would recommend that she starts one supplement at a time, in case of side effects, so she can be sure which supplement is the culprit, should that occur.
Have a look at the ROS website (theros.org.uk) as there's lots of information about exercise on there. Many of us with osteoporosis exercise quite hard, but it's important to build up gradually and get advice about doing it safely (for example, engage your core, don't bend the back forwards, bend at the knees and hips instead). I'm 67, have osteoporosis and can happily hop, jump and skip. I was diagnosed almost 10 years ago and with a combination of diet, exercise and supplements have managed to considerably slow down my bone loss. But we're all different, so it will depend on whether or not your friend has underlying risk factors that can't be addressed.
Thank you I will ask her, I think it was due to body weight going down that the doctor did it. I'll see if she can get back to the doctor and ask for more details.
Yes I'm not sure why the doctor didn't prescribe D! She'll be taking K2 not K1 if she goes ahead with K. Thank you, one supplement at a time is very wise.
That is so great you have slowed down your bone loss, and without any medications. As far as diet goes, I think she has quite a good amount of calcium including non-dairy sources, so maybe the D, K, and possibly magnesium are worth looking into, and then more of the bone-building exercise. I will check out the ROS website, thank you 😊
Met00, you always give good advises and I like tonrrad your comments.
Since we have the same age and I discover osteoporosis 4 years ago( spine Tscore of -2.1 then and -3,2 now) may I ask what are your scores for hip and spinal? I dont remember if you take any medicines. Did you? Thanks
That's very kind of you to say so, Verauk! I was diagnosed almost 10 years ago, took meds for a year but didn't like the side effects so have taken nothing since. My first DEXA scan gave scores of -3.2 spine and -2.3 hip, the second one -3.6 spine, -2.5 hip. However, I was very suspicious of the spine score, so have had private REMS scans since then. The first REMS, 15 months after my second DEXA, gave spine and hip scores of -2.4 hip, -2.6 neck of femur and spine. I started taking a low dose of strontium citrate in 2020, which helped my spine more than my hip, with scores last year of -2.5 hip, 2.8 neck of femur and -1.9 spine! I'm now doing squats, lunges etc with increasing weights about 3 times a week, which I hope will help my hips in particular. Since 2019, REMS scans have shown my total hip score staying virtually unchanged, my neck of femur has worsened very slightly and my spine has improved dramatically! One of the advantages of REMS scans is that they give a score for bone strength too. Again, my spine strength score has improved, but my hip score worsened very slightly. I was told that bone strength can actually change within a matter of months, and I hadn't been exercising much prior to the scan, so am hoping next time it will have improved again!
Hi there Carrie234..I would also get her to ask her doctor to check her Thyroid levels.I am 72,female.In 2013 I was diagnosed with Hyperthyroidism but wasn't told and nothing was followed up.I now have a multi nodular goitre and Osteoporosis secondary to Hyperthyroidism!!!! As you can imagine I am not happy.Im starting IV TREATMENT for the Osteoporosis in 2 weeks.Thank goodness it was my new doctor that found it all.
You're a good friend to gather information for her.
You've received some very good advice here and I would just add that Margaret Martin is a Physical Therapist specialising in bone health and is an excellent resource. There are all sorts of videos on exercise and bone health on her MelioGuide YouTube channel. Even if your friend's bone density is 'normal for her' she might wish to be proactive and try to prevent osteoporosis as she continues to age.
Carrie234, I'm not a doctor but I have learn a lot here at this net group and I feel confortable to give my experiences.
Seems that she is doing everything right( by the way I'm also vegetarian)but my advise to her is to increase protein consumption( in my case I negleted) including lots of tofu, chickpeas and other sources of veggie proteins. And keep exercising( the right one's ) and at the ROS page there are good videos.
Hi Verauk, Although I'm not a strict vegetarian (I eat fish and very rarely meat occasionally) I was getting my protein mainly from beans. But then I recently found out that the phytates in beans might inhibit calcium consumption. So now I'm wondering perhaps other sources of good protein other than meat. I was wondering, what do you eat for protein?
Mainly chickpeas, lentils, eggs( two a day ideal in terms of protein are tree) beans( but I put then in water for 12 hour before cook , discharge this water and cook with a new water. This helps to take off some phytates). Also tofu and occasionaly fish( but I will start eat more fish).
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I asked ChatGPT about Fosamax. How does the medication Fosamax fake your DEXA score?
Strontium, is it helpful for bone density?
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do vertebral fractures occur when a person is NOT on any osteoporosis drugs?
