Osteopenia and Osteoporosis

Bone is living tissue that remodels throughout life. We look at hormones, nutrients, muscle, balance, gut absorption, and inflammation to protect your skeleton.

What you may be noticing

A bone density scan showed osteopenia or osteoporosis. Perhaps you have lost height, broken a bone with a minor fall, or have a family history of fractures. Or you are entering menopause, or taking a medication known to affect bone, and want to protect your skeleton.

A fracture after a minor fall, sudden severe back pain, or new spinal deformity needs medical evaluation. Medication decisions for osteoporosis belong with your physician; I never ask anyone to stop a prescribed medication.

Why it is rarely one thing

Bone is living tissue, constantly broken down and rebuilt. That remodeling depends on hormones, nutrients, mechanical load, inflammation, and the brain systems that keep you upright.

Estrogen protects bone, which is why loss accelerates after menopause, and medications that block estrogen, such as aromatase inhibitors used after breast cancer, speed loss as well. Testosterone protects bone in men. Low vitamin D, protein, magnesium, and vitamin K2 limit bone building. Celiac disease and gut inflammation reduce absorption. An overactive thyroid or parathyroid, long-term steroid use, chronic inflammation, smoking, and heavy alcohol use weaken bone.

Supplements are not automatically safe either. Calcium balance depends on parathyroid hormone, kidney function, and vitamin D, and in some conditions, including certain cancers, calcium in the blood is already high. Vitamin K interacts with warfarin. That is why I check before I add.

Most fractures follow falls, and falls are a brain event. Balance depends on the vestibular system, cerebellum, vision, and proprioception working together. Not only calcium, but a whole-body process directed by the nervous system.

Patterns we look for

• Estrogen and testosterone status, and bone-affecting medications.
• Calcium balance: total and ionized calcium, albumin, parathyroid hormone, phosphorus, and kidney function.
• Vitamin D, magnesium, vitamin K2, and protein intake.
• Gut absorption, including celiac disease.
• Thyroid function.
• Inflammation markers.
• Muscle mass and strength.
• Balance, gait, vestibular and cerebellar function, and fall risk.
• Spinal posture and safe movement patterns.

How I evaluate it

The comprehensive functional neurological exam assesses balance, gait, vestibular function, eye movements, coordination, proprioception, and reaction time, which predict fall risk.

Functional labs may include vitamin D, total and ionized calcium with albumin, parathyroid hormone, phosphorus, magnesium, creatinine and eGFR, a full thyroid panel, sex hormones, inflammatory markers, and celiac screening. I coordinate with your physician for bone density testing and fracture risk, and with your oncology team when bone-directed treatments are involved.

How we address it

1. Coordinate with your physician on bone density, fracture risk, and medication decisions.
2. Check calcium balance, kidney function, and medication interactions before adding bone nutrients.
3. Build strength with progressive resistance and high-load bone training, adapted safely to your skeleton.
4. Protect the spine: favor extension and scapular stability, and avoid loaded forward bending and twisting when fracture risk is high.
5. Train balance with vestibular, cerebellar, and proprioceptive exercises.
6. Replenish vitamin D, magnesium, vitamin K2, and adequate protein through food first, and restore gut absorption.
7. Coordinate dental care with your physician if you take a bone-directed medication, and reduce inflammation, alcohol, and smoking.

Bone responds to load at every age. Supervised strength training has been shown to improve bone density even in people with low bone mass.

Strong muscles, a well-tuned balance system, and nourished bones work together to keep you upright and active.

Book your Comprehensive Functional Medicine Eval/Neurological Exam today to discover what the contributing root causes are that are underlying your health concerns.