We don’t often think about them, but we can’t do anything without them. Our bones pretty much take care of themselves up to the age of “peak bone.”  Throughout our lives, our bones are constantly “remodeling” – clearing out the old parts and replacing those with new bone – and that amount steadily increases up to our maximum bone density at about the age of 30, so-called “peak bone”. Thereafter, the “clearing out” proceeds at a steadily increasing rate and the rate of replacement slows down. 

What most people don’t know is that both rates—clearing out and replacing—are both modifiable by the choices we make and the actions we take. We are capable of making new bone—even strong bone—throughout our lives.

Great news, except the actual news isn’t so great: the rate of hip fractures is steadily increasing and expecting to double by 2050. More of us are living longer (great!) but attention to our bones is not always keeping up with our lifespan. Loss of bone quality and strength goes by the terms osteopenia (moderate bone loss) and osteopenia (marked bone loss).

BEST NEWS IS THAT YOU CAN TAKE GOOD CARE OF YOUR BONES.

I suggest three steps you can take to improve the strength of your bones.

1) ASK FOR THREE TESTS, if you are at increased risk for any of the following reasons.

The THREE TESTS include a bone density test (a minimal-radiation x-ray known as a DEXA) and two blood tests: C-telopeptide (CTX) and Procollagen-1 Peptide (P1NP). 

Who’s at increased risk?

Everyone over the age of 50, women more than men.  (Currently about 10 million folks in the US over the age of 50, 80% women, 20% men.)

Your risk is even higher if you

• Regularly take corticosteroids, anticonvulsants, or proton-pump-inhibitors.

• Have difficulties with your digestive tract, especially if you’ve been told you are sensitive to gluten

• Drink more than 3 cups of coffee or 2 servings of alcohol daily, or if you smoke cigarettes.

• Sit more than you exercise

• Have deficiencies of calcium, vitamin D, protein, omega 3’s, B vitamins.

• Or high levels of homocysteine   

2) CHECK OUT THE RESULTS FOR YOURSELF.    Your bone density test will categorize your bone strength in one of three categories:

• Normal, with bone density within the normal range compared to others your age.

• Osteopenia, slightly diminished bone density, in measurements called a T-score, ranging from -1.0 to -2.5

• Osteoporosis, bone at greatest risk of fracture, with a T-score -2.5 and lower.

Now let’s look at those lab tests and see how we can optimize them.

3) TAKE ACTION DEPENDING ON THE BLOOD TEST RESULTS

FIRST:  Let’s start with the CTX. You’d like it (in a perfect world), less than 150, but even less than 250 would be good.  If it’s higher, the steps you can take include:

• Aim for a vitamin D level of 50-70ng/mL

• Adequate calcium: best sources about half food and half supplements totaling about 1200 mg a day. (More than that as a supplement strengthens your bones but can raise your risk of heart disease or stroke.)

• Stabilizing your bone with a complex vitamin K (Thorne Vitamin K, Jarrow K-Right are good examples), omega-3 fish oil, adequate B vitamins, and perhaps the phytoestrogens found in genistein and/or hops! (I mean the hops, not the tasty brewed version known as beer!)

• Talk to your doctor about the hormones that can stabilize bone density: estrogen, progesterone, testosterone, and DHEA.

SECOND:  Your P1NP should ideally be > 75, a number you can tweak yourself if you:

• Eat sufficient protein: past the age of 60 you need to eat more to absorb what you need. Current recommendations are 0.75 – 1.0 GRAM of protein per each POUND of your lean body weight. That protein should be complete protein, sourced from animal, dairy or soy protein.

• Supplementing with creatine is safe and very helpful, Creatine Monohydrate 5 grams daily, stirs pretty easily into most anything. Recommended for all ages, and the only apparent side effect is the promotion of new brain cells!

• Adequate magnesium, B vitamins,fish oil and

• MOST IMPORTANT OF ALL:  Resistance exercise!!  It’s great to work with a trainer, either in person or remotely, or with the help of skillful authors such as Dr. Stacy Sims, PhD, specializing in Female Physiology. She’s active on social media and has written a practical guide to increasing health and strength, Next Level,  aimed primarily at women but useful to men as well with recommendations for strength building life choices and exercises.

It goes without saying that all of the above details can be tweaked and personalized,according to your own health, resources and goals.  The bottom line is that most of us (excluding some unusual bone-related illnesses) can rebuild bone, but only if we know how our bones are to start with and how to “nudge” our body to rebuild bone.