Osteoporosis – What’s Your Risk?

If you think that it’s only little old ladies that get osteoporosis, think again. Bone loss can begin as early as the age of thirty. The greatest years of bone loss occur between age 40 and 50 in women and continue on an accelerated downward incline after menopause.

What is Osteoporosis?

Osteoporosis is when bone resorption, or breakdown, exceeds new bone formation. If this process continues, this leads to weak bones and increased risk for fracture.

Indicators of increased risk for accelerated bone loss

  1. Small stature and bones to start with
  2. Medications for depression, gastric reflux, seizures, and steroids
  3. Muscle and bone pain
  4. Vitamin D deficiency
  5. Gum recession
  6. Weight loss surgery
  7. Endocrine problems, menopause and andropause


Osteoporosis is diagnosed by DEXA (bone densitometry) and by bone resorption markers. Most of you are familiar with a bone mineral density scan or DEXA which is recommended when a women reaches age 65. Many insurance companies and Medicare will not pay for bone density scanning until a woman reaches age 65. But I just told you that bone loss begins much earlier! Unfortunately, the DEXA scan is not sensitive to ongoing bone loss and you must have bone loss before the DEXA shows anything. Therefore the DEXA is not recommended until you are likely to have osteopenia or osteoporosis. Changes in scans can generally be seen over about 2 years and may not pick up gains or loss in bone that occur over weeks to months.

NTX (N-telopeptide) and Dpd (dypyridine)

NTX  or crosslinked N-telopeptide and DPD or Deoxypyridinoline are measures of bone turnover and can be used to assess the rate of bone loss. These tests allow us to determine if a person is losing bone at an excessive rate, thereby increasing her risk for osteoporosis. Unlike the DEXA, we can follow these markers of bone metabolism and see changes in as little as 12 weeks. We can measure if our therapy is actually slowing the rate of bone loss.

Treatment for accelerated bone loss

Unfortunately many treatments of traditional medicine do not start until one has the disease and treatments frequently have significant side effects. We now know that estrogen and its partner hormones may not be enough to prevent osteoporosis. I have my hormones perfectly balanced and I recently had an elevated NTX. So what should I do? Biphosphonates? No way!

Ways to prevent bone loss and slow bone turnover

  1. Maximize your supplements – Ossein hydroxyapatite or microcrystalline hydroxyapatite (MCHC) is a supplement created from lypholized bovine bone meal. It contains all the minerals including calcium necessary for healthy bone development. Studies support added benefit when compared to calcium alone. Other important minerals are zinc, manganese, magnesium and copper. It is unlikely that you will need to take extra of these minerals if you have a healthy diet or take a good multi vitamin along with an MCHC supplement. Of course Vitamin D in the form of Vitamin D3, Vitamin K particularly K2 and MK7 is essential.

A supplement called choline stabilized orthosilicic acid (OSA) has been shown to positively impact excessive bone turnover. Strontium as strontium citrate, can be added to further slow bone loss. 75% of the time you will see significant improvement in NTX and/or DPD. A form of hops has been developed that has been shown to decrease markers of bone turnover by 40%

  1. The decline in hormones DHEA, testosterone, progesterone and estradiol causes accelerated bone loss. Hormone replacement therapy is effective in slowing and preventing bone loss but alone may not be enough to prevent osteoporosis.
  2. Elevated cortisol states whether due to excessive stress or corticosteroid intake will cause excessive bone loss. Lose your stress and develop ways to decrease your cortisol. Consider yoga, meditation, and other ways to enhance your social and spiritual support community.
  3. Of course, let’s not forget exercise – the answer to many of our common ills. Note that exercise must be weight-bearing, not swimming or cycling.

Don’t wait until you are 65 to do something about your risk for bone loss. Find a practitioner that understands prevention of osteoporosis and start saving your bones today.

Marsha Nunley MD
Marsha Nunley MD
I am an internist, trained and experienced in Western Medicine, who believes that illness and disease are best treated by working to discover their underlying causes. Come to me for bioidentical hormones, advice on healthy aging, and whole-body medicine.