How to Increase Bone Density and My Recent DEXA Scan

Did you know that, on average, women lose 10% of their bone mass in the first five years of menopause?! You can thank the drop in estrogen and progesterone for a big part of that change (both hormones impact bone mass, not just estrogen) and even if you choose to use menopause hormone therapy, you can still expect to lose some bone mass. This is why I recommend all women get a DEXA scan before menopause, at the onset of menopause, 5 years after menopause and then continue to monitor, depending on the individual bone density.

 As this is so important to me, I have regularly tested my bone density levels. I established a baseline 2015, which was just prior to menopause. My bone mineral density (BMD) in grams per squared centimeters was 1.093. This data is compared to a young adult in the T-score and to those of the same age in a Z score. This is then rated as a percentile. In 2015, I was in the 88th percentile for my age.

 My second test was in 2020, since I was almost 5 years post menopause. My BMD went down by 5.6% to 1.032. Although not as bad as the average 10% loss, any decline is not what we want. Because I was on the younger side when I went into menopause (49), my percentile to those of the same age went down to the 70th percentile.

 I recently tested myself again in October of 2024. I was very pleasantly surprised that I had actually increased my BMD from 2020 by 2.1%! My age matched Z score had improved significantly so that I am now in the 99th percentile! See charts for further reference.

 Additionally, my lean mass (muscle) is exactly the same as my first test in 2015! It went down by 1.7% from 2015 to 2020 and is now back up to where it was in 2015. Very proud of that, considering I was 48 in the first test and am now 57.

What did I do to optimize my BMD and muscle mass?

·      Increased my weight bearing activities. I was injured from 2018 to 2021 and had to reduce my running significantly. Since then, I have been able to run more consistently and increase my run volume. I also do plyometrics.

·      Eat more protein. I eat more than 1 gram per pound of body weight. I do this consistently… every single day!

·      Lift heavy weights. I do 3 days per week out of my triathlon season and 2 days per week during my higher volume season, which is about 6-8 months of the year. This means I don’t get to more than 12 reps with the weight I’m lifting. I increase as needed and ideally choose a weight that will get me to failure around 8 reps. This can depend on if I have a spotter but lifting lighter weights for more reps will not make the impact you want for bone density and muscle mass.

·      Eat calcium in quality yogurt (Strauss family or Wallaby are my favorite brands because from grass fed cows), cottage cheese (Good Culture is a great brand), half and half (Organic Valley Grass fed is the best) and from other cheeses. I also get calcium from leafy greens but don’t rely on that as my main source.

·      Take a vitamin D3 supplement that also has vitamin K2. I test my vitamin D levels every quarter and adjust my dosage to keep my level in the proper range (50-80 ng/mL).

·      Take a quality bone density supplement that includes calcium in the form of Microcrystalline Hydroxyapatite Concentrate (MCHC) as well as the other minerals needed to support healthy bone density, such as phosphorus, magnesium, zinc, vitamin C and boron.

·      Eat enough calories! I eat a good amount of fat in my diet, along with the protein mentioned above, and healthy carbs, particularly around my training sessions. This ensures I am not in a calorie deficit.

·      I added in menopause hormone therapy (MHT) in 2018. This was prior to my lowest BMD in 2020 so, although this helps, one cannot rely solely on MHT. Other lifestyle and nutrition changes are needed.

 Ladies (and older men!), please do a DEXA scan and don’t want! Each year you ignore loss, can put you at higher risk. Additionally, most physicians do not authorize you get a DEXA until already in menopause or post fracture. You can take matters into your own hands and get your own DEXA scan. These cost me $99, which is much cheaper than the cost insurance pays. There are more and more options coming available for you to get a DEXA scan directly without an approval so why wait?