Key Topics & Timestamps
- 0:00 Introduction to bone health and Kevin Ellis, the Bone Coach
- 4:00 Understanding osteopenia and osteoporosis diagnoses
- 8:00 Bone quality vs bone density: What matters more?
- 12:30 Advanced bone testing: TBS and REMS scans
- 20:00 Conventional medication treatments and their role
- 27:00 Nutrition strategies to boost bone strength
- 33:00 Exercise tips for different bone health levels
- 41:00 Hormones and their critical role in bone health
- 48:00 Bone turnover markers for tracking progress
- 55:00 Risks of long-term medication use on bones
- 1:02:00 Kevin Ellis’s personal osteoporosis story
- 1:10:00 Actionable steps and resources for bone health
- 1:15:00 Q&A and final thoughts
Why Bone Health Deserves Your Attention
As a physician deeply invested in women's health, I repeatedly see how osteoporosis and osteopenia can quietly undermine vitality and independence. These bone conditions often become visible only after fractures, leaving many feeling lost and unsure of the best path forward.
In this blog, inspired by a richly informative podcast episode with Kevin Ellis—the Bone Coach—I want to share everything you need to know about diagnosing, managing, and improving bone health, especially if you or someone you love has been told to “just take calcium.” There’s far more to the story than that simple advice.
What Are Osteopenia and Osteoporosis?
Osteopenia and osteoporosis both describe conditions of low bone mass, diagnosed by a bone density scan called a DEXA scan.
Osteopenia: Defined by a T-score between -1 and -2.5, this condition indicates low bone mass but not yet osteoporosis. It’s a warning sign—a signal to start intervention sooner rather than later.
Osteoporosis: Diagnosed when the T-score is below -2.5, representing fragile bones with a higher risk for fractures.
These scores guide treatment decisions, but it’s essential to understand that bone density is only one piece of the puzzle.
Bone Quality: The Missing Piece
Bone density alone doesn’t tell the full story. Bone quality—which includes the bone's structural integrity and microarchitecture—is just as crucial. Some people with osteoporosis by DEXA have never fractured, while others with osteopenia may experience multiple fractures due to poor bone quality.
Tests like the Trabecular Bone Score (TBS) or REMS (Radiofrequency Echographic Multispectrometry) scans are emerging tools to assess bone quality. These tests provide a fuller picture and help tailor treatment plans more precisely.
Advanced Testing Techniques
Not all DEXA facilities offer TBS; it’s important to ask. REMS technology, an ultrasound-based method, measures both density and quality and provides a five-year fragility score to better predict fracture risk. These advanced tools improve diagnostic accuracy and help individuals monitor their condition beyond traditional scans.
Medication: When and How
For those with severe osteoporosis or multiple fractures, medications like bisphosphonates or anabolic agents (e.g., Forteo, Tymlos) may be prescribed. They can increase bone density and reduce fracture risk but may cause adverse effects with long-term use, such as suppressed bone remodeling leading to brittle bones.
Kevin emphasizes that medication should be part of an individualized, multi-faceted plan and should ideally be paired with monitoring tools like bone turnover markers to optimize effectiveness and avoid long-term downsides.
Natural Strategies for Stronger Bones: Nutrition
The foundation of bone health is built on nutrition. Key nutrients include:
Collagen peptides, essential for building the bone protein matrix.
Vitamin D3 and Vitamin K2, which facilitate calcium absorption and proper bone mineralization.
Vitamin C, vital for collagen synthesis.
Specialized compounds like delta and gamma tocotrienols have shown promise in reducing bone loss and inflammation.
Kevin recommends clinically studied supplements such as "Healthy Bones Co-Collegen Peptides" and "Anatrol Bone Support" for an evidence-based approach.
Effective Exercise for Osteopenia and Osteoporosis
Exercise is crucial, but it must be tailored to individual bone health levels.
For good bone quality or mild osteopenia: Resistance training with heavy weights, compound lifts like squats and deadlifts, and impact exercises (e.g., hopping, stair climbing) stimulate bone building.
For those with low bone density or fractures, Low-impact exercises such as controlled squats with the support of handrails, resistance bands, and vibration plates are safer options.
Avoid high-impact or heavy-weighted vests if vertebral fractures are present, to reduce fracture risk.
Balance exercises are vital to prevent falls, a leading cause of fractures among the elderly.
Walking alone does not provide enough mechanical stimulus to strengthen bones, so incorporating strength and impact exercises is important.
Hormones: The Silent Regulators of Bone Health
Hormonal shifts, especially during menopause, directly impact bone resorption and formation. Estrogen protects against excessive bone breakdown by slowing osteoclast activity, while hormones like testosterone and progesterone promote bone formation by stimulating osteoblasts.
Kevin stresses that hormone replacement therapy under medical guidance can be a cornerstone of bone health maintenance, particularly when combined with nutrition and exercise.
Monitoring Bone Turnover Markers: A Game Changer
One major barrier in bone health management is the delay in seeing results. DEXA scans show changes over the years, leaving patients anxious about effectiveness.
Bone turnover markers such as:
CTX (marker of bone resorption)
P1NP (marker of bone formation)
can be tested through blood every few months, providing real-time feedback. These markers help adjust therapies promptly, empowering patients and clinicians to optimize treatment plans proactively.
Avoiding Pitfalls: Long-Term Medication Risks
Long-term bisphosphonate use can overly suppress bone remodeling, causing accumulation of microdamage and fragile bones despite stable or improved density scores. This may increase rare but serious fracture types.
Kevin highlights the importance of cycling medications with anabolic agents and anti-resorptive drugs, and pairing them with lifestyle changes to protect bone quality and longevity.
Kevin Ellis’s Personal Bone Health Journey
Kevin’s story deeply resonates—as a former Marine diagnosed with osteoporosis in his 30s due to celiac disease, he struggled with poor nutrient absorption and bone loss. His journey from diagnosis through healing inspired the creation of a global coaching program, reaching over 280,000 people to help them build stronger bones with education, testing, and personalized plans.
Actionable Steps to Improve Your Bone Health Today
Get a comprehensive bone health assessment, including bone density and quality tests.
Test bone turnover markers (CTX and P1NP) for ongoing monitoring.
Incorporate evidence-based supplements like collagen peptides, vitamins D3/K2, and antioxidants.
Engage in appropriate exercise tailored to your bone health level.
Work with knowledgeable healthcare providers to optimize hormone balance.
Avoid harmful practices like excessively light weights or high-impact activities without clearance.
Track progress frequently to stay motivated and adjust interventions.
Why You Should Listen to the Full Podcast Episode
This blog offers a detailed overview, but the full podcast episode with Kevin Ellis is a treasure trove of additional insights, personal stories, and deep dives into complex subjects like advanced testing and holistic management strategies.
Whether you’re newly diagnosed or looking for ways to optimize your bone health long-term, this conversation will empower you with confidence and practical knowledge.
Listen to the complete episode today to take your next right step toward stronger bones and a healthier future.
Q&A
Q: When should I start monitoring my bone health?
A: Ideally, in your 40s, or earlier if you have risk factors like family history or autoimmune diseases.
Q: Are bone turnover markers necessary?
A: Yes, they provide early and actionable feedback on bone health changes, enabling timely adjustments.
Q: Can osteoporosis be reversed naturally?
A: With the right combination of nutrition, exercise, hormonal balance, and monitoring, significant improvements are possible.
Q: Are medications always required?
A: Not always. They are crucial for severe cases but should be part of a comprehensive plan including lifestyle changes.
Bone health is more than numbers on a scan—it is the foundation of mobility, independence, and quality of life. Take control of your bone health journey today with knowledge, testing, and action.
This is Dr. Anna Cabeca, reminding you that strong bones build strong lives.
Links Mentioned:
Bone Coach (Use code DRANNA)
Healthy Bones Co. (Use code DRANNA)
Osteo IQ (Use code DRANNA)
