Face-Off with Osteoporosis, My Story 

Healthy. Fit. Energetic. Lively. This was my positive self-perception until I was diagnosed with osteoporosis in my fifth decade of life. 

I love fitness and healthy eating—so much that I earned an M.S. in kinesiology and later went back to college to earn a B.S. in nutrition with an emphasis in dietetics. I worked for many years as a certified fitness instructor and personal trainer. 

 After finishing my nutrition studies, I passed the nutrition and dietetic technician, registered (NDTR) exam from the Commission on Dietetic Registration (CDR), the credentialing agency for the Academy of Nutrition and Dietetics. 

I learned to love running and lifting weights as a teen. In my 20s and 30s, my workday entailed teaching fitness classes and personal training sessions with individuals. Off the clock, I might do some recreational bodybuilding and/or cardio. 

I continued lifting weights and sweating through cardio sessions most days out of the week into mid-life, so I was shocked when I found out my bones were becoming weak and fragile! 

​​Why do I have osteoporosis?​ 

The truth is that although I used to curl a 45-pound bar with my biceps, I have most of the risk factors for osteoporosis. 

• Short stature 

• Low body weight and body mass index (BMI) 

• Caucasian race 

• Long-term use of antacids for irritable bowel syndrome (IBS) management 

Plus, my mother has osteoporosis. Fortunately, I was never a smoker.  

In addition, my aging, arthritic knees curtailed impact exercises like running and jumping. Long-term lifestyle choices, such as frequent consumption of coffee and wine, while limiting high-fat, calorie-dense, and dairy foods, did not help preserve bone mass—not that I gave it much thought at the time. 

Post menopause 

All this meant that as I hurtled toward menopause, my bones were crumbling. However, I might never have known had it not been for Dr. Shanil Juma at Texas Woman’s University and his research on berries*. 

While studying nutrition in late mid-life, I enrolled in this study. (I had always enjoyed lab work in exercise physiology, so I thought, “Why not”?) 

In addition to drinking a daily 12-ounce supplement from powdered raspberries, I would get free bloodwork and dual-energy x-ray absorptiometry (DEXA) scans at the beginning and end of the six-month study period.  

Most women do not receive an osteoporosis screening until age 65! 

My mind was blown when, at age 51, I learned that I had osteopenia in my spine and hips. A year later, at my next checkup, I shared this info with my gynecologist, who ordered another DEXA scan, which revealed further bone demineralization, moving into the territory of osteoporosis! 

How do I fix this? 

I was lucky. Most women do not receive DEXA screening for osteoporosis until age 65. Plus, at the time of my DEXA scan, I was actively working on a degree in nutrition! This helped me know which supplements and foods might increase bone mineral density. 

Don’t get me wrong: I also started on hormone replacement therapy (HRT), a combo of estrogen and progesterone. One of the causes of osteoporosis in post-menopausal women is lack of estrogen. 

However, I looked hard at my diet and lifestyle. Changes included: 

• More dairy products, especially milk and cheese, calcium-rich leafy greens, and legumes 

• Less meat and more fish, chicken, eggs, and tofu 

• Supplements: Absorbable calcium and vitamin D twice per day and collagen peptides daily 

• Less caffeine and minimal wine​/alcohol​ intake 

• Learning to play tennis 

Endocrinologist 

Because my decline in mass was sudden and alarming for a fifty-ish woman, I was referred to an endocrinologist, Dr. Minh-Da Le. She performed different types of labs that made her suspect I might have hypophosphatasia, 

This genetic disorder is characterized by soft bones and dental problems and was ruled out via a DNA test. She initially thought I should start bisphosphonate therapy, which some practitioners feel should be standard treatment for women ages 70 or older.  

Side effects from bisphosphonates are unpleasant and range from gastrointestinal and esophageal distress to osteonecrosis of the jaw, in which gum tissue no longer covers the jawbone, and it dies. 

Jaw issues are rare. However, feeling flu-like symptoms for several days following the treatment is normal. 

Four years = better bone mass 

Bone building, remodeling in clinical-speak, is a slow process, although bisphosphonates are one of the quickest methods.  

Repeated DEXAs over the last four years have shown small but measurable improvements in my bone mass. I no longer have osteoporosis in my spine or hip, just my femoral neck, and the severity has declined. The -2.5 T-score of my femoral neck grazes the osteoporosis category. 

Dr. Le said that she has noticed that often the bone density in the spine tends to increase more than other areas when a patient treats their osteoporosis. 

Changes to eating and my activity in conjunction with estrogen therapy have not remineralized my bones to the point where they are normal. But I am not considered frail, and my fracture risk is much lower. 

Living the experience of death caused by osteoporosis 

Although my mother-in-law lived into old age, it was not always a ripe old age. In the final decade of her life, she relied upon a walker to get from room to room and took multiple medications to manage chronic pain. 

The walker became part of her life after both hips had been replaced. Although the first hip replacement was planned, the second required emergency surgery after she fell and broke it. 

In the years after her second hip was replaced, my husband and I watched <as she> her dwindle<d> to a weight of 100 pounds from 140 to 150. 

She smoked for probably 50 years but had tapered off and then, quit. She had chronic obstructive pulmonary disease (COPD) and did not like to use oxygen even though she lived at altitude. 

At the age of 89, she got up in the middle of the night to use the bathroom and missed her bed as she returned, hitting the rug over hard tile floors with her butt​ocks​. After two days of increasing pain and inability to put any weight on her legs, we took her to the E.R.  

Her X-rays revealed a fresh fracture in a tissue-thin pelvic bone that was riddled with lines from many healed fractures that had occurred with previous falls.  

The ​E.R. ​doctor said her osteoporosis was so severe that the only treatment for the fracture was waiting to see if it would heal on its own, as the previous ones had, and pain management. He said she should have been treated for osteoporosis. 

Although she was screened for osteoporosis once, many years before, there was never any repeat screening. Maybe some of her need for pain medicine was because of these untreated, undiagnosed fractures in the pelvic area and perhaps other bones in her body? 

My husband and I certainly were not aware of her earlier pelvic fissures, and I don’t believe she knew about them despite her continued aches and pains. Most likely, she thought aging caused her discomfort. 

She was soon transferred to a skilled nursing facility, where she died a few days later. 

She had many risk factors for osteoporosis, such as smoking, Caucasian ethnicity, low muscle mass, poor diet, little sun exposure, and breaking her hip. Why hadn’t any of her doctors, including her hip surgeons, suggested that she be tested for osteoporosis? 

Treatment might not have prevented her death (she was 89). But it certainly could have improved her quality of life. 

Lucky me 

I was born in the year of the rabbit and have often felt the luck of the rabbit as I glide through life. Having early-onset osteoporosis is unfortunate, but finding out about it soon enough to see improvement without hard drugs is lucky! 

I have the rare good fortune of loving to work out and knowing something about supplements and nutrition for better bones. 

Also, after seeing my mother-in-law’s dire situation, I know what can happen if fragile, brittle bones are not treated. They will break and lead to a world of hurt and potentially, a premature death!  

I incorporate balance exercises as a part of my daily routine since falls are a direct cause of broken bones.  

If necessary, in a few years, I will try bisphosphonates or other medications like denosumab (Prolia) or raloxifene (Evista). The latter is used to prevent breast cancer, too.  

Of course, I plan to continue eating a healthy array of foods, mostly from plants with some eggs, fish, and chicken for plenty of protein along with fiber and phytonutrients. 

Phytonutrients are the health-giving secret of plants, anti-inflammatory antioxidants that are a gift to the body’s many cells and are delivered as a bonus along with vitamins, minerals, and fiber. 

Practical Dietitians have developed resources, so you know what to eat to get nutrition from your food to support your bone health (and your muscles). Their recommendations, which I follow, are a recipe for a healthy, fit, energetic, and lively life at any age! 

*Katelin Hatcher, R.D., L.D. published this research in a graduate thesis: “THE EFFECT OF WHOLE RED RASPBERRY JUICE ON BONE DENSITY AND BIOMARKERS OF BONE IN POSTMENOPAUSAL OSTEOPENIC WOMEN.”