Drugs or exercise and vitamins?

In order to absorb calcium, we need to take one that is highly absorbable and not take all the recommended daily dose at one time. I take a tablet at every meal. I’ve been using Algaecal, made from algae. It also contains Vitamin D and magnesium.

You are correct in that you would need additional D and Mg. So many pills!

if your dexa results are -1.9 you do not have osteoporosis so I wonder why they are pushing you so hard to take something. I can understand your reluctance. Perhaps you can do some bone blood marker tests to see if you are currently losing bone. If you are not, you *might*be able to maintain with increased weight bearing exercise, lifting weights, diet and supplements. It takes a lot of attention but it's worth it the effort. You can also consider HRT depending on your age and risk factors. That would help you preserve your density. Yes, it is a pharmaceutical but it is a replacement for what we lose in menopause and the estrogen will help to preserve your bone mass in a more natural way than the drug options. I am on it now but wish I had started in my 50s as I wouldn't be in the situation I'm in now.
For those that decide to try the natural route, I would suggest retaking the dexa in a year along with testing your bone markers to see if you are stabilized. I was adamant about not taking drugs and doing it naturally as that's the way I live my life. I did everything "right" from tracking all of my nutrients, 7 prunes daily, a daily 1 hour hill walk in a weighted vest, lifting weights, 1.5 hour dance class 2x a week, hundreds of core reps for strength and stability. I even stood all day when at my computer so my weight bearing was a constant. In the 2 years of doing everything in my power to keep my bones strong, I lost a lot of my spine, going from -2.9 to -3.2. At that point, I realized there was literally nothing I could do to stop this bone loss but to use a pharmaceutical. On Forteo I gained back some of the lost bone but not all of it. It is easy to lose bone but hard to gain it back. Test early so that you can make the important decisions on whether it is necessary to consider pharmaceuticals to avoid further loss that you may have a hard time regaining.

@teb and others: From online: "Vitamin K2 can be further divided into several different subtypes. The most important ones are MK-4 and MK-7."

For MK-7 45 mcg is recommended by McCormick but some sites say 100-200mcg. Still mcg.

"A daily dose of 500 to 1000 mcg of MK-4 is adequate and close to healthy ancestral consumption" on the same site and that agrees with what McCormick suggested for me.

I have no blood clotting or heart issues and am not on an anti-coagulant. I would be wary of the doses cited in some of these posts unless a provider tells me to. Apparently some of you have providers recommending those doses so you can feel comfortable.

Don’t know if you’re walking your 4 miles at once?? It’s preferred to break that up into maybe 2or 3 different times of the day. Gives your bones a chance to be stimulated more than the once. Know that you need to walk quickly for it to be osteogenic- I’ve read at least 3.1 miles/hour in one resource, where another recommends 3.6. That’s quick!!! Just an aside, long distance running is not the ticket with osteoporosis. I will also tell you that the elliptical will give input but walking is better as your feet are coming down in contact with the ground with each step. On the elliptical your feet are stationary, so not as much stimulation is provided. Exercises that target specific areas for hips, spine , upper extremities etc should be included in your work outs. Some cardio and BALANCE. I see you’re doing yoga. Depending on where you’re at be aware of different positions to avoid.
Happy training!!! Good luck!!

I wanted to make a correction. On my MK 4 supplement it is 45mg of Vitamin K per day, not mcg, a pretty large amount.

I went to an Endocrinologist and a rheumatologist and they weren’t interested in seeing why my bone density was getting worse, they just wanted me to take the strong bone building meds then take Prolia after that. I like to know why something is happening in addition to trying to fix the problem. I eat well, take supplements, exercise daily. It might have something to do with my digestion but I need to get that checked out.

@tkdesign my 46mcg is MK 7. That is a large dose of MK4!

@trathfon62 my experience is that once we are past menopause, we lose bone naturally. The biggest drop for me was right at menopause (and also at the beginning of cancer meds that dropped estrogen further). In other words after an initial big drop, for me, the rate of loss eased- but continued. No matter what I ate, what supplements I took or how I exercised.

Tai chi helped with balance and body awareness- and other benefits. I stay away from yoga.

We are living longer. I believe a lot of us will face the need for meds, unfortunately.

Just wanted to share some studies and information that’s out there on Vitamin K2. It’s a bit all over the map, somewhat inconclusive but the 45 mg comes from studies out of Japan where that dose has been used therapeutically as an osteoporosis treatment since 1995.
https://pubmed.ncbi.nlm.nih.gov/18830045/
The medicinal dose used in Japan is in the form of MK4, given in 15mg doses 3x a day. (MK4 has a shorter half life than MK7 therefore it is given throughout the day)
This is the Japanese pharmaceutical:
https://www.rad-ar.or.jp/siori/english/search/result?n=444
Some potential side effects are listed. Though more studies are needed, this is where integrative practitioners are getting that dose recommendation from. I’m not suggesting that this is what individuals should be taking, just clarifying the 45 mg dosage and offering up the info to ponder. Overall, there have been mixed results on studies with vitamin K. It may be due to confounders like whether or not supplementation included calcium and vitamin D.

Here’s a great article on Vitamin K from Cleveland Clinic
https://health.clevelandclinic.org/do-you-need-vitamin-k-supplements-for-your-bone-health/
One takeaway is that there have been mixed results based upon studies but overall, inadequate vitamin K increased the risk of hip fracture. An “adequate” dose for bone health is 90 mcg for women.

This 3 year study showed improvement with a dose of 180 mcg of MK7 (the form of K2 that has a longer half life).
https://pubmed.ncbi.nlm.nih.gov/23525894/
A study that analyzed data from the large Nurses’ Health Study found that women who consumed less than 109 micrograms (mcg) of vitamin K per day were more likely to break a hip.
https://pubmed.ncbi.nlm.nih.gov/9925126/
A study of participants (both men and women) in the large Framingham Heart Study also showed a link between low vitamin K intake and increased risk of hip fractures. This study also showed an association between low dietary intake of vitamin K and low bone density in women.
https://pubmed.ncbi.nlm.nih.gov/12540415/
This article is quite thorough in its overview and analysis
https://www.naturalmedicinejournal.com/journal/vitamin-k-and-osteoporosis
So, this may be another (confusing) tool in the toolbox to address bone strength and/or density. Wish there was consensus on dosage and efficacy but apparently more studies are needed to determine that. Best to evaluate our own needs with input from our own medical support team.