Updated: Sep 7
Bone health has been on my mind almost my entire life. I hope my story may inspire you to be able to take positive steps to improve your own bone health. At the age of three, I can still remember going to visit a friend of my parent’s and slipping on a recently waxed floor. I can remember the painful car ride to the hospital with my mother in the back seat. I can remember the smell of the nitrous oxide gas as they put me to sleep. Unfortunately, that fall caused a break in my leg that was in such a manner that it required that I be put in a body cast for six weeks. I know that time was probably harder on my parents than me. I was showered with attention. Pictures of me show a little girl smiling. The next major memory I have of this experience was when they cut the body cast off of me and I was so frightened as I felt weightless and I cried out. All of those memories were 57 years ago but they are so vivid, I share all of this detail so that you can truly understand why bone health has been in my thoughts almost my entire life.
That broken bone was not my last. At 5, I was running down the street with some dear playmates and tripped and fell on my arm resulting in a break. At 12, I was playing flag football with some neighbors and fell on my arm and broke it. At 18, I was in a terrible car accident my freshman year of college and almost completely crushed my L1 vertebrae and fractured my sternum. I was told that if the vertebrae had gone another ¼ inch into my spinal cord, I would probably have never walked again. My accident is a story in itself and required much surgery, a fusion of T9-L3 vertebrae and Harington rods which I had removed 5 years later. It required another body cast for 6 months and years of getting my strength back and healing nerve damage. And finally, at the age of 40, I slipped on the top step of a staircase, tumbled down only to land at the bottom with another broken leg. This involved many painful weeks of wearing a boot and having to be on crutches while I tried to take care of two young children.
Many of these events involved significant impact but it always seemed odd to me that I had experienced more broken bones than almost anyone I knew. I may never know the answer to my true bone health during those events but I do know now.
In addition to my own experiences, thirty years ago my mother had been identified to have osteoporosis during a screening event that led to countless years of medications that seemed to never make a true difference. Some medications even resulted in harmful side effects. Several of my aunts had also been diagnosed with osteoporosis. It was always on my mind; I didn’t want to go down that same path.
As a registered dietitian nutritionist (RDN), I have always understood many of the foundational components for healthy bones such as calcium, magnesium, vitamin D and others and I have tried to make sure I support my bones nutritionally. I have been an avid exerciser all of my life and have walked, run and done yoga to try and keep my bones healthy. I started getting DEXA scans in 2003 to get a baseline and, unfortunately by 2014, I had been diagnosed with osteopenia. It was in April of 2021, however, that I received the call that my bone health was truly declining. The call went like this: “Ms Davis, based on the results of your DEXA scan, we would like to refer you to an Osteoporosis clinic so that you can be placed on the proper medications.” Even though I practice functional nutrition and try to get to the root cause of disease, I am not against conventional medicine when warranted. But as I have shared previously, I knew based off of my family history that there was more to this diagnosis, and those medications may only cause me harm. I was determined to try and figure out more about my bone health and what I needed to do to support it. I spent countless hours digging into the research and started using a bone supplement that I felt would be the best for me. I continued to focus on my diet and exercise. During the next year, I had 2 odd occurrences happen with my health. My usually uneventful dentist visits turned stressful as I began getting lectured about not brushing and flossing properly. They even required me to start coming every 3 months instead of the standard 6 months. It was the same story each visit for over a year.
My blood pressure was also spiking to dangerous levels. I knew I could not ignore this but I was puzzled. Although it was a stressful time for all of us with the pandemic, the main thing that had changed was that I was using a new supplement.
About this time, I had also started to incorporate more and more genetic analysis into my private practice and I had done a couple of different panels on myself. One of the companies I used was Self Decode - whose professional software I now use to help my own patients in my private practice. It gave me valuable insight and I also took the raw data and used Genetic Lifehacks to obtain a “cheat sheet” of sorts that highlighted “snps'' in my genes that could give me clues to my health. A “snp” is a variation at a single position in our DNA sequence that may impact our health both negatively and sometimes positively. It was clear from my genetics that I had many snps in regard to Vitamin D genes, especially my vitamin D receptors and issues with my Vitamin K2 genes. Vitamin K2 activates proteins that makes sure calcium goes to the skeletal system and not to soft tissues like our arteries, breasts or kidneys. (I will be writing more about this in the near future.)
I practice science-based nutrition so I did more testing on myself based off of this genetic information to gain more objective data. I did a full micronutrient panel through Vibrant Wellness to get a better picture. Vibrant is one the few labs that tests for K2. Feel free to reach out for more information. Overall, my results looked like someone of very good health, except my Vitamin D and Vitamin K2 were clinically low.
Based on this information, I switched myself to another bone health supplement, AlgaeCal Plus that had a better balance of easy to absorb bone supporting nutrients and more K2. I now use this product with all of my clients.
I do not recommend treating yourself without the guidance of a licensed healthcare professional. I was confident as a practitioner with this information, however, to start supplementing with additional Vitamin D3, I used a liquid form based off of my needs and combined that with additional K2. I only order from my professional dispensary, Fullscript, so that I am guaranteed quality. I carefully monitored my blood pressure, and within a week, it was under excellent control. A couple of months later, I returned to the dentist and was told I no longer had a buildup of tartar on my teeth. As you can tell from my childhood picture, it was taught at an early age that Vitamin D was was important for bone health, but clearly Vitamin K2 was what I also needed more of to get the calcium away from places it should not be.
In August of this year, I scheduled an appointment to get a more sophisticated look at my bones using REMS technology. Here is an overview shared by Andrew Bush, MD, who is the director of the Bone Health Center at Central Carolina Orthopedic Associates.
REMS is equivalent to DXA in determining BMD according to the World Health Organization standards
REMS can be used to diagnose and to monitor osteoporosis
REMS is radiation free - it is ultrasound-based
REMS is done in a provider’s office and results are immediately available
REMS is portable (significant public health value)
REMS learning curve is not steep - REMS is not prone to user error
REMS is not prone to artifact error or patient positioning error
REMS has a low LSC (0.5-1.0% - error rate) can be used to monitor bone over short periods of time
REMS measures BMD and also provides a Fragility Score
Fragility Score is a measure of BONE QUALITY
FDA approved in the US in 2018
REMS is used in the European Union and multiple other countries: Italy, Belgium. France. United Kingdom, Poland, Australia, Japan, India, Brazil, Canada, Spain, United States.
REMS was designated the Official method for bone densitometry in Italy in 2020.
The Echolight REMS Discussion Group also contains a lot of valuable information.
I never felt completely confident that my spine was being evaluated properly in a DEXA scan since it was fused. I also wanted to avoid unneeded radiation as I had had more than my fair share during my life from all the x-rays from past broken bones. After many months of what I felt like was the right bone health support for myself, I was thrilled to get a report showing the diagnosis of osteopenia, rather than osteoporosis, and that my overall bone health looked good. This was most likely from a combination of a better bone health program and a more accurate evaluation of my bone health. I will repeat the REMS in a year or less and will also have some bone turnover marker labs run to also help evaluate my progress. Our skeletal system is constantly remodeling. I am confident that by providing my body with the right nutrients, focusing on optimal absorption and continuing with the right weight bearing activities (e.g., additional strength training), I can obtain normal bone health once again and hopefully have healthier bones than I ever had growing up.
I am also excited to share that as a result of my passion for bone health, I will be collaborating with Central Carolina Orthopedic. When a referral is appropriate, I will be able to provide nutrition education and support to their clients receiving REMS evaluations.
There are so many factors involved in bone health.
Have you been told your bone health is not optimal?
Do you have a family history of osteoporosis?
Do you have a condition like intestinal bowel disease (IBD) or post bariatric gastric surgery that can alter absorption and affect your bone health?
Do you want more general information on how to keep your bones healthy?
I would love to help you.
Best in Health,
Jana Davis MS,RDN,CDCES
The information shared is for informational purposes only and is not intended to diagnose, treat, or cure any type of disease. If you purchase products linked from my article, I may receive a small portion of the proceeds, and these affiliations help to support my work. These are products and services that I have researched, that I trust and that I also personally use.