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Dealing with osteopenia, ways to increase bone density

marzNC

Angel Diva
A while back, there was a thread about skiing with osteopenia/osteoporosis . It’s probably an issue for many Divas who are over 50, whether they know it or not. Been learning a lot recently about ways to increase bone density and wanted to share info because the topic is important for women of any age. Some of the questions I started with include:
  • What exactly is osteopenia/osteoporosis? What’s the difference?
  • Taking supplements for add calcium and Vitamin D is obviously a good idea, but how much?
  • What exercises would help decrease bone loss? Can new bone be created?
Hope Divas with diagnosed with osteopenia/osteoporosis will chime in with their experience. If you have not given the topic much thought before and have any questions, please ask so we can all learn more sooner rather than later.

Oh, in case anyone is worried . . . from what I’ve found so far, there is more reason to keep skiing than to stay off the slopes. :smile:
 

marzNC

Angel Diva
Recently I did a bone density screening for the first time. I’m approaching 60, so it was a bit overdue. Turned out my hips are in fine shape, but there is evidence of bone loss in my spine. Enough to say that there is evidence of “the presence of an osteopenic syndrome.” Osteopenia is not a disease but implies higher risk for fracture and likely future progression to osteoporosis if not addressed. My doctor’s comment was that there was no need for drug intervention but I should do weight bearing exercise more. We didn’t spend time talking about ski conditioning and ski trips at my last appointment with her since it was during the summer. :smile:

When I mentioned osteopenia to my person trainer, as I expected she knew exactly what type of exercises would be helpful. She is over 60 and many of her clients are older women. The key for building bone is working with heavier weight and/or doing activities that involve impact. Impact in terms of jumping or running is more relevant for people with low bone mass in their lower body.

One of the first videos I found is of a 66yo woman using a 26 lb kettle bell. The narration by her trainer is to the point. He certainly had to get it right . . . she is his mother-in-law. I included this video in a blog post together with a couple others that provide a quick introduction to the concept that exercises that are weight bearing or use resistance are important for everyone, especially women over 40.

 

tinymoose

Ski Diva Extraordinaire
My family is full of folks with osteoporosis and osteopenia. My mom was diagnosed with osteoporosis in her 40s. I've had osteopenia density levels since my 20s. It's assumed I've always had low density bones... yay, genetics! Oddly enough, I've only ever broken a thumb and a large toe despite being involved in risky sports like gymnastics and skiing. And the bones healed quickly and thoroughly so I'm really not all that concerned at this point. I'm hoping gymnastics and skiing help me maintain what bone density I do have for as long as possible.

Anyhow, best recs are take calcium supplements (2 of my aunts were able to improve their bone density this way without it progressing), weight bearing exercises, and avoid drinks with phosphoric acid (I'm TERRIBLE with this). Phosphoric acid is in dark colas (Coke, Pepsi, Dr. Pepper). It leaches calcium from your bones. Obviously, eating a healthy diet and getting calcium that way is good too. I'm really good at eating cheese, not so much with the calcium-rich veggies.
 
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santacruz skier

Angel Diva
My family is full of folks with osteoporosis and osteopenia. My mom was diagnosed with osteoporosis in her 40s. I've had osteopenia density levels since my 20s. It's assumed I've always had low density bones... yay, genetics! Oddly enough, I've only ever broken a thumb and a large toe despite being involved in risky sports like gymnastics and skiing. And the bones healed quickly and thoroughly so I'm really not all that concerned at this point. I'm hoping gymnastics and skiing help me maintain what bone density I do have for as long as possible.

Anyhow, best recs are take calcium supplements (2 of my aunts were able to improve their bone density this way without it progressing), weight bearing exercises, and avoid drinks with phosphoric acid (I'm TERRIBLE with this). Phosphoric acid is in dark colas (Coke, Pepsi, Dr. Pepper). It leaches calcium from your bones. Obviously, eating a healthy diet and getting calcium that way is good too. I'm really good at eating cheese, not so much with the calcium-rich veggies.
Yep, I got it as well. I resisted taking Fosamax for years until my doctor said I shouldn't be doing high risk sports such as skiing, etc. So have been taking Fosamax a couple of years (bone density greatly improved - no longer osteoporosis).. Trick is not to take it longer than five years as the risk of fracture is relatively low but the healing process is slower...
 
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altagirl

Moderator
Staff member
When do they typically recommend getting tested? Given my build and family history, I would be shocked if I have this issue, but you never know.
 

marzNC

Angel Diva
One of the more useful websites I came across was actually for kids. Created by an M.D. who is also a professor around 2000. It's called Bone Biology for Kids. There includes a webpage that shows how bone density varies for high level athletes in a few sports.

Bone Density in Athletes

Alpine skiing is not included, but the info for cross-country skiing looks good. When compared to a control group who are not athletes, XC skiers have higher bone density all over their bodies. Volleyball is similar. Gymnastics is even better for hips and slightly lower for the leg.

Spine: 12% higher
Hip: 17% higher
Arm: 6% higher
Leg: 12% higher

In contrast, speed cyclists were slightly lower than the controls. Swimmers were slightly lower than the controls for both hip and leg by 3%.

Spine: not different
Hip: 2% lower
Arm: 1% lower
Leg: 1% higher

Dr. Susan Ott has a fairly comprehensive website designed for both patients and physicians on Osteoporosis and Bone Physiology. It will take a while to read through the material there.
 

marzNC

Angel Diva
When do they typically recommend getting tested? Given my build and family history, I would be shocked if I have this issue, but you never know.
What I've read is that usually bone density starts decreasing around age 35. For women, the five years after menopause is when the decrease accelerates because bone building is related to estrogen. I was already thinking about it when my doctor suggested the screening this summer. I started menopause 5-6 years ago and did not take any medications.

Here's the recommendation based on the National Osteoporosis Foundation guidelines about who should consider bone density testing:
  • All postmenopausal women below age 65 who have risk factors for osteoporosis.
  • All women aged 65 and older.
  • Women with medical conditions associated with osteoporosis. Your health care provider can tell you if you have a medical condition associated with osteoporosis.
  • Men age 70 or older.
  • Men ages 50-69 with risk factors for osteoporosis or medical conditions associated with osteoporosis.
It's a good idea to check how your health insurance covers a bone density test. When I did mine, the note by my doctor that said it was for "screening" was missed so the wrong code was submitted for insurance. The first bill I got was a pretty big chunk of about $1000. Once the error was corrected, I only paid $25.
 

marzNC

Angel Diva
Turns out that the National Osteoporosis Foundation is promoting the World Osteoporosis Day on Oct. 20, 2015 that is an annual event set up by the International Osteoporosis Foundation. Apparently white is the color to wear that day to "celebrate bone health."

It's pretty clear that being more aware of nutrition and exercise that's good for building bone can make a big difference. Not just for older people. Can be even more important for children and young adults so that they build as much bone as possible before the inevitable decrease starts in their 30s.
 

ski diva

Administrator
Staff member
Yep, I got it as well. I resisted taking Fosamax for years until my doctor said I shouldn't be doing high risk sports such as skiing, etc. So have been taking Fosamax a couple of years (bone density greatly improved - no longer osteoporosis).. Trick is not to take it longer than five years as the risk of fracture is relatively low but the healing process is slower...

I took it for five years and had to stop because of the risks. My bone density didn't get worse, but it didn't improve, either. So I'm just doing what I can right now -- weights, calcium, vitamin D. We'll see what the next scan reveals.
 

santacruz skier

Angel Diva
I took it for five years and had to stop because of the risks. My bone density didn't get worse, but it didn't improve, either. So I'm just doing what I can right now -- weights, calcium, vitamin D. We'll see what the next scan reveals.
Yes, after reading all the articles about Fosamax, I was very much against it. Until my numbers got worse and worse. I've had 3 or 4 bone density scans and the most recent scan showed significant improvement. I'm a terrible pill popper but once a week is not so bad. At five years no more. Interesting enough, I fractured my baby toe in Mexico this summer (beach umbrella fell and smashed it) and it has taken forever to heal.....
 

marzNC

Angel Diva
When do they typically recommend getting tested? Given my build and family history, I would be shocked if I have this issue, but you never know.
Have found mention of having the first bone density test around age 50 to 55. I think for me 50 might have been too early. I'm close enough to "normal" even now that if I'd been tested at 50 and nothing was found, then I might have put off doing another test until age 65.

Perhaps the best approach is probably to discuss with your physician any time after age 45. There are a lot of risk factors to consider.
 

marzNC

Angel Diva
I took it for five years and had to stop because of the risks. My bone density didn't get worse, but it didn't improve, either. So I'm just doing what I can right now -- weights, calcium, vitamin D. We'll see what the next scan reveals.
How much weight do you typically use? How many reps for one exercise?

How much time will there be between scans?
 

santacruz skier

Angel Diva
FYI - my first bone density scan was around 50 .... Seems like I've been getting them every 2-3 years.
 

tinymoose

Ski Diva Extraordinaire
I'm really hesitant with drugs like Fosamax, and I don't know what I'll do down the road when I'm faced with that decision. As of right now I'm pretty solidly in camp No, but I'm always open to changing my mind based on current research. My mother was on Fosamax for probably a good 10 years or so before she went off of it. Her doc actually recommended stopping it because of concerns that it increases the brittleness of bone, even while increasing the density. I'm not sure how her bone scans have looked in recent years since going off it, though. She hasn't really mentioned anything to me.

ETA: Yay, gymnastics improves density in some areas! I'm counting on it, since I hate most forms of exercise. lol I'm planning on being like that 86 yr. old lady that does gymnastics.
 

santacruz skier

Angel Diva
My doctor says no more than five years. Max.
 

ski diva

Administrator
Staff member
How much weight do you typically use? How many reps for one exercise?

How much time will there be between scans?

I'm not sure how much time between scans. I know I had a baseline scan, then another after I'd been on Fosamax for five years, I suppose to see what was going on. I don't know what the schedule for a rescan is. My doctor knows my numbers and knows that osteoporosis runs in my family, so I guess I'm counting on him to keep me on track.

As for weights, I have a whole regimen that I do, and the weights vary according to the exercise. I don't go really heavy -- just enough to feel like I'm getting a workout and not enough to strain myself -- and I generally do 12 reps in a set (and generally 3 sets of a particular exercise). There's a good article on how much weight to use here.

Incidentally, I liked that kettlebell video you put up, @marzNC. I'm going to incorporate that into my routine.
 

Swamp Dog

Ski Diva Extraordinaire
make sure your Vitamin D levels are adequate. This helps with absorption of calcium. Those of us in the northeast have notorious low levels of vitamin D.
 

santacruz skier

Angel Diva

contesstant

Ski Diva Extraordinaire
There was a study released very recently (I heard about it last week) that supplementing might not be that effective and might not be worthwhile because of the additional risk of kidney stones, etc. I'll try to hunt it down.

I am taking the route of a good vit D supplement (have been on gel caps for years now) and a green smoothie a day, loaded with organic leafy greens to get additional calcium. I eat a lot of dairy (whole dairy!) This way I feel I am ensuring I am getting bio-available forms of calcium vs. a giant tablet that may or may not be absorbed. And with the way glyphosate chelates minerals from the soil, I feel organic is the only way to go.

I am probably at an increased risk due to genetics and being very fine-boned. I asked for a bone scan last year but was denied. Thanks, Tricare and military budget cuts! I'm 46 so will push again in a few years.

**sidenote** it's always curious to me that cost-saving measures recommended by the gov't. are often in the form of what I would consider vital preventive screenings such as pap smears (now recommended every 5 years??!) and mammograms which are no longer recommended annually. And of course, the military health system adopts these policies immediately. I have to advocate for myself and my daughter more than ever, especially now that we are part of the "retiree system".

Here is the recent article from Time mag about calcium supplements:
https://time.com/4053338/calcium-supplements-bone-health/
 

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