Your bone density blueprint

The official guidelines on bone health are bananas to me.  

Women lose 10-20% of their total bone mass in their 40s and 50s. 

So the fact that most guidelines don’t recommend a DEXA scan until 65 is a travesty. 

Last week I shared that at 44, I already have osteopenia. (Read about it here if you missed it!) 

This week: I’m diving into what I’m doing about it—and why your 30s, 40s, and 50s are the most powerful time to protect your bones for life.

What to know: The best time to build new bone is yesterday.

We tend to think of bone loss as a “later” problem. But…

📉 Most women hit peak bone mass by age 30. After that, we start to lose more than we build.

A few major life stages can accelerate that loss:

• Pregnancy: Your baby’s development increases calcium needs dramatically. If your diet can’t keep up, your body pulls it from your bones (Annals of the New York Academy of Sciences, 2021)
• Breastfeeding: Estrogen dips, calcium leaves with milk, and bone density can drop by 5–10% in just months (Journal of Perinatal Education, 2005).
• Menopause: The estrogen cliff hits and 1 in 2 women over 50 ends up with low bone density (Journal of the American Osteopathic Association 2019).

What to do: Weight train, eat right, support with supplements, add HRT. 

Add weights, trampolines, and impact. 

Bones aren’t static, they’re living tissues. To grow stronger, they need stress. 

Specifically: Axial load—force applied vertically through the bone via weight-bearing or impact activities. 

• Resistance training: Compounded exercises like squats and deadlifts 3x per week can boost BMD by 3-5% (Journal of Strength and Conditioning Research, 2013).
• Impact sports: Think: jogging, jumping rope, even box jumps. Any impact that “challenges” your bones has been shown to increase BMD (Sports Health).
• Rebounders: Mini trampoline workouts (45-60 min 2x per week) can improve bone density in just 12 weeks (Clinical Interventions in Aging, 2019).
• Whole body vibration: A Power Plate can increase lower body strength, improve circulation, and increase bone mineral density—even in women with osteoporosis (Brazilian Journal of Medical and Biological Research, 2024). 
• Cutting-edge tech: The BioDensity machine adds compressive force to 4 compounded exercises to target total body bone density, build muscle, and lower blood glucose. 

⚠️ Not for bones:

• Yoga or Pilates
• Walking (unless you add weight)
• Bodyweight workouts (unless they involve jumping)

Eat your veggies. 

• Veggies = Strong bones: 9 servings of veggies per day decreases calcium loss (Nutrients, 2015)
• Focus on veggies high in calcium like broccoli, kale, and collard greens

⚠️ Avoid high-fat, high-sugar, and calorie-restricted diets—they tank BMD (Nutrients, 2024)

Supplement with calcium, magnesium, and strontium after 30. 

While food comes first, here’s what research supports:

• Calcium: look for MCHC paired with phosphorus like AlgeCal Plus or Metagenics’ Bone Builder Plus. 
• Magnesium glycinate: boosted BMD in 71% of women (BioMetals, 2021). 
• Strontium: 600 mg/day cut the risk of fractures in half (International Journal of Molecular Sciences, 2021)

I test supplements with my patients and always start low and go slow. 

Hormone replacement therapy: Test early. Start early. 

Estrogen helps regulate the cells that build and break down bone. When levels fall during perimenopause and menopause, bone loss accelerates.

• HRT can increase BMD by 10% and significantly lower the risk of osteopenia and fractures (Menopause, 2023)

Short answer: consider it early.

Drug therapies aren’t a forever fix. 

Bone meds like bisphosphonates (Fosamax), monoclonal antibodies (Prolia), and anabolic agents (Forteo, Evenity) can help slow or reverse bone loss—but they come with caveats. 

Side effects may include GI issues, jaw complications, and concerns from long-term use (especially in animal studies). 

Stopping suddenly? That can trigger rapid bone loss and rebound fractures. For these reasons, I don’t prescribe them. 

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