So, what happens is, when we’re young, our bones have protein in them, as well as calcium. That’s why it’s important to have a diet full of green leafy vegetables, and products that have calcium, whether it be milk, yogurt, cheese, or tofu. And we also need vitamin D because it helps us absorb calcium better. We want enough but we don’t want too much. Too much calcium and vitamin D can give you what’s called milk-alkali syndrome, where you’re depositing calcium deposits around your body where you don’t want it to be. Particularly for us women, estrogen has been really helpful to help us build stronger bones. Then as we go through menopause, we lose our hormones, and the balance of building up bone and then chewing up bone changes.

Our bones get the strongest by our late 20s. If we’ve had some sort of problem when we were young, if we had bulimia, if we didn’t eat enough, if we had autoimmune diseases like sarcoidosis, or rheumatoid arthritis, or anything that requires that we take steroids, then we don’t build up as much bone. The other thing that can do it is just a really bad diet. Not eating enough, being too thin, smoking, and drinking a lot of alcohol. So we have to take care of ourselves. The other thing that can help us make stronger bones is exercise. So to me, exercise and “Use it or Lose it” is kind of the secret of life. You’ll hear even doctors say “Oh, we buy supplements, and it will fix everything from foggy brain to fat bottoms to loss of purpose in life.” But really, it’s exercise that will make your mood better, help you sleep better, decrease your risk of heart attacks, strokes, diabetes, and dementia. And keep your bones stronger. So if there’s one thing you take from this talk, you need to have enough calcium, vitamin D and exercise.

So, we’re active, then we hit our 50s, and we go through menopause. The estrogen levels really drop, and estrogen helps us build bones. I’m one of those doctors who was taught that women going through menopause need to continue taking estrogen tablets, and that’s what we used to do. The problem is that estrogen increases the risk of breast cancer, uterine cancer, blood clots, and does not prevent dementia. So these days, we only use estrogen if you’ve got hot flashes to help with the transition, but we don’t use it long term to treat thin bones. So, what are we going to do? And how do we know you know who has thin bones?