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Introduction:

Bone density typically silently declines with age.  Maintaining strong bones will make your future life better.  As a forward thinking woman, you know that the time to act is now.  Your future self will thank you for giving her the gift of a strong structure to use to make a big impact on the world. In this episode, we’ll go over the 3 areas in which you can influence the strength of your bones so that you can make an intelligent plan to age with strength.

Why Should You Care About Your Bone Density Now?

You probably know that you don’t want to have low bone density.  It gets talked about, which is a very good thing.  But not a lot of specifics of what to do and when to start are mentioned, which is not so great.  Most old people know that they don’t want to break their hip and end up in a nursing home in chronic pain.  But do you think about preventing that now?  It’s way way easier to prevent that outcome if you start now than if you start when you’re 80 and your bones are already super fragile.  And it doesn’t need to be complicated or difficult.

Other than not wanting to break your hip and have to go into a nursing home, why do you care about having strong bones?  Do you have reasons?  Your skeleton is your structural framework, and you want to have a strong structural framework so that you can have a more robust experience of life and be able to do all the things you want to do.  Most people with osteopenia or osteoporosis don’t have noticeable symptoms, which is why it’s important to get your bone density checked periodically.  But some people do have symptoms, mostly pain.  There are studies showing chronic pain in people with osteoporosis who have not yet had a fracture.

There are tons of consequences of chronic pain, even at a low level, that impact your quality of life.  Impaired sleep decreases your effectiveness in pretty much every area of your life.  The emotional impact of pain is huge.  Being able to complete your daily activities is difficult, let alone being able to show up to help other people in their lives.  Some people with osteoporosis say carrying weight is painful, bending and moving is painful, they feel chronically fatigued, or that cold and damp weather affects them more than it used to.

The biggest problem I see with having low bone density is that you’re kind of a ticking time bomb.  Any tiny misstep can be catastrophic.  If you don’t get your bone density tested, you don’t know how bad things are until you have a devastating injury that might result in lifelong pain and or decreased independence.  If you do know you have osteopenia or osteoporosis, you know that you’re fragile and you can’t do the same rough and tumble type things that other people do.  You have to be a little bit limited.

Bone density is pretty tightly correlated with muscle strength.  If you have feeble bones, you most likely have feeble muscles, because strong muscles pull strongly on bones, making the bones adapt to that force.  On the one hand it seems kind of obvious, but the reality is that if bone density is measured to be low in someone, the medical establishment will say “you have low bone density, let’s improve your bone density” and do one of the only things they ever do, which is to prescribe a drug instead of saying “you have low bone density, let’s get you jacked.”  Which I think would be an awesome thing to say to a fragile little old lady.

3 Ways To Mind Your Bone Density:

I think about the tasks that promote strong bones in 3 general categories:  

-The way you move

-Your nutrient absorption 

-Your hormone status 

This doesn’t need to be overwhelming or some kind of exhaustive list.  I do think it’s useful to have an idea of the things that influence your bone density, so that you’re not stuck thinking it’s all about calcium or genetics or bisphosphonate prescription medications.  Osteopenia and osteoporosis are serious and seriously life-experience-limiting and seriously preventable.  And you have 3 main dials you can manipulate to create the experience that you want.

1: The Way You Move

When you can maintain structural strength into your later decades, you’re much less likely to be limited in terms of adventures you can experience, you’re more likely to be able to assist others, and you’re more likely to be able to maintain healthy movement patterns that prevent injuries and chronic pain.  We talked about those in episode 61 “choose not to have injuries and pain”.  A lot of injuries and pain conditions that crop up are related to our structural alignment and movement patterns.  When you correct body alignment and posture, you create a lot more years of pain free movement.  Conversely, if you become kyphotic (that hunched over position) or otherwise have to hold your body in strange positions because of weakened or broken bones, you create more pain and weakness in other often distant areas of the body.

The way you move now matters to your future self. A lot.  Do you know which athletes have the strongest bones?  Cyclists?  Swimmers?  Rock climbers?  Bowlers?  Haha.  It’s gymnasts.  High strength and precise high impact ground strikes.  Most endurance athletes, like cyclists and swimmers and even distance runners have low bone density.  Athletes participating in power sports that generate a lot of force or impact have high bone density.

There’s a guy who invented a workout system that I use who also invented a different device called osteostrong that was inspired by the forces acting on a gymnast’s body.  His name is John Janquish.  He does a good job of explaining how your central nervous system has a process called neural inhibition that prevents you from damaging yourself, which is a good thing.

But if you fire a muscle that’s connected to a weak bone, neural inhibition prevents you from producing more force with that muscle, which prevents you from growing that muscle and getting stronger so that you don’t damage your bone.  So raising bone density takes away some limitation on your ability to grow more muscle.  And strengthening your muscles strengthens your ligaments and tendons, all of which is good.  If you need to work on your bone density and have access to a location with an osteostrong machine, you should totally look into it.

The main thing with osteostrong is regrowing bone that you’ve lost.  Studies show that gymnasts get up to 10x their body weight in impact force in their gymnastic escapades.  One study found that what you need to effectively grow new bone is 4.2 times your body weight.  The vast majority of people who lift weights don’t lift nearly that much.  Lifting heavy correctly is ridiculously awesome for you, but for severely osteoporotic people, osteostrong is able to deliver a force that is impossible to achieve on your own in the gym.  There are a couple of other cool devices that help a little bit with bone density: whole body vibration and high-power PEMF.  I do both of those on the regular just for funsies.  Well, really for all of the other beneficial effects they have, which are many.  They both have a positive effect on bones.

Cool devices are fun and exciting and I love them, but the best friend you have for your bone density is free and available to everyone equally.  It’s a pretty great gift that we all take for granted and is no respecter of persons, so to speak.  Haha.  Can you guess what it is?  I’ve talked about Joan Vernikos before, she was the Director of Life Sciences at NASA for a long time.  She wrote a book and in it she says “While the country was figuring out who pays for health care, here I was, sitting on a practical, inexpensive, scientifically proven solution derived from research paid for by the taxpayer!  If astronauts could regain their good health after shaking off the ill effects of spaceflight, so could people suffering similar health problems due to their sedentary lifestyles.  My challenge was to provide clear, practical guidance to show the public the value of making use of our old friend gravity, simply through doing everyday activities that were of a different nature than traditional vigorous exercises in the gym.”  {end a}

Did you hear it?  Our old friend is… gravity.  All too often we neglect our old friend and don’t let it work its magic on us.  Most of us tend to lose 1% of our bone density per year.  Astronauts lose 2-5% of their bone density per month.  Why?  From a very real thing called gravity deprivation syndrome.  I’d love to experience gravity deprivation for a short amount of time- it would be so cool to float around and, I don’t know, eat m&ms from the air or whatever you do when you’re weightless.  But I don’t want to suffer the effects of gravity deprivation syndrome.  Some astronauts say that getting your inner ear switched back on by coming back into a gravity field (when  you come home) is pretty unpleasant and that trying to coordinate your movements and maintain your balance is a challenge.  And that they’ll often let go of their pen or their book or their orange or whatever, expecting it to float next to them and then it shockingly falls on the floor.  That would be funny.

A growing number of studies are reporting that tons of us are experiencing a form of gravity deprivation syndrome.  Not by expecting out snacks to float around us, but by removing gravity from our lives.  Removing gravity likely accounts for at least 22% of cases of coronary heart disease, 22% of cases of colon cancer, 18% of osteoporotic fractures, 12% of cases of diabetes, 12% of cases of hypertension and 5% of cases of breast cancer.  Researchers Steven Lewis and Charles Hennekins, who estimated those numbers, estimate that this results in at least $24 billion of US healthcare spending.  All preventable by our old free friend gravity.  

We remove gravity from our lives by sitting for long stretches of time.  It’s a big deal with $24 billion dollar consequences, and it’s not nearly as fun as floating around with your hair sticking up eating m&ms.  You can decrease your chances of getting all of those diseases I just listed, including osteoporotic fractures, by befriending gravity a little more.  Joan Vernikos explains that space research proves that the body responds best to gravity signals that are frequent, low intensity start-stop type movements experienced frequently throughout the day.

This means a high intensity gravity resistant workout (like lifting weights at the gym) is good, but not enough.  You can’t workout once a day and expect to be able to sit the rest of the day.  It’s really about getting your butt off your chair on a regular basis.  In her book, she says “The results showed that the benefits came not from how long one stood up, but how many times one stood up.”  She says you need to stand up a minimum of 16 times a day if you’re lying down all day or 32-36 times per day if you’re sitting all day.  This means not sitting for more than 20-30 minutes at a time.

Dr. Vernikos did a bunch of studies showing that the negative effects of sitting on plasma volume, heart rate, blood pressure, cortisol, ACTH, plasma renin, catecholamines and vasopressin come on after about 20 minutes of sitting.  So just getting your hindquarters off the chair every 20 minutes helps prevent a lot of those consequences that start building up after 20 minutes.  It really is not about how long you stand up, just how many times you stand up throughout the day.  It’s not even a problem of how many total hours you spend in a seated position, but how many minutes or hours you sit in a row without standing up.  And standing up for hours in the same position without a break is also not good.

So how can you use this space wisdom to improve your life?  It really is about getting a little timer and standing up every 20 minutes.  I mentioned this before, but once I saw how my mentor, Brian Johnson, does this it totally clicked for me.  He sets a timer on his old school casio watch for 1,000 seconds (which is 16.666 minutes) and he goes about his day doing his work. When that timer goes off he doesn’t even break concentration, he just stands up from his chair as he keeps working and sits back down and resets the timer to stand up again in 1,000 more seconds.  

That’s when I realized that I could do that.  I work at 2 pharmacies, one where I stand and one where I sit.  Maintaining high energy all day long used to be a struggle for me, back in my 20s and 30s.  It was not fun.  And Tuesdays were pretty draining.  I didn’t try to overanalyze it back then, but since I’ve started standing up every 17 minutes throughout my 10 hour shift of sitting, it’s gotten way, way easier.  I’m not wiped out at 4:30pm like I used to be.  I still have energy to do other stuff when I get home at 7:00 at night.  Part of that is from other daily habits I’ve mastered over the last few years, but a lot of it is just from never sitting for more than 20 minutes in a row.  Amazing.  Please try it.  

Send me a message at healthcouragecollective@gmail.com if you need any tips or encouragement.  I have a silent timer that doesn’t beep and annoy my coworkers, it’s fabulous.  Standing and walking aren’t enough to get your bone density crazy high, but they’re way better than sitting for long periods in a row, and once you add in some high-impact and or properly performed heavy lifts, you’ll be set up for structural strength.

2: Nutrient Absorption

You aren’t quite what you eat.  You’re what you’re able to absorb and assimilate into your body.  Your bone density is actually a good indicator of how well you’re able to properly absorb the minerals you eat.  If it’s low, you might have a problem with your microbiome, digestive enzymes or stomach pH.  You probably know that your bones need calcium.  The US recommends 1,200mg of calcium a day.  Europe recommends 700.  A 2009 study showed that 566mg/day of calcium was enough to protect bones as long as you have enough vitamin D.  One study of 170,991 women even found that more than 700mg/day of calcium  actually increased the risk of hip bone fractures.  You need enough calcium, but not too much, and it’s definitely not the only thing you need.  Your bones are made with proper amounts of calcium, magnesium, manganese, copper, boron, phosphorus, strontium and vitamins D and K2.

We need to have a separate discussion about the vital importance to all of your other body functions of proper amounts of minerals in your diet via food and/or supplements.  Just remember that minerals do a lot and that excess calcium and calcium without all of the other minerals can be harmful to your bones and calcium without vitamin D and vitamin K2 is likely to go to the wrong places, like your coronary arteries, which is very bad.

The best way to optimize your diet to improve your bone density would be to get your nutrient levels tested.  Without that, we’re just guessing, but chances are quite high that you’re low in magnesium and low in vitamin D and low in vitamin K2.  If I were to take a shot in the dark, I would start there.  Most people are deficient in those 3 things, and they have a huge impact on your bone density.  Go way back and listen to episode 21 about vitamin K2.  It’s amazing.  Don’t overlook it.  It’s such an easy way to make sure you’re getting your calcium where it needs to be, and most people don’t get nearly enough.

If you know your bone density is low and looking for a supplement, find a bone health supplement like OsteoPrev by ortho molecular or Bone Restore by Life Extension.  OsteoBalance by Pure Encapsulations is ok but doesn’t have vitamin K2.  You want something that has more than just calcium.  There are also probably other good combination products.  Boron is good to have in there.  You’ll probably need additional magnesium and vitamin D.  The point is to think of way more nutrients than just calcium.

Colorful vegetables have trace minerals and polyphenols that can help with bone building.  Lactoferrin in whey protein can help support strong bones.  Too little protein is bad for bone building, but tons of protein is also bad for bones.  Drinking soda is bad for literally everything except Coca Cola's revenue sheet, so please please please please don’t drink soda regularly if you want to be a force for good in the world.  It’s also bad for your bones.  So is excessive coffee and alcohol and excessive standard iodized salt and excessive amounts of vitamin A.  Smoking, too. Bad.  Just don’t do it.  Having too low of body fat is bad for your bone density and having a high homocysteine level has a negative effect on bone density as well as your risk for cardiovascular disease.

Remember all the milk mustache ads from the 90s?  Everyone cool had a milk mustache ad.  Mary-Kate and Ashley Olsen, that kid who was Tim the Toolman’s son on whatever that show was called that had wilson the neighbor whose face you never saw, Jennifer Aniston, Brittany Spears, Venus and Serena Williams, Harrison Ford, Beyonce, even Taylor Swift had a milk mustache ad in 2008.  Sorry, pop icons, but dairy is not that great for bones.  I think industrial dairy is bad all around, but if you tolerate and like responsibly farmed dairy, I don’t think it’s bad or good for your bones per se.  It’s ok for bones, but if you hate or don’t tolerate dairy, your bones will be fine.

Digestive issues like microbiome imbalance, gluten intolerance, leaky gut, certainly crohn’s, even acid reflux disease all can contribute to poor nutrient absorption, which can lead to low bone density.  Long term use of acid-reducing drugs, especially proton pump inhibitors like prevacid, prilosec, protonix, nexium, aciphex and dexilant can all lead to low bone density via raising stomach pH to the point that minerals are not properly absorbed.  This is a big deal.  If you’re on one of these drugs, see what you can do to get off of it if possible.  Unless you have beret’s esophagus or esophageal cancer or something extreme.  Talk to your doctor.

3: Your Hormone Status

Your #1 hormone that you want optimized is usually always your insulin.  So make sure you’re taking care of that.  I can help you get on track.  You want your cortisol in check.  High stress causes chronically high cortisol, and that decreases your bone density.  So does taking corticosteroid medications, because they act like cortisol in your body.  Having too high of thyroid levels can decrease your bone density.  Most people’s levels are too low, but if yours are high or if you get too high of a dose of thyroid replacement, that will impair your bone density.

This isn’t a hormone, but just really quick, new studies are starting to show that taking stimulants for ADHD like Adderall and Ritalin and such decrease bone density and may have a lifelong impact.  They don’t know yet, but they recommend monitoring for extended periods of time.  I can tell you that a ton of people, many of them young, take those medications and may be impacting their long term health.

Human growth hormone and insulin like growth factor 1 can help a little with bone density.  Testosterone in the proper amounts helps to protect your bones from loss.  Also great for your muscles and breast health.  DHEA is a hormone of youth and seems to protect bone health, one study showed a 4% increase in bone density after adding DHEA.  Studies are inconsistent about how much progesterone helps protect bone density as we age.  It either helps or doesn’t, but it for sure doesn’t make it worse.  Progesterone is good for lots of other things, so you want a proper amount.  

If you’ve listened to me much before, you’ll probably know what I’m going to say next, because I always get on this soapbox, but synthetic progestins are not progesterone, and synthetic progestins have been shown to decrease bone density.  One synthetic progestin used as birth control in young women, DepoProvera, has a blackbox warning about decreasing bone density.  Not good.  

The Women’s Health Initiative study is one of the most controversial and oft repeated studies of all time.  I don’t know how many hundreds or thousands of hours have been spent fighting over its results, but one of the conclusions of the study that didn’t get any argument from anyone is that estrogen protects bone density.  Women on estrogen in the study had 40% fewer hip and spine fractures than those not, unless they were smokers. Smoking cancels out any positive effect of estrogen on bones.  Maintaining youthful levels of estrogen definitely protects against bone loss.  It appears that the positive effect lasts for up to 15 years after you stop taking estrogen.  Not much else does that.  What if your countertops stayed clean for 15 years after you stopped washing the dishes?

If you want to know more about the basics of bioidentical hormones, be sure to check out my Udemy class.  That will get you up to speed and feeling confident and informed if you’re considering looking into taking them.  I thought this would be a quick and easy episode, but there’s so much to having good bone mineral density.  We didn’t even get into osteoblasts vs. osteoclasts, but just know that like everything in your body, you are constantly breaking down bone and also constantly building it back up.  You don’t want to break it down more quickly than you’re building it back up.

Maintaining Strong Bones is Easier Than Remineralizing Weak Bones

Maintaining good bone density with a happy equilibrium of osteoclastic and osteoblastic activity is much easier than trying to build up bone density from a really low starting point.  It can be done, but it takes a lot of attention to all 3 of these areas, and it gets harder the older you get. So if you get your bones strong now and then all you have to do is maintain them, you’re way better off than waiting till you become a porcelain doll of an 80 year old and trying to get to work on it then.

If you can avoid having to take a prescription medication for osteopenia or osteoporosis, I think you absolutely should.  There are some bad and scary things with those medications.  For some people they’re kind of the only choice, and they’re better than breaking your hip or vertebrae, but barely.  Post-bisphosphonate bones are abnormal in a bad way, Dr. Weinstein has shown that they have abnormally large osteoclasts with an abnormally high number of nuclei.  Plus they can sometimes cause osteonecrosis of the jaw, which is bone death due to insufficient blood supply, because they prevent bone breakdown so much that the old bone hangs around longer than it should but still loses its life support.  Not good.

If you have questions about minding your bone density, send me a message at healthcouragecollective@gmail.com.  

1-The way you move: High impact activities like gymnastic vaulting promote bone density the most.  Lifting heavy things is hugely important.  Allowing gravity to work on your body every 20 minutes by standing up from your chair. 

2- The nutrients you are able to absorb: Eating and or taking all the right minerals and vitamins and making sure your gut health is optimized so you can absorb them.  Vitamins K2 and D are super important. 

3- Your hormone balance.    Keeping your hormones as balanced as you feel comfortable doing.  Naturally or via supplementation.  Estrogen is the biggest player, but also reducing your stress and making sure your thyroid levels are on target, and testosterone and DHEA play a role.

You’ve got this.  I would love for you to get a dexa scan.  Please seriously consider it.  Google “dexa scan near me” and see what comes up.  They’re about $75 in my area.  I do one once a year, it takes about 7 minutes.  It’ll give you tons of useful info, and making an intelligent plan starts with knowing where you are and where you want to be.  Once you have that, we can get you on track to getting there.  Next week we’re going to talk about the value of accepting age related decline.  Kinda counter to what I typically preach.  I think it’ll be good. Until then, create structural strength and don’t be normal.