My grandmother loved me dearly, but it was hard to feel the love when it was wedding season. As a kid, we would go to Pakistan every year to visit my grandparents and attend wedding season. Weddings in Pakistan are not what we are used to in the western world. These weddings are multi-day affairs, steeped in tradition and sensory delight, a kaleidoscope of colors, flavors, music and dance. Unfortunately for me it also meant bangle season. Bangles are gorgeous and really mandatory wedding attire in southeast asian cultures. My grandmother loved the gold ones, but my more modern cousins embraced glass. My Irish bones, inherited from my mom, were not meant for bangles, and the glass ones? Ha! My grandmother was determined to get them on me though. She would contort my hand like she was binding a geisha’s foot and somehow, after much laughter (hers) and tears (mine), she would get them on. She was a very determined woman.
In the past year I have discovered that my strong Irish bones may look strong, but in fact, they are not. My mom had severe osteoporosis, and not only did it kill her, but it made the last few months of her life a living hell. My mom lived with us in her final years. She had Parkinson’s Dementia and her mobility was extremely limited. When she took a fall last August and broke her hip I knew it would be the end, but I had no idea how much she would suffer. She required 24/7 care, and she would never walk again. She was bed bound and in diapers, and she lost her will to live. My strong mama, the one who kept telling my girls that she would dance at their weddings and live until 100, died in 3 months. I have to be honest, sometimes I silently blamed her. She was always so focused on her kids and grandkids, but she never took care of herself. She never exercised, she didn’t eat well and her strength and mobility were diminished well before the signs of Parkinson’s Disease appeared. But then I had a wake up call.
After her fall I had my own bone density checked. I have been an athlete most of my life. I was a competitive rower in college, and I have been running, hiking and yoga-ing for the decades since. I also eat really healthy. I am addicted to ice cream (hello calcium!), but otherwise my body just craves whole grains, salad, fruits and veggies. I was gobsmacked when I saw my results. At 51 years old I have osteopenia, in my femurs! When I was a collegiate rower my thigh circumference was larger than my waist, how could I have osteopenia?! Well, it turns out that genetics is a huge factor in bone health, and my Irish bones may be large, but not so healthy. I had also stopped lifting weights decades ago, and it turns out that lifting heavy weights is really important to protect our bones.
The good news is that osteopenia is reversible. The bad news is that there is no pill or easy fix to do this. This is my plan to protect my bones.
Build Muscle with better nutrition. Stronger muscles equal stronger bones. I aim for 1 gram of protein per pound of body weight (ideal body weight). I really struggle with this because I prefer a primarily plant based diet, but, by supplementing with protein shakes and adding nuts & seeds to everything, I am getting closer.
Build Muscle by strength training. I need accountability so I organized a strength class at my house 2 days a week. We started with using bands and our own body weight, but now we have built up to using weights and incorporating more impact exercises (jumping). These are both critical for bone density.
Topical testosterone. My testosterone level was 18ng/dL. According to the lab readout, this is a “normal range”, but my libido and bone density would say otherwise. Testosterone is essential for bone density, muscle mass and energy, and ours starts decreasing in our late 20s but can really plummet during perimenopause. Topical testosterone is extremely safe, although years of patriarchal B.S. in medicine have made prescribing options limited. I am using a tiny dose, 5mg topically each day, and after a few months I have to say, I feel fantastic. My energy and libido are back, and I am pretty sure my bones, and my husband, are thanking me. Most women feel best at levels of 40-60 ng/dL, and side effects are typically only noted when women approach levels of 80 ng/dL. For this reason testosterone pellets are rarely recommended. They can push her levels up way too high, but topical testosterone is a great option. Make sure you talk to your doctor about this, because testosterone replacement is something that requires monitoring.
Supplements. Calcium rich foods are great, but taking Calcium supplements have not been proven to be effective at improving bone density and could make you more prone to kidney stones. Vitamin D and magnesium are really important though, especially for postmenopausal women. I take 2000 IU of vitamin D and 2 grams of magnesium l-threonate daily. The magnesium helps with sleep too. I am not a fan of supplements, mostly because the industry is completely unregulated and you don’t know for certain what you are getting, but the benefits outweigh the risks for these two. Talk to your doctor about what is most appropriate for you.
Good Sleep Habits. Yes, sleep plays a significant role in both bone density and muscle health. During sleep, the body undergoes essential processes involved in bone formation, repair, and remodeling. Growth hormone, which is crucial for bone and muscle growth, is primarily released during deep sleep stages. Additionally, adequate sleep helps regulate hormones such as cortisol and parathyroid hormone, which influence bone metabolism and calcium balance.
During sleep, the body repairs damaged muscle tissue and synthesizes new muscle proteins, contributing to muscle growth and strength. Lack of sleep or poor sleep quality can impair muscle recovery and lead to muscle weakness, fatigue, and decreased muscle mass over time. Shoot for 7-9 hours.