Understanding advice for dealing with osteoporosis and navigating info

Posted by galactica @galactica, Apr 23, 2023

I am looking at where I went wrong following the advice to exercise, eat well and take supplements. I did all of that - religiously for 9 months and I failed and in looking and how that could have happened I have been revising my actions and the advice I followed and what went wrong so I can correct it and hopefully help others. I am embarrassed to say that it was just not obvious to me.

I was told that walking is great for osteoporosis - so I did a lot of walking. Working up to 10k steps a day - But I am now learning that walking, just walking does not build bone density if it’s leisurely, even if for long duration. It has to be at a significant pace. And of course stair climbing and the elliptical but the heart rate has to rise to a particular level as well. Find out what that is for your body.

Weight bearing exercises - that is not enough. The exercises have to specially and safely address the spine and other bones and they have to be done properly or one loses the benefit of the exercise. I needed more of some exercises and fewer of the others and squats, for example, I was not doing them properly even though I had trainers watching me. My exercise physiologist helped me with proper form.

A wide variety of vegetables is recommended - but there are fruits, vegetables and nuts that are high in oxalates. If, like me, you have an issue with oxalates or are consistently eating a high oxalate diet - spinach, Swiss chard, rhubarb, almonds, prunes - like I was - day in and day out - oxalates bind to calcium and are excreted through urine.

I was eating copious amounts of rhubarb, Swiss chard, collards, sweet potatoes, almonds, almond flour in my crackers and foods. I thought I was eating calcium rich foods that were helping me but they were making me worse. Nobody told me this could be detrimental to my particular bone health.

I know look at not only calcium content but how high the oxalate content is. So I am actually absorbing the calcium intake in and it is going to my bones. It bears looking into this. My calcium oxalate level on the 24 hr urine test was 396. I brought it down to the normal level of 21 by changing my diet alone. No medication. However I had to be diligent and I am now navigating getting enough nutrients and calcium while regulating oxalates.

It’s not enough to “eat a lot of green leafy vegetables and have your plate look like a rainbow of colors”. Because many have high or moderately high oxalate content and either need to be boiled and the water drained in order to reduce the oxalate level, or avoided altogether depending on your situation. It’s important to read up on and understand how oxalates affect bone health and I had to figure this out the hard way because no one told me, not one doctor. Until it was a problem. With osteoporosis and bone health in general, I think this is a critical piece of information. I dont understand why this is not included in the general information.

The other part of the equation is our digestive system. I realized that if my digestive system was not absorbing nutrients properly, no matter how much or how nutrient dense my diet is, if my body is not absorbing and redirecting g these nutrients to the parts of my body that need it, the benefit is greatly reduced. The digestive system has to be healthy and able to absorb the nutrients you put into it. I thought just eating a pristine healthy diet would fix this but sometimes one needs a little more support in this area.

I wanted to mention this because for me, I realized that it was not enough to know what to do, and all I was told and all I read was what to do. I know now it has everything to do with how and to ask questions and when told I am making myself crazy (vs being given answers to my questions) to go elsewhere. I am learning to ask the how’s and the whys these things are happening and to research as much as I can instead of just following what I have been told to do, which is just not enough, at least for me and my body.

And I also believe that there is this assumption that everyone with osteoporosis is going to take medication so maybe it’s not important to know. And that the medication will just fix the bones. But it is important to know. So important, whether one takes meds or not, doctors and healthcare providers have to go a big step further to offer more than the status quo of walking, weight bearing exercise and eating leafy green vegetables, as do the sites that put out information on bone health.

This is what I am learning.

Interested in more discussions like this? Go to the Osteoporosis & Bone Health Support Group.

After menopause, bone density loss may be inevitable, but I admire your efforts. Does boiling spinach retain calcium but eliminate oxalates? How can we get calcium from almonds? I am asking more for my daughter, but she and I both cannot eat dairy. (I am just finishing Tymlos and need to go back to being cognizant of holistic approaches.)

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I am fumbling through this and bit the bullet and got an exercise physiologist to work with, and a nutritionist - both highly experienced in working with women who have osteoporosis. I am reading every pro bone health website alternative and non alternative, for nutrition, exercise reading all I can on oxalates - a lot of conflicting info on oxalate levels of different foods.

I know what to eat but I need help making sure every meal is balanced. And I know that can look many ways - I don’t drink, cut out caffeine, I don’t eat processed foods and I read all ingredients. I want to avoid additives. I drink water, water with lemon, green tea and some herbal teas.

I research all foods that have calcium and what their oxalate levels are and my nutritionist will work with me on this - it’s especially important for me because I am 60 and like all of us need the calcium. For me it’s a fine line and I don’t want to become obsessed but I also believe that women need to be aware to understand if this is something that can affect bone density.

There is a lot I want to do and experience. Age has always been a matter of mind for me - so I am being as proactive as I can be and making sure I understand everything I am being told/given and if not, to not be afraid to question it to better understand. If I am met with resistance or made to feel like I am too much - I know to go elsewhere - to look for healthcare providers that will at least listen and respect my needs and concerns - does not mean we need to agree.

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Very interesting! I had not heard of oxilates, will be watching for that in the foods we eat! Thank you for the information & best of luck to you.

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@suzy7

Very interesting! I had not heard of oxilates, will be watching for that in the foods we eat! Thank you for the information & best of luck to you.

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It may not be an issue for you and you may not need to change your diet but it bears mentioning to your doctor or provider in case it is an issue. I want to raise awareness that it can affect bone density for some women.

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I feel the same. That I have done everything I was supposed to do regarding diet and exercise. I still do that, but I did have to go on Tymlos - which I am currently on with no side effects. None that are apparent anyway.
I have an endocrinologist and a rheumatologist following my osteoporosis. I trust them both, but I also consult with a doctor in Berkeley - Dr. Lani Simpson. She wrote a book called "Bone Health." She has a website and a bunch of Youtube videos. I started sending her my DEXA results a few years ago and she would tell me what she thought about my options. She generally agrees with my doctors here. She is very pro exercise and diet but isn't opposed to the drugs. She also wrote a book about Vitamin D. I feel that she is the best source of information that is current and impartial. Dr. Lani has osteoporosis herself.

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@susanfalcon52

I feel the same. That I have done everything I was supposed to do regarding diet and exercise. I still do that, but I did have to go on Tymlos - which I am currently on with no side effects. None that are apparent anyway.
I have an endocrinologist and a rheumatologist following my osteoporosis. I trust them both, but I also consult with a doctor in Berkeley - Dr. Lani Simpson. She wrote a book called "Bone Health." She has a website and a bunch of Youtube videos. I started sending her my DEXA results a few years ago and she would tell me what she thought about my options. She generally agrees with my doctors here. She is very pro exercise and diet but isn't opposed to the drugs. She also wrote a book about Vitamin D. I feel that she is the best source of information that is current and impartial. Dr. Lani has osteoporosis herself.

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I have done a masterclass with Lani Simpson and she was at the time trying to decide which med to take. She drinks calcium citrate all day 🙂

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The information you put out here is extremely important. My Chinese friends all told me about oxalate and spinach thus they all boil spinach for 30 seconds to 1 minute before eating. Their healthcare education has a detailed table about which vegetables need to be boiled for how long to remove oxalate. I did not believe it since I searched websites here and almost no mention about oxalate and bone density at all. I religiously ate spinach and kale (raw) everyday after breast cancer mastectomy thought these are “super food” until my Chinese friend told me kale is better not to be eaten in raw. I searched and found out one should not eat kale more than twice a week. The healthcare providers in America lacks basic education about the whole body approach.

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Thank you for learning! Now I won't have to learn any more! 🙂 I will be 80 in less than 2 months and I do wonder how much time and money I should spend making myself whole. That same investment in me could be going to research. Oh well, just a little philosophic for a Monday morning. //Please keep your mind active on all the issues that face those of us with bad bones.

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@windyshores

After menopause, bone density loss may be inevitable, but I admire your efforts. Does boiling spinach retain calcium but eliminate oxalates? How can we get calcium from almonds? I am asking more for my daughter, but she and I both cannot eat dairy. (I am just finishing Tymlos and need to go back to being cognizant of holistic approaches.)

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Chinese doctors told people to boil spinach between 30 seconds to 1 minute thus to remove oxalate but still keep majority nutrients.

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Have you thought about taking collagen supplement? It can help build bone and muscles.

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