This is a summary post of a talk I gave at the Quantified Self Amsterdam conference. You can see the video here.
In 2013, at the age of 38, I was diagnosed with having osteopenia from a routine DXA scan.
Osteopenia is low bone density, not full blown osteoporosis.
In 2015 it had gotten worse, just on the borderline to osteoporosis when I got a follow-up scan.
Getting this diagnosis so young was a wakeup call. I already knew I was unhealthy, overweight, and had some long-term health issues. This was what led me down the route of self-tracking and moving over to a healthier lifestyle.
Standard Western Approach to Osteoporosis
When diagnosed I got routine follow up questions & tests. Was I eating enough dairy (I wasn’t, I’m lactose intolerant)? Am I getting enough exercise?
They do blood tests — calcium, thyroid, vitamin D, testosterone. All came out OK.
Their recommendations — eat dairy come back when I’m 50.
Was my osteoporosis lifestyle realted?
Overall I wasn’t healthy. I wasn’t living a healthy lifestyle, eating a healthy diet, getting enough exercise.
Maybe osteoporosis was just one symptom of many other health problems I’d been having. If I tackled those problems, then maybe the osteoporosis would resolve itself? Or at least not get any worse?
Gut problems causing Osteoporosis?
Most of my life I’ve suffered from Irritable Bowel Syndrome (IBS).
For healthy bones, we need a load of different nutrients, not just calcium. They need vitamin D, vitamin K2, magnesium, phosphorous.
Mostly these are absorbed in the large intestine (bowel).
If the bowel is inflamed, it’s not going to absorb these nutrients.
Healing gut issues
My gut issues were all bad diet related.
No more junk food. Removing processed foods, sticking with Paleo principles — no gluten, no dairy, no fast-carb foods.
Mark Hyman’s books were a great starting point. I’ve been mainly on the paleo diet since.
I’ve tried other things also along the way — bone broth, giving up alcohol. Meal replacement drinks don’t work.
Once we stop putting junk into our systems, the body naturally starts to heal.
Bone health related to the microbiome?
So much new science coming out almost every day on the microbiome — the latest saying it has a big part in:
- Blood sugar regulation
- Controlling our appetite
- Controlling our mood
Could it be responsible for bone health?
There’s some research showing there’s a strong relation between the microbiome and bone health — Chris Kresser has written about it.
The reasons behind it:
- Immune system triggered by bad bacteria in the gut impacts bone re-growth.
- Unhealthy microbiome was reducing nutrient absorption.
- Germ-free mice show bone growth impacted.
With the IBS and bad diet, and taking way too many antibiotics over my life my microbiome was in pretty bad condition.
uBiome confirmed — I was low on two types of good bacteria.
I’ve been on high strength probiotics and more fibre since, but I need to do a follow-up test to see what changes have happened.
Healthy Liver = healthy bones?
Any blood test I’ve ever done in my life showed I had high levels of bilirubin — a liver biomarker.
Bilirubin is old red blood cells. It’s taken out of the blood by the liver and dumped out for the body through the bile. High levels can eventually lead to jaundice.
Doctors diagnosed it as being ‘Gilberts Syndrome’, a genetic syndrome. They said, and there was nothing that could do, but also it was nothing to worry about.
Since the osteoporosis diagnosis, I looked in deeper for any connection.
The latest research is saying there is a connection between the high level of bilirubin and bone health:
- Patients with liver disease are much more likely to have osteoporosis.
- Bilirubin is toxic to bone regrowth.
High bilirubin levels are also related to the microbiome. Bilirubin is broken down by good gut bacteria in healthy microbiomes. Bilirubin is reabsorbed into the blood stream if it’s not broken down.
What I tried:
- No more alcohol. There’s medical advice saying people with Gilbert’s syndrome shouldn’t drink alcohol.
- Cleaning up the diet — less sugar & processed food feeding the bad bacteria and more fibre to feed the good bacteria.
- Probiotics — good gut bacteria break down bilirubin.
- In the last 12 months there’s been a dramatic drop in my bilirubin levels:
Above are blood tests with the company Thriva.
Exercise and bone health
Bones, just like muscle — they get stronger with exercise.
I’ve always done some exercise, but maybe not the best kind for bone health. So jogging and weight lifting are going to work better than cycling and swimming.
More exercise is a work in progress.
Where to go from here?
So much information out on the web on alternative approaches. Other approaches I’m investigating are:
· High-Intensity Interval Training — lots of
· Improving low stomach acid — helps with nutrient absorption.
And of course, there is new science coming out in medicine in areas like the microbiome. Even vitamin K2 was relatively unknown until recently. There are new discoveries on the microbiome every other week.
Continuing research is key.
The more I dig into osteoporosis, what can cause it, what can help rebuild it, it’s clear that there’s so much more going on that simple calcium intake.
For me, a big part of the reason I have osteoporosis is from an unhealthy lifestyle. Sure, maybe there are many things out of my control, with Gilbert’s syndrome and having taken too many antibiotics as a kid.
But — there’s a load of stuff I can do right now tackle this.
I haven’t had a DXA scan since 2015 so I don’t know directly how it’s impacted by the changes. And even if it doesn’t work, I’ll still be healthier, fitter and have my IBS under control. Not bad side-effects.
IBS and osteoporosis
Microbiome and osteoporosis:
- How Your Gut Affects Your Bones
- The Microbiota and Bone Health: Yet Another Reason to Protect Your Gut — Chris Kresser
Bilirubin and osteoporosis:
- Bile And Its Role In Bone Health
- Bone Mineral Densities in Individuals with Gilbert’s Syndrome: A Cross-Sectional, Case-Control Pilot Study