Low T-scores, 70+ who decline medications and remain fracture free

I was skiing and got 2 compression fractures that hurt so bad- healed in time thankfully. I did take Evenity & a Reclast infusion afterwards.
Stayed osteoporosis but improved. May start Tymlos (with intense daily exercise as my new normal).
Went from -4 to -2.5 in spine now.
I have stumbled many times doing normal stuff and no problems so that’s a good sign.

It’s such a personal decision and I probably wouldn’t have taken anything but for those fractures. I am active but no more skiing. I am 67 now.

Demographic: Age 70; menopause at 50
T-scores: Lumbar Spine -2.3; Femoral Neck -2.5; Left Femur -2.4; Right Femur -2.3; Total hip -2.5; Left Forearm -2.3 (in 2022, my total hip was -3.5 and the other scores about the same - the MD thinks the total hip was an erroneous score for ??? reason).
Nutrition: plants, eggs, fish, some chicken, dairy - I increased my protein a lot after my diagnosis.
Supplements: D3, MK4, Magnesium Glycinate, collagen, creatine, protein powder (inconsistently), fish oil.
Exercise: walk daily and to run most errands, Onero, Pilates, resistance bands, balance and posture routines
Falls: I fell 2x in the mountains training for a very long hike; I had a virus and fainted in my bathroom - woke up on the floor - my Apple Watch called 911 and I had to get staples in my head; I fell off an electric bicycle taking a corner too fast; I slid on a plastic dog bone and landed on my knee. No fractures on any of the above.

I started HRT 10 days ago - I don't know if I will stick with it or not. My MD and I will decide. Pissed about the Women's Health Initiative (misnomer).

All this said, my CTX and P1NP scores aren't good and by TBS isn't good either (big surprise to me given my falls). I'm retesting late this summer. If the results remain low, I might consider medication. I don't want to take anything and more than that, I don't want to fracture. I despise this diagnosis more than I can say and I suspect most of us feel the same way.

76, menopause at 50, no HRT or other prescription drugs of any kind. Bad fall, broken right wrist at 63. Have fallen multiple times since with low T scores and no breaks. Both sisters and mother had Osteoporosis. One who took all bone drugs died from breaking both shoulders and a leg at 83. I do bone health exercises that focus on strength and balance and lift weights at the Y. Plants based diet, magnesium, D, C and now Biotin. I’ve also eaten whole, organic foods since 1975. With the exception of eating out. After both hips replaced my T score has improved as I’m able to walk and do more exercise. I’m very careful. I use walking sticks and love them.

and do more exercise

Not really part of your cohort as I've been on meds since 2018. I did want to mention, though, that I had a significant motorcycle accident in 2017 after being diagnosed with osteoporosis in my hips and didn't break anything. So clearly bone quality carries a lot of weight in determining whether you fracture. Since then I've stumbled and landed on my wrists and fallen over once or twice without fracturing.

I did fracture my T8 vertebra but it wasn't from falling. I was rinsing my hair under the bathtub faucet and straining to get the back of my head under the water stream. I pressed my ribcage down hard on the edge of the bathtub while my spine was flexed. I felt a sudden burning pain in my ribcage that radiated around to the front and months of pain afterwards. I thought it was a muscle pull but after it didn't get better, I had an x-ray.

I think as long as you continue what you are doing and be careful about how you move and avoiding fall risks, you are doing the right thing for you.

I have a couple of years of Reclast coming up then I will likely stop meds and see how I do. I haven't had another fracture since my first in 2023 and haven't really changed my lifestyle except to be more careful about placing a load on a flexed spine.

Edited to add that my lumbar T-score was -1.6 when I fractured. Hips were around -2.6 when I had my accident and didn't fracture.

I am 75 with severe osteoporosis, -4.1 spine, -2.7 in hips and. I have refused any bone drugs and so far am fracture free. I can't take Tymlos or Forteo because I have parathyroid issues, which are a reason for my bad DEXA scores. It's a complicated situation and I'm being monitored by my Endocrinologist. I've read that bisphosphonates and Evenity don't offer much benefit in fracture prevention so I don't want to take them. I walk, garden, and do some of the exercises recommended on the Facebook site "Brick House Bones" by Dr Lisa Moore, a PT specializing in osteoporosis. I take great precautions to prevent falls, so do several exercises a day to help with balance.

Anyway, I take a lot of supplements. Here's my list:

Vitamin K: This helps direct calcium to your bones. I take two forms of Vitamin K in high doses: 180mcg of vitamin K2 MK-7 (Menaquinone-7) TrueVantage brand and 45,000 mcg (45 mg) of vitamin K2 MK-4 (Menaquinone-4) Life Extension K2 High Potency brand. These high doses are discussed more in a topic in this support group titled: Vitamin K: High Doses of MK-4 and MK-7 Show Promising Results

Collagen as Fortibone: I take a daily powdered collagen supplement that contains Fortibone, which has been shown in studies to help bones. The cheapest brand I found on Amazon is AlgaeCal, cheapest if you buy two or three at a time. I make a smoothie with it along with some juice, banana, and other fruit. It also contains 11 grams of protein per serving.

Protein powder: Protein is important for your bones so I take Oath Nutrition Clear Whey Isolate Protein Powder. Their Frosty Lemonade is my favorite flavor. Mixed with water it takes like foamy lemonade. I've tried other protein powders but many of them leave a bad aftertaste.

Prunes: Studies have shown that eating 5-6 prunes a day can help bones because of their high content of Boron. In one trial, supplementing with 3 mg/day of boron reduced calcium loss by 44% in women with adequate magnesium — in less than one month! In women with low magnesium, calcium loss was reduced by half as much. So far, I'm trying to get my boron from food, including the prunes.

Magnesium is also important, so I take 250-300mg of magnesium glycinate/day.

Calcium, I alternate New Chapter Bone Strength algae sourced calcium along with Citrical mini's and Seen Calcium Chews, which gets its calcium from food. Each chew contains 500mg calcium.

I also take vitamin D, C, B complex and fish oil capsules.

@lornabaldwin
Please say more about having your hips replaced. I’d like to understand the situation around that. I would guess that once that happens, you don’t have to worry about osteoporosis or breaks at all.

@sassysaveur that's not true. Only need to NOT worry where the bone has been replaced.

Your post shows some appalling ignorance regarding bones and their deterioration. I APOLOGIZE in advance because I know what I am expressing is harsh - but I read it as very smug.

Let me help educate you: Your bones are not "one thing." Each of your bones are different in density. The measurements available to us are ONLY A GUESS and a generalization of where we are at. I will offer you my scenario:
I see the worlds BEST orthopedic spine surgeon at UCSD. I have been monitored with Dexa scans for over 30 years at different medical facilities. I had my hips replaced in 2012, 2014, and a major lumbar surgery in 2018. Despite WONDERFUL Dexa scores and a move to a PREMIUM diagnostic machine with TBS scoring, I was told I was out of osteopenia in 2023 before my switch to the TBS machines.
Fast forward to cervical spine surgery: My C-5 fell APART in their hands! crumbled it was so paper thin. After TWO surgeries -- because the screws were not stable because the surrounding bones were not strong enough to HOLD the hardware, I was immediately whisked off to the bone medicines, where I GRATEFULLY stay, even with the side effects.

It is a 5 year protocol with 2 years of daily Tymlos and 3 annual infusions of Reclast. A total of 5 years of my life in exchange for STRONGER, DENSER bones. I'll be done at 72, and it will be good for 10 years.
Your T scores are terrible, and you should be on bone meds. My scores were like yours.

I have had several amazing conversations with top drawer orthopedic surgeons and they don't KNOW until they open you up what, in reality, they will find. I have always eaten perfectly, I have trained for nutritional chemistry, taken health and biological sciences and not of it helped me when I got to this state of being.

I hope you've had your calcium levels taken to be sure you are not hardening your arteries. 3 times I've been told to take calcium and 3 times the doctor calls me and says NO CALCIUM. I ended up with dad's coronary heart disease and calcium causes plaque/hardening of the arteries with CAD.

I am on BHRT and very happy to have restarted that after a 10 year hiatus. How do you think you can build bones without hormones, I do not know. You can't. End of story. Not anything meaningful.
People are selling you hype and you bought it. This site is for knowledge and fact based science. Not "I WISH" something to be true. But it is not. There are real places to go for the science online. NIH is one.
Building bones is an anabolic process. Do you know what that means? It means you can't reach the bones directly to build them.
I do agree that the resistance and weight-bearing exercises are best. I walk every day twice a day because it has long been proven that smashing your legs into the concrete beneath one's feet is terrific for bone building. Girl, you'd better wake up and smell the bone meds before it is TOO LATE and you can't do a thing about it!
The way you phrased your question is silly. NO ONE can substantiate that getting into your 70s and the things you listed are enough. Especially with your T scores! Holy cow.
Side effects are okay for me. Why? because my body is building bone. There is no guessing about it! We do the numbers. In two more months I will go back for my next DEXA. I hope and PLAN for good results - because its the only thing out there to guarantee I am maintaining what I got.
I went into menopause early. 47. Your bones deteriorate faster. Why? because you don't have hormones.
Strontium is a whole other subject. People like me would be out because of the CAD.
I wish you a fracture free life. I had fractures when they went in to do the hip implants. Or, they fractured my bones then. They don't seem to know. You wouldn't know if you did. Some people know by the spinal back pain they start getting.
I think all that stuff you are doing is great. But it will be too late if you wait to change your mind.

here's what your numbers say about RIGHT NOW:
You said: does strontium increase bone densityYes, strontium increases bone density, but the way it works is complex. It incorporates directly into your bone tissue and stimulates new bone formation while slowing down bone breakdown.However, because strontium is heavier than calcium, it artificially inflates your bone mineral density (BMD) scores on standard DEXA scans. This means your bone density reading may appear higher than your actual bone strength.If you are considering strontium for bone health, keep these distinctions in mind:Pharmaceutical Strontium (Strontium Ranelate): This prescription medication has been clinically proven to reduce the risk of fractures. It is typically used in Europe and other countries, but it is not commonly prescribed in the US due to cardiovascular safety concerns.Over-the-Counter Strontium (Strontium Citrate): Widely available in the US as a nutritional supplement, it lacks the large-scale, long-term clinical trials supporting fracture prevention seen with the prescription form.Scan Adjustments: If you take strontium, it is critical to inform your doctor, as bone density scanners can misinterpret strontium's density.Consult with your primary care provider or a bone health specialist to determine the safest and most effective treatment plan for your specific needs. To learn more about treatment guidelines for osteoporosis, you can visit the National Institutes of Health (NIH) Osteoporosis and Related Bone Diseases National Resource Center.This is for informational purposes only. For medical advice or diagnosis, consult a professional. AI responses may include mistakes. Learn more12 sitesSTRONTIUM: NOT ALL IT'S CRACKED UP TO BEDiscussion: Strontium ranelate is commonly sold as an over the counter supplement in the United States for bone health and has bee...SHM AbstractsChange in Bone Mineral Density with Strontium CitrateStandard doses of SrR (2g) and SrC (1944mg) deliver 680mg of elemental Sr, twice the amount naturally present in the human body on...Symbiosis Online PublishingCardiovascular safety of calcium, magnesium and strontium - PMCBone effects Strontium lactate and strontium chloride have both been studied as potential treatments for osteoporosis in human and...PubMed Central (PMC) (.gov)Show allYou said: -3.7 lumbar; -2.0 femur t scroesBased on your T-scores, you have severe osteoporosis in your lumbar spine (-3.7) and osteopenia (low bone mass) in your femur neck (-2.0).Because your lumbar spine T-score is \(-2.5\) or lower, it falls clearly into the category of osteoporosis. A score of \(-3.7\) indicates a significantly elevated risk for spinal compression fractures, making proactive medical management crucial.

Accidents happen. Better get your head out of the clouds and over to the endocrinologist's office. We try so hard to keep people here ON THEIR BONE meds because they are SO IMPORTANT for people who want to stay active and independent. I saw your post and it reeked of someone thumbing their nose at what a lot of us go through, in order to stay on the medicine and have better numbers. It takes dedication and YEARS of commitment. I hope you change your mind.

@loriesco
Oh I did not realize the hip replacement was not the entire hip bone. So if I understand you correctly, there are other bones around the replacement hardware that are still vulnerable?

@sassysaveur absolutely! And everyone has a different surgery as well so different amounts of the bone may or may not be removed.