Osteopenia, Osteoporosis, and Why We Need to Act Sooner

Yes, this is off topic for what I normally discuss here on this blog. However, the amount of women in their 40’s that I have seen lately with poor bone density scores is alarming.

Osteoporosis and osteopenia are no longer just conditions we talk about in the context of aging. More and more, I’m seeing women in their 40s showing bone density numbers that raise serious red flags—numbers that, just a decade ago, we’d typically expect only in postmenopausal women.

Let’s Talk T-Scores

If you’ve had a DEXA (bone density) scan, you’ve probably heard of your T-score. This number compares your bone density to that of a healthy 30-year-old:

• Normal: T-score above -1.0

• Osteopenia: T-score between -1.0 and -2.5

• Osteoporosis: T-score of -2.5 or lower

While osteopenia is often considered the “warning zone,” it’s not a place to wait and watch—it’s a call to action. And for many of the younger women I see, the drop into that danger zone is happening much earlier than it should.

A Bone Scan Every 5 Years? That’s Not Enough

Waiting five years between DEXA scans is outdated advice. If you're already in the osteopenic range—or trending that way—we need to know sooner rather than later whether you're holding steady or continuing to lose bone density. Monitoring your progress more frequently helps us adjust strategies in real time and avoid crossing the line into osteoporosis.

The Holistic Approach to Stronger Bones

There is no one-pill-fits-all solution. That’s why I take a multi-faceted, holistic approach to improving and preserving bone density:

🥗 Nutrition

We assess your intake of bone-building nutrients like calcium, magnesium, vitamin D, vitamin K2, and protein. But it’s not just about supplements—it’s about creating a sustainable plan based on whole foods that support bone metabolism.

🧬 Hormone Health

Hormones like estrogen, progesterone, and testosterone play a massive role in bone density. We work with trusted partners to test and optimize hormone levels when appropriate, especially in women going through perimenopause or experiencing irregular cycles.

🏋️ Strength Training

Resistance training is non-negotiable when it comes to building and preserving bone. We focus on progressively loading the body to stimulate bone formation safely and effectively.

🦘 Light Plyometrics

Yes—jumping can be good for you. When introduced correctly, light plyometric movements (like hopping or skipping drills) create the type of impact forces that signal your bones to stay strong and adapt.

The Power of Targeted Supplementation

As women age, maintaining strong and healthy bones becomes a top priority—especially as the risk of osteoporosis and fractures increases after menopause. While exercise and a nutrient-rich diet form the foundation of bone health, targeted supplementation can play a crucial role in preserving bone density. In this post, we’ll break down some of the key players—Vitamin K (both MK-4 and MK-7), calcium, and Vitamin D—and how they work synergistically to support skeletal strength. We’ll also touch on one of the most overlooked keys to making these supplements effective: proper absorption.

1. Calcium: The Structural Backbone

Calcium is the primary mineral found in bones. But while it’s often the first supplement recommended for bone health, it’s not a magic bullet on its own. In fact, calcium needs the right partners to ensure it actually reaches the bone and doesn’t deposit in soft tissues like arteries.

• How much? The amount of calcium a woman needs varies widely based on dietary intake and blood markers. Supplementation usually ranges from 500–1,200 mg per day, ideally taken in smaller, divided doses for better absorption.

• Form matters: Calcium citrate is more easily absorbed than calcium carbonate, especially in older adults or those with reduced stomach acid.

2. Vitamin D: The Calcium Gatekeeper

Vitamin D enhances calcium absorption in the gut and plays a role in remodeling bone tissue. Without adequate Vitamin D, even a calcium-rich diet or supplement won’t be fully effective.

• Optimal delivery: Sunlight! But in absence of that, be sure to consume your supplements of Vitamin D as fat-soluble, it’s best taken in a capsule or softgel that includes a fat like olive oil to enhance absorption.

• Dosage: Needs vary depending on your current vitamin D levels from your bloodwork, but many women benefit from 1,000–2,000 IU daily, or more if blood work shows a deficiency. Your provider may recommend a higher, targeted dose based on lab results.

3. Vitamin K: The Unsung Hero

Vitamin K plays a vital role in directing calcium to the bones and away from soft tissues. It activates osteocalcin, a protein that binds calcium to the bone matrix. There are two main forms of vitamin K used in supplements:

• MK-4 (menaquinone-4): A fast-acting form typically found in higher doses in therapeutic protocols. It has been used in Japan in high doses for bone loss treatment.

• MK-7 (menaquinone-7): A longer-acting form, often derived from fermented natto. It stays in the bloodstream longer and supports long-term calcium regulation.

• Dosage: Research-backed ranges are about 45 mg/day for MK-4 (used therapeutically) and 100–200 mcg/day for MK-7. Again, blood work and dietary intake help determine what’s right for you.

The Key to Effectiveness: Personalization & Absorption

One size doesn’t fit all. Bone-supporting supplements should be personalized based on:

• Blood work: To assess your Vitamin D status, calcium levels, and overall bone turnover markers.

• Dietary intake: If your diet already provides substantial calcium or K2, your supplement needs may be lower.

• Absorption strategy: Use capsules or softgels that include a fat source, like olive oil or MCT oil, to help absorb fat-soluble vitamins like D and K.

• What your doctor recommends

Final Thoughts

Osteoporosis is a silent disease—but it doesn’t have to catch you off guard. If your T-scores are even borderline low, don’t wait. You deserve better than a “wait and see” approach. Through a thoughtful combination of nutrition, hormone support, resistance training, and dynamic movement, we can not only halt the progression—we can reverse it.

For aging women, a bone-supportive supplement stack tailored to lab results and paired with healthy fats can make all the difference. Always consult with your healthcare provider before starting or adjusting your supplementation routine—and consider getting baseline bloodwork to guide the most effective, individualized plan.

If you’re curious about where your bone health stands or want to build a plan to strengthen your skeleton for years to come, reach out. You’re never too young—or too strong—to start building better bones.