I am too old to consider looking buff - I just want to be healthy!
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Nutrition plays an important role in maintaining bone health, as well - for example, getting necessary nutrients like calcium and vitamin D through food (and sunlight), eating prunes, getting enough protein. As for weights, there is more to it than just hoisting a weight. That’s why I recommend the two women above. They explain things so well.
I’ll second Margaret Martin on YouTube for tons of helpful videos on osteoporosis and how to exercise carefully - including using progressively heavier weights which is supposed to be really beneficial.
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Absolutely. And getting enough calories, specifically, is very important. Being slender is a big risk factor for fragile bones. Being underweight is even worse. Anyone with a history of a restrictive eating disorder (e.g. anorexia) should get their bone density test early. Even just a history of chronic dieting or overexercise.
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My endo tells me to get fatter every time. I told him that after my last appointment, I bought some cake! One thing about thoracic fractures: the whole thorax is shorter and there isn’t much room in there for meals!
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Well, I am supposed to lose weight for my potentially arthritic knee and gain weight for my osteo. I hate that I have lost height and now at the same weight my BMI is higher.
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Yep there are activities and goals that are in conflict. We have to pick our poison as it were.
I have knee issues from playing sports my whole life, as well as osteopenia. It’s my priority to keep the weight off (still trying to keep good muscle mass though, which in and of itself is tough as we age.)
I went scuba diving a few years ago after a long layoff, and on dry land the 20-30 pounds of gear made my knees feel like they were going to explode. No way I want to feel that way every day with every step, so I’ll choose the osteopenia/osteoporosis risk.
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Compared to some folk, I have not lost a lot of weight. But… I consider it two jugs of milk, which I would not want to be carting around with me all the time.
This is one of the many ways that BMI is not a good measure. I give all my patients full permission to ignore it.
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My need to avoid oxylates, which form kidney stones in my body, is at odds with my need to consume foods that unfortunately contain oxylates. I eat some things I shouldn’t (like spinach), but I do it in moderation. I’m also slim, but I have muscle - and between protein and creatine, I’m working on increasing or at least maintaining my muscle mass to protect my bones. I have to avoid calcium supplements, and I take vitamin K2 to try to coax the calcium from food into my bones. It’s a balancing act.
I really like Great Bones, Taking Control of Your Osteoporosis, by R. Keith McCormick, DC. He emphasizes finding the root cause of poor Dexa scores and addressing those reasons. He is for osteoporosis meds when necessary, but he encourages people to understand what medication is best for their own particular situation - and he says that it’s really important to monitor to make sure that the medication is actually working. It’s a great read if you want to take a deeper dive.
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There a study somewhere out there that found using BMI based on height at 40 rather than current height was a better predictor of overall morbidity and mortality. So I embraced that and I calculate my BMI based on my full adult height not whatever this shrinking thing is!
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This is what I figure - although I measure shorter, that was my full height and I chose to use it for BMI!
“Great Bones” is very long, and can be used as a reference. It is so helpful. McCormick also does consults. I see a mainstream endo and have also see McCormick a few times over the last 15 years. He did Forteo himself, followed by Fosamax (alendronate). His spine, I read, is currently -3.3 so I wonder if he will do meds again. His original book was “A Holistic Approach to Osteoporosis.” I love that he still has that content- updated- in “Great Bones” and also the most complete info on meds I have found anywhere.
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After my most recent injury, doctor is pushing me to start meds. I have low bone mass but not osteoporosis. I twisted my ankle and the X-rays says:
Minimal osseous irregularity at the distolateral calcaneus and fifth metatarsal shaft, nonspecific, compatible with prior injuries/fractures…Calcaneal enthesopathy. Bones are demineralized. Polyarticular osteoarthrosis, most pronounced and severe at the second tarsometatarsal joint. Hallux valgus and second hammertoe deformities on this nonweightbearing study. Os naviculare.
So this all inspired my doctor to strongly encourage me to start meds.
I know I have arthritis in various parts of my body, especially hands, feet, and neck. I really do not want to start a new drug that I have to take for five years. No idea what is right, I already take calcium and Vitamin D and am unlikely to change my diet. I could add exercise; already do Tai Chi.
Also I think this report indicates I have an extra bit of bone in my foot which can cause extra pain - hooray.
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Unless your doctor specializes in osteoporosis, I would strongly encourage you to see one who does before starting medication based on the xray report. (I liken it to when H’s doctor wanted to start him on bp meds. He went to a cardiologist for a full work up, and the cardiologist told him that there was no reason for him to be on bp meds.)
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She was recommending it even before my last DEXA scan, and more so after that. The X-ray just gave her an opportunity to refresh her suggestion. But perhaps asking to see a specialist is a good idea - a delaying plan, at least!
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I’ve been diagnosed with osteoporosis but the main reason I’ve been diagnosed with that instead of osteopenia is that my mother broke her hip. Now my daughter says I should do whatever it takes not to break a hip so that she doesn’t get osteoporosis.
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BMI has other confounders, since it does not distinguish between fat versus muscle and bone.
Perhaps waist / height ratio may be a better simple proxy of body fat. (Though the height current versus maximum issue may still exist here.)
I’ve found the UAB Health Professions site helpful to see examples of good posture while doing daily activities
lhttps://www.uab.edu/shp/toneyourbones/step-5-strength-balance-and-posture/posture
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I would see an endocrinologist. Did your DEXA scan show osteopenia only? I don’t understand the med recommendation based on an x-ray that showed osteoarthritis and some unspecified demineralization of bone. You didn’t fracture anything, right? Was this a PCP? Kind of mystified.
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