Her Bone Density Kept Dropping…And Here’s Why
If you are working on osteoporosis, you need to know this: bone changes take time.
Bone mineral density moves slowly. You do not check it every few months. You are in this for the long haul.
Sometimes success is simple. You did not fall. Or you fell and did not break a bone.
A real patient case
This case is a 68-year-old woman.
She came in mainly for digestive issues, like chronic heartburn and GERD. She also had known osteoporosis for a while.
She was taking a proton pump inhibitor (PPI) for a long time. She was also taking alendronate, a common bisphosphonate (brand name Fosamax).
Even with that, her most recent DEXA scan did not improve. She was still in the osteoporosis range, not just osteopenia.
The first root cause clue: low vitamin D
On her first visit, her blood work showed she was low in vitamin D.
She started vitamin D3 with K2. The dose was 5,000 IU, which was described as not a lot.
Then her primary care provider checked her vitamin D again. It came back at 33. They told her that was too high and told her to stop the supplement.
The approach here was different. The focus was bone mineral density and calcium absorption. The goal was to keep vitamin D higher, and they did not see toxicity until much higher levels (around 150).
Why gut health still mattered
Alongside bone support, they also worked on gut health.
The goal was to keep improving digestion while supporting the nutrients and habits that protect bone over time.
Lowering risk: getting off the PPI
Over time, she was able to get off the PPI on her own, using nutraceutical support.
That was seen as a big win because being off the PPI lowered her compounded risk.
Other changes that supported bone and strength
- Calcium form: Her calcium was changed to calcium citrate because it is more absorbable.
- Hormone support: She started bioidentical HRT. Because she is older, the expected gains were smaller than if she were 10 years younger, but still considered beneficial.
- Exercise focus: She had been focusing mostly on cardio. The plan shifted toward adding more weights, plus more balance and flexibility work.
What to remember
You might not get a “wow” DEXA result right away.
But you can still move in the right direction by lowering risk and supporting the things that help bone long-term: vitamin D status, better absorption, smarter calcium, hormone support when appropriate, and strength plus balance training.
FAQ
Can you walk me through a patient case study that you did with um relating to osteoporosis, bone health, etc.?
This case was a 68-year-old woman with osteoporosis and chronic digestive issues. She had been on a PPI for a long time and was also taking alendronate (Fosamax). Her latest DEXA scan did not show improvement and she was still in the osteoporosis range. The plan included vitamin D3 with K2, gut health support, switching calcium to calcium citrate, getting off the PPI with nutraceutical support, starting bioidentical HRT, and shifting exercise toward weights, balance, and flexibility.
So what are you doing? Just curious, like sorry interrupt the story, but like what do you do in that scenario?
In this case, it was framed as a difference of opinion. The priority was bone mineral density and supporting calcium absorption. The goal was to keep vitamin D elevated for that purpose, and the level of 33 was not considered close to toxicity.
