Bones Matter.

Said the woman getting her 4th hip replacement.

I had my first hip replacement at fifty, my second at fifty-two, and my third at fifty-six—all on the same hip, my left one.

For years, no one could tell me why the first two failed. Was I allergic to titanium? Was the prosthesis too large? Was it a surgical error? Multiple theories were floated, but nothing stuck. 

Maybe it was just bad luck.

At sixty, during a bone scan at the Mayo Clinic, someone finally named the real culprit.

My bones weren’t too porous. They were too hard.

My bones were so hard the screws couldn’t get a true grip. Without that anchor, they slowly loosened—and once they did, the liner destabilized, and the cup began to slip.

Then the pain, and... a new doctor.

Bone density and osteoarthritis ...

have a relationship that’s a little counterintuitive—and honestly, a little maddening. 

For a long time, researchers noticed that many people with osteoarthritis (especially those with bone spurs and “extra” bony changes) can show higher bone density on scans, which led to the myth that OA somehow protects you from bone loss.

But real life isn’t that tidy. 

You can absolutely have achy, arthritic joints and fragile bones—or a “good” density number and a higher fracture risk—because OA changes the way you move. I have great bone density but horrible osteoarthritis.

Pain makes us compensate. 

We walk differently, we load differently, we get stiffer, we get a little less active, balance can slip, and falls become more likely.

And here’s another wrinkle: arthritis—especially in the spine—can artificially inflate bone density scores, so the scan can look better than your bone quality really is.

That’s why this isn’t about one diagnosis canceling out the other—it’s about supporting the whole system with strength, stability, and smart loading so both bones and joints hold up.

Bone Density: The Real-Life Game Plan

What you do every day matters more than what you do once in a while.

If bone density is on your radar—osteopenia, family history, early menopause, steroid use, low body weight, hip replacements, you name it—here’s the encouraging truth: bone is living tissue. It responds to what you feed it and how you load it.

Think of bone support as a 3-part foundation:

1. Smart loading (exercise)

2. Enough building blocks (protein + minerals)

3. Helpful “coaches” (vitamin D, K2, and a few strategic add-ons)

1) Strength training is non-negotiable

Bones need mechanical stress to stay strong. The best data support progressive resistance training (and, when appropriate, some impact work) to help maintain or improve bone density and reduce the risk for osteoporosis.

What “counts” (simple version):

• 2–3 strength sessions/week (Pilates, weights, etc)

• Emphasize: hips, legs, back, and pushing/pulling patterns

• Progress slowly: heavier over time beats “harder” workouts in bursts

Add weight-bearing movement most days

• Walking, stairs, hiking, dancing—these are bones’ steady drumbeat. Mixed loading patterns are especially helpful in post-menopausal women.

Balance + fall prevention is part of bone health

• Bone density is only half the story. Fracture prevention also depends on balance, reaction time, and muscle strength. Be sure your workouts include balance and stability challenges.

2) Nutrition: bone needs more than calcium

Protein is a bone nutrient

• Bone is made of a collagen matrix to which minerals attach. If protein is too low, bone-building suffers. A practical target many clinicians use: ~25–35g protein per meal, adjusted to your body size and goals.
  

Calcium: “food first,” supplement the gap

• Most women do best aiming for their recommended total calcium from food + supplements combined:

• Women 51+: 1,200 mg/day total calcium

• If you supplement calcium, consider smaller split doses rather than one large single dose (many people tolerate it better).

Vitamin D: essential, but don’t megadose blindly

• Recommended intake (general population):
• Adults 19–70: 600 IU/day
• Adults 71+: 800 IU/da
  
  

• Test your 25(OH)D for dosing guidance.
  "Twenty-five hydroxy vitamin D”) is the main blood test used to measure your body’s vitamin D status. It reflects your vitamin D stores from both sun exposure and supplements/food, and it’s the number clinicians use to decide whether you’re low, adequate, or high—so you’re not guessing at a dose.

Where to get it tested

• Primary care / OB-GYN / functional medicine clinic: ask for a “25-hydroxy vitamin D” lab. (It’s a very common order.)

• Walk-in labs (cash pay): Labcorp “OnDemand” and Quest “Direct” often offer vitamin D testing without a doctor’s visit (availability varies by state).

• At-home kits: Some companies offer finger-prick vitamin D tests, but I generally prefer a standard lab draw when possible for consistency/accuracy.

3) Supplements: a smart, simple “core stack” (for most osteopenia clients)

A) Bone mineral blend (foundation)

• This usually includes calcium + magnesium + supportive cofactors.
• Why: The mineral supply has to be there—without it, the rest is just wishful thinking. Calcium RDAs are typically 1,000–1,200 mg/day for adults depending on age/sex.

B) Vitamin D3

• Why: Supports calcium absorption and bone metabolism. Vitamin D status is best assessed with 25(OH)D.

C) Vitamin K2 (MK-7)

• Why: Often paired with D + calcium to support proper calcium utilization.
  Big caution: If someone takes warfarin, vitamin K needs clinician oversight.
  

Helpful add-ons (optional, but can be meaningful)

Magnesium (if not already in the blend)

• Magnesium supports bone and vitamin D metabolism. NIH fact sheets are a great place to check dosing and safety.

Collagen peptides

• Why: Collagen is part of bone’s scaffolding. Collagen can be a helpful add-on—especially when paired with protein adequacy and strength training.

“All-in-one” bone formulas

• If convenience improves consistency, there are comprehensive bone formulas for people who won’t stick with multiple bottles.

Two Calcium and Vitamin D Assessment Tools

Click buttons to learn more about your calcium and vitamin D needs.

If you are interested in learning more about quality brand supplements for bone health and much more, consider signing up for my FullScript online store. 

Receive 15% off all purchases for being a part of this circle.

Until next month—remember: small changes count, consistency wins, and you’re not behind.