I was 60 years old when I was first diagnosed with osteoporosis after my first DEXA scan, a low-dose, Dual-Energy X-ray Absorptiometry scan to assess bone density and predict the risk of fractures. It was an unpleasant—and not uncommon—surprise.

Like many women of my generation, I’ve been physically active most of my life. A runner until I quit in my 40s, then a hiker, a walker, a Zumba instructor and a fitness instructor.

I was probably advised to take 1200 mg of calcium supplements at the time and to start taking Fosamax, a popular medication used to treat and prevent osteoporosis.

I declined.

I’m very health conscious and drug averse unless absolutely required. I checked the possible Fosamax side effects of longitudinal bone fractures, necrosis of the jaw and other issues and said, “nope.”

I had a second bone density scan a year and a half later and my numbers were rapidly heading into the negatives.

Still drug averse, I felt righteous about my health as I had been aging well otherwise. I was a vegan and then a vegetarian. No caffeine for 45 years. I’ve been off all types of sugar for most of my adult life because I’ve learned that I can’t regulate it. One bite is too much and a hundred bites isn’t enough, which puts me in a perpetual state of craving and hangover.

I continued to follow common medical recommendations for osteoporosis –– good nutrition, walking, strength training, stretching, balance exercises, lifting light weights with multiple reps, in what we believed were bone building exercises. And to avoid lifting anything heavy.

Like the weight of an average toddler.

Now we know it’s not enough.

I kept getting every new alternative high-tech bone test over the years, looking for a miracle — data to prove that even though my DEXA scan numbers were bad, my bones were strong. No such luck.

In the meantime, with the threat of spinal and hip fractures still abstract –– it’s not like I could see my fragile bones –– my big plan was to continue to keep moving and simply not fall, which is how the majority of us fracture. Longevity studies predict one-third of older adults will die within a year after a hip fracture.

Finally, at 73 and 13 years after my first diagnosis, I stumbled across a breathtaking new piece of the puzzle. One course correction that has modified my approach and made me more hopeful.

The LIFTMOR Study, a medically supervised program with diagnosed osteopenia and osteoporosis patients conducted at the Bone Clinic in Australia, demonstrated bone density could be stabilized and even slowly reversed through a twice-weekly, 30-minute High Intensity Resistance and Impact training (HiRIT) program.

The DEXA-scan numbers in the study showed spinal bone density had increased by 3% in Bone Mineral Density (BMD) in eight months. Just stopping bone loss is huge. We normally lose 2% of bone per year starting at about 20. But to gain? That’s really big news.

The more startling revelation in the study by Dr. Belinda Beck was the discovery that despite DEXA scan scores initially showing very little improvement in bone density in the hip –– specifically the head of the femur —- advanced technology actually revealed the bones had changed their geometry, making the cortical bone thicker and stronger. So although the DEXA scan showed very little improvement, in fact, the femoral neck cortex had improved by 27%.

That’s huge! Unheard of in the bone-density world.

With the LIFTMOR study in hand, I consulted my endocrinologists and with their somewhat reserved support and blessing, I’m four months into my year-long bone project — my study of one. According to my current medical predictions, my DEXA scan scores say I have a 50/50 chance of a hip fracture. My lower spine, L1-L4, isn’t good but it’s stronger than the head of my femur.

The first step has been enrolling in an Onero class specifically designed for clients with low bone density, using the LIFTMOR protocols with close supervision. It is certified by the Australian Bone Institute and all instructors are Physical Therapists or Exercise Physiologists.

With a total, focused approach on everything bone related, I’ll retest in April and see if I have been able to reverse my DEXA scan numbers. Building bone strength is a slow process. It’s personal and multifaceted and complicated. It’s nutrition and movement. It’s drug interactions, genetics and more.

And I’ve also come to believe that the DEXA scan data is only one, somewhat limited piece of data to accurately predict fractures.

Despite its popularity, it doesn’t reveal the whole picture of bone health, life span and health span. Why is it, I wondered, that people I know with much better DEXA-scan scores than mine have had multiple fractures and I haven’t had any? Is it just that I haven’t fallen? Yet?

The medical professionals I’ve consulted pretty much universally admit we don’t have the technology to determine bone strength and bone quality. But because it’s one of the few universal measurements, it’s the data being used to prescribe lifetime bone density drugs.

Dynamic Aging
In the meantime, I believe my long-time involvement with Dynamic Aging has been the biggest factor in slowing down my bone loss trend over the past decade. More than an exercise class, Biomechanist and author Katy Bowman promotes a lifetime whole body movement practice. It taught me how to change my habits of how I stand and move and that a neutrally aligned spine is what allows gravity to load my hips and spine while I walk, hike, lift, and carry. I discovered that if I was leaning forward as I walked, or standing with my knees bent, gravity was working my muscles in my thighs and putting pressure on my knees and feet. But not where I need it for bone building. My femur. My spine.

My work as a Certified Restorative Exercise Specialist with Katy Bowman has paid off in ways I didn’t predict, including providing a solid foundation for protecting my spine when lifting heavy weights in the

program.

Nutrition
My endocrinologists still advise me to take 1200 grams of calcium per day — but in my food, three times a day, without supplements. I track my calcium intake with an app –– I use Cronometer –– along with 400 IU of Vitamin D3, to absorb and deliver the calcium, along with some fat. I track my protein intake since protein plays a crucial role in maintaining and building strong bones, and builds muscle to protect me if and when I fall. I feel like a mad scientist as I enter weighed and measured meals in my nutrition app each meal. When I don’t track my food, I discover I’m often ingesting less calcium and protein than I think.

Medications
I continue to be wary of osteoporosis meds. The side effects still scare me, especially since once I start, most protocols require I migrate to a second drug. One prescription might be to build bone, the next would be to retain bone.

I’ve been privy to many scary anecdotes about side effects and rebounds by fitness clients. Because of a separate health issue, a good friend missed her semi-annual shot of Prolia, a drug which builds bone. Within three months of the missed shot, she broke two vertebrae. Two months later she broke three more. Apparently as soon as the drug ends, it has a rebound effect by rapidly breaking bone down faster than it built it. She is back on Prolia but is being encouraged to substitute to another bone building drug in November, which has other possible side effects, including stroke and heart disease.

Community
I’m not alone in my personal journey to a full-on, whatever-it-takes strategy to strengthen my bones. I have joined some vibrant online groups like Brick House Bones with Dr. Lisa Moore, a pragmatic and able physical therapist in Washington who works with thousands of people who are committed to their own bone health. I am also part of the Be Stronger online strength training program at Body Wisdom Studio with Nancy Allen Burns, for active, aging adults like me. If you’re lucky enough to live in the San Francisco Bay Area, her amazing and challenging in-person classes are in the Point Richmond studio.

What’s next?

I plan to continue to Dynamically Age — be curious, nutrition smart, include a nutritious movement diet to include balance, cardio, impact, resistance training and weight bearing activities. A daily dose of pretty rigorous cardio is essential for my mental health —- dragon boat paddling, hiking, Zumba, which enhances my overall well-being and my spirits. Spending time outdoors regardless of the weather is also essential to my emotional resilience. I’m documenting my movement and nutrition on a daily basis, with the ultimate question each night –– ‘What have I done for my bones today?’

What I now believe
Genetics, drug interactions, not banking bone strength because of ‘fad’ diets in my early years probably caused my osteoporosis. Data now shows that very specific HiRIT weight lifting exercise is the most important factor in rebuilding bone strength. Nutrition, balance, sleep and more all support my concentrated exercise focus.

As scary as my DEXA scan scores are, I remind myself it is only one number that scores bone density and it doesn’t reveal strength and quality and resilience. So far I’m achieving my number one goal of bone health — no fractures! My mentors also remind me to consider — where would I be at 73 if I hadn’t exercised all these years?

Four months into my bone-building project, I’m equally excited, committed, frustrated and exhausted. I’m discovering it’s complicated to do it all, that I know just about as much as any lay person about osteoporosis, and probably as much –– or more –– than most general medical practitioners. I have a vested interest in being cutting-edge informed. I continue to be curious and motivated and unafraid to ask questions, to pursue help, be my own advocate.

Ultimately, I want to pay forward what I know to our next generations of daughters, granddaughters, daughters-in-law to share how so many of us my age and younger have gotten to this osteoporosis crisis. I want us all to carry the message to younger generations to check their bone density early to set a baseline score until there is more informed data, incorporate appropriate heavy weight lifting early, pay attention to what medications they are taking right now that restricts mineral absorption, bank their calcium early and don’t be misled to think having an active life will be enough. Ultimately, I want our medical experts to also write the prescription for exercise as a proven, data driven solution to osteopenia and osteoporosis.