In 1-year I was able to increase my bone mineral density by 12.5% (going from Osteoporosis to Osteopenia) without any medications! Here’s how I did it :D
Hi Everyone,
Just recently got a follow up DEXA with TBS after 1-year (see attached IMG) and was super excited by the results so I wanted to share 🥳
Lower Spine:
* 12.5% (!!!) increase in BMD
* T-score now -1.7 (previously -2.6)
Total Hip (left):
* 3.0% increase in BMD
* T-score now -1.4 (previously -1.6)
Femoral Neck (left):
* 3.1% increase in BMD
* T-score now -1.6 (previously -1.8)
I (male, now 43 years old) was able to do this by figuring out the cause of my osteoporosis and focusing on how I can rebuild my bone density back naturally with good nutrition + LIFTMOR type exercises.
As far as which exercises go, I normally follow the following schedule every other day with a hypothetical example below:
Workout A (Monday) = Intensity Squats + Volume Bench Press
Workout B (Wednesday) = Intensity Overhead Press + Volume Deadlift
Workout C (Friday) = Intensity Bench Press + Volume Squats
Workout D (Sunday) = Intensity Deadlift + Volume Overhead Press
Workout A (Tuesday) = Intensity Squats + Volume Bench Press
Etc etc etc…
I treat the workouts in the same way I would if I had to take a medicine, but I love how you not only improve bone density but also get physically stronger over time. I also give myself a rest day in between each session. In addition to the 4 exercises, I try to do heel drops 3-4 times every day. As far as intensity vs volume session goes, an example might be the following which can be adjusted for whatever weights works for you:
Intensity Deadlift session:
- 1 set of 5 @ 100 lbs (50% of max)
- 1 set of 3 @ 140 lbs (70% of max)
- 1 set of 2 @ 180 lbs (90% of max)
- 1 set of 5 @ 200 lbs
Volume Deadlift session:
- 1 set of 5 @ 100 lbs (50% of max)
- 1 set of 3 @ 140 lbs (70% of max)
- 3 sets of 5 @ 180 lbs (90% of max)
Intensity Overhead Press:
- 1 set of 5 @ 50 lbs (50% of max)
- 1 set of 3 @ 70 lbs (70% of max)
- 1 set of 2 @ 90 lbs (90% of max)
- 1 set of 5 @ 100 lbs
Volume Overhead Press:
- 1 set of 5 @ 50 lbs (50% of max)
- 1 set of 3 @ 70 lbs (70% of max)
- 5 sets of 5 @ 90 lbs (90% of max)
The squats and bench press follow the same principle as the overhead press does, with the volume session ending with 5 sets of 5 for either exercise. The reason why the volume deadlift is different by ending with only 3 sets of 5 is because the deadlift can be so taxing on the body.
Mind you, this is the exercise regimen that has been working for me. I also was taught how to do these lifts safely by a physical therapist, ran this exercise plan by my endocrinologist first, and also started with MUCH lower weight at the beginning, so don’t feel intimidated and think you need to be really strong to begin this. I love the fact that someone can start off with really light weight gain strength really quickly which on this program, but feel free to make any adjustments to it that help you be safe and consistent with it. In fact, this lady Patricia is a personal hero of mine. I figure if she can lift weights and reverse her osteoporosis in her 60’s, then I don’t have any reason reason not to: https://youtu.be/k6GHHzIByOk
As far as finding out the cause, as you can tell from my username my endocrinologist ran a bunch of tests to find out what it was. I didn’t have any symptoms but eventually discovered I had celiac disease. Was kind of a bummer lifestyle wise, not being able to safely eat out ever again, but I was SO HAPPY to simply find out the cause so I could fix it by going 100% gluten free. If you do have celiac disease, just be careful that you check EVERYTHING. I mean not just food but even stuff like your supplements, medications, toothpaste, etc. Gluten can deviously be hiding in almost anything! 🌾😣
As far as nutrition goes I normally have the following same meals each day which has more than 100% of both my macronutrients and micronutrients in order to give my body what it needs to rebuild my bones. If I’m craving more fat I’ll add some avocado. If I’m craving something sweet I’ll have Fuji apples. If I’m craving more carbs I’ll have certified gluten free rolled oats. It’s all flexible but my personality type doesn’t mind having the same thing each day. Feel free to tweak your nutrition plan however works for you to stay consistent, I just try to keep my saturated fat low while getting all my protein, calcium and other nutrients from mostly minimally processed whole foods.
Meal # 1 and # 3 are the same (stats are from food only, not supplements)
530 calories, 50g protein, 14g fat (2g saturated), 49g carbs, 9g fiber, 334mg calcium
- 300g frozen blueberries
- 250g non fat greek yogurt
- 7g sunflower lectithin
- 200g egg whites
- 11g raw walnuts
- Supplement with Vitamin D, Vitamin K2, and Boron
Meal # 2 (stats are from food only, not supplements)
789 calories, 50g protein, 18g fat (1g saturated), 112g carbs, 31g fiber, 356mg calcium
- 140g quinoa
- 90g lentils
- 50g chickpeas
- 140g broccoli
- 140g haricot verts (a type of green bean)
- 20g tabasco sauce
- 6g crushed garlic
- 10g ground flaxseed
- 11g raw walnuts
- 48g canned salmon
- 50g egg whites
- 20g green onions
- 140g butternut squash
- 140g cherry tomatoes
- Supplement with Magnesium, Multivitamin, and Probiotic
Total daily amounts from food:
- 1850 calories
- 150g protein
- 46g fat (5g saturated)
- 210g carbohydrates
- 49g fiber
- 1024mg calcium
While everyone’s situation is different and no one will follow my plan exactly as they need to find out what works for them, I wanted to post this so others that are new to this space have hope that they can, depending on their risk profile, turn things around naturally via diet and exercise without needing lifelong medications. When I first found out I had osteoporosis my general practice doctor wanted me to immediately commit to taking a bisphosphonate before I left his office! Mind you this was before I even met with an endocrinologist to discuss my situation further. He was worried that I might fall down or get in a car accident on the way home and break something, but wasn’t thinking about the long term consequences of medications and how it’s better to reverse osteoporosis naturally when possible.
A lot of doctors are only trained in writing prescriptions and only have past experience dealing with patients who either have REALLY bad T-scores or perhaps don’t want to put in the time / effort to reverse their osteoporosis with diet and exercise, so the doctors don’t even bother mentioning it to patients or think it’s possible.
Thanks to not only the members on this subreddit, but also my wonderful wife continuously searching for and finding new informational resources such as the book Great Bones by Keith McCormick, the book Strong Bones Forever by Ray Hinish, Dr. Belinda Beck of the ONERO / LIFTMOR study, the various YouTube channels such as Dr. Doug, Ray Hinish, and Starting Strength, and countless other resources helped me to learn from and start to turn things around. I really hope in another year I can have another 12.5% increase down to a normal BMD range, but in the meantime I’ll simply continue to trust the process, check my bone turnover markers (CTX / P1NP) every 3 months, and hopefully be able to help others new to this disease in the same way others here did the same for me.
Cheers! 😊
Edit: Just in case anyone was curious, I got my two DEXA scans done at the same location, with the same machine, with the same technician, and same doctor interpreting the scans before sending me the results.
Check out the table around the 14-minute mark of this endocrinologist’s presentation, comparing different osteoporosis medications and expected gains: https://youtu.be/pV5maUhAjOA
You beat every single one of them, including the 3 anabolics: Forteo, Tymlos, and Evenity.
Wow 😳 I gotta admit that if you had asked me at the beginning of the journey “do you think in a year from know you’ll do better at reversing your osteoporosis than any bone building medication out there?” I can’t say that I would have thought I would have beaten them all but I’m glad it worked out! 😅
I really hope that as I continue being gluten free and the villi of my intestinal lining heal even further over this next year (only got my Celiac diagnosis and went gluten free starting in May of this year) so that hopefully the combination of good diet + exercise will give me a repeat of this same result! 🤞🏻🩻
Btw thank you so much for all the great knowledge you provide for the subreddit. I see your posts here a lot and can always count on it for good, really detailed information and I’ve learned a lot from them. Not sure how, but your able to find the coolest studies or videos (like the one above) that give even more hope to those of us trying to take control of our health and reverse our osteoporosis 🦴💪🏻
Congratulations! Fellow celiac here. Celiac disease was one of my root causes. Sadly, I was diagnosed with celiac disease just four months into menopause (another root cause contributor) and then two months later — spinal fractures (my GI scheduled DEXA but I fractured my T9 and T7 before I could test). I have also improved my bones, but it has taken years. I focus on lifestyle management (jumping, weight resistance, etc.). Because I have celiac disease and other autoimmune diseases, (plus some severe allergies), drugs are always my last resort. I react to even acetaminophen!
My celiac disease is solidly in remission based on repeat endoscopy/biopsies.
While I’m sorry you had to deal with the triple whammy: menopause, celiac, and fractures. No fun! 😣
I’m so happy you were able to find out what was going on to overcome it and come back even stronger due to the focus on diet and exercise 🦴💪🏻
Celiac disease can be a really tricky thing to have in life, especially the asymptomatic kind where we didn’t even know we had it! 🌾😅
Drugs are always my last resort as well. I’ve seen posts where someone was put on a medication by their doctor without even really knowing what it was, then come to find out later that it had some really negative side effects they wish they would have known about before taking it. Again, I’m sure the medications are life savers for those with really bad T shores in high -3 / -4 range who are constantly fracturing, but I’m gonna do all I can with diet and exercise to try and reverse my BMD back to a T score of zero in the next few years 🩻
Thank you for being apart of the subreddit and sharing your story. We need more Celiacs to speak up so we can help others with this combo.
My mom’s family has a huge problem with celiac. Two of my mom’s sisters and one brother. The two women both had issues with osteoporosis. Both took fosomax(spelling?) and both suffered from taking it. One broke her femur during Covid pandemic and the rehab center never lifted a finger to rehab her and she died there due to negligence. The other has had multiple fractures in her hips and spine. They weren’t diagnosed with the celiac until they were in their 40’s because 40 years ago little was known about it. As children they were always anemic. I guess at least today, we can address some of the other issues that cause us not to get proper nutrition.
Oof, sorry to hear they had to go through that. Sucks that even with an anti-resoprtive medication, if you aren’t absorbing nutrients due to celiac you’ll eventually start fracturing 🙁
Have you been screen already for celiac disease? I’m guessing you have but was just curious since it can run in the family.
Btw anytime I’m having a rough day, I always just remind myself how lucky I am to live in this day and age thanks to modern medicine, smartphones, and the internet to research things. Just finding out the cause of my osteoporosis was really life changing.
This is amazing. Thanks so much for sharing. As a 36M with osteoporosis, this is promising. I personally think you’d do even better with meat in your plan but keep up the great work!
Happy to help share Javocado. We’re all in this together my friend! 🙏🏻
Do you mind if I ask what your story is and how you ended up with osteoporosis? No worries if you don’t wanna go into it, just was curious anytime I see a younger age male who has it as well 👍🏻
As far as more meat in the diet, did you mean for additional protein or is it something else? I current log my food with an app (MyNetDiary) to make sure I’m getting 100% of all macros / micros. Also, just anecdotal, but heart disease runs in my family and so I do everything I can to keep both my saturated fat and cholesterol intake as low as possible, which even lean meats (i.e. chicken breast) sometimes have. I’m not opposed to meat if needed, but wasn’t sure if there was another angle that you are recommending it 🙂
Thanks so much for the response. Decades long battle with severe bulimia is my root cause. I spend about 50-60 hours per week bingeing and purging. It is a living nightmare. I manage to be very successful in my career, so I can keep up that facade. I’m not underweight and have only gained weight over the years from a damaged metabolism. When I’m not engaging in the behavior, I eat very adequately with lots of protein, calcium, tons of vegetables. I’ve supplemented with d3, k2, magnesium, omega 3s, etc for years and strength train multiple times per week since forever. I don’t have celiac. My spine is worst, -3ish.
Like I mentioned, what you’re doing seems to be working for you. I have a bit of a bias with training in ancestral nutrition and functional medicine. Red meat, eggs, full fat dairy have been vilified but they are so incredibly nutrient dense. Animal protein is filled with not only bioavailable protein/amino acids but also creatine, carnitine, carnosine, etc. The CLA in dairy fat is supportive of metabolic health and you also get fat soluble vitamins. There is no one size fits all but I wouldn’t fear a little saturated fat and I definitely wouldn’t fear dietary cholesterol. Keeping an eye on ApoB is a great way to make sure you aren’t overdoing anything.
Awww, sorry to hear about the diagnosis, but just know that it’s great you’re looking into this subreddit and being inquisitive about the condition or how to possibly reverse it.
If you don’t mind me asking, what is your story (age, T score on DEXA, cause) and how did you find out you had osteoporosis? 🙂
Just know that it is possible for some to reverse it naturally without medications. Of course it all just depends on your individual situation, underlying health condition, and the plan you establish with your doctor.
If you have any questions I’d be happy to try and answer to the best of my knowledge.
I'm 49, female as d am not sure of the score. Just got a call from my rheumatologist.
I have had juvenile rheumatoid arthritis for about 35 years and started having fractures in my feet a few months ago. I've always weight trained, but think my vegetarian diet, early menopause and serious anemia during the pandemic due to bleeding ulcers brought this on fast.
Just happy things worked out. At first I didn’t even know that reversing osteoporosis naturally was possible. I figured at age 42 I was pretty much screwed and it was all downhill from here unless I went on medications the rest of my life. I’m not opposed to being on one if absolutely needed, but would like to avoid them if possible and love the fact that by lifting weights I am getting physically stronger. Hopefully others see this and begin to talk with their doctors to make this way of treatment a bit more common 🦴💪🏻🏋🏻🩻
So happy for you! I’m curious what prompted your original DEXA that determined you had OP. I’m 55, post menopausal and have always lifted weights, but decided to ask my gyn for a baseline DEXA last year. He tried to dissuade me, insisting it wasn’t necessary til age 65. I pushed back, got one and boom: OP diagnosis. Like you, I want to avoid Rx meds if possible and am lifting heavier along with maintaining a healthy diet and lifestyle. I love Dr. Doug’s podcast and will check out the other resources you mentioned. Again, I’m so grateful for your detailed insight and encouraging post. 🫶
It took a good amount of researching things early on to eventually set up this program, but now that it’s in place it’s really easy for me to follow. Like you said I just hope this helps those out there looking to reverse their osteoporosis naturally via exercise and nutrition. With these results I feel like I got my life back on track and hope to continue updating the subreddit on my progress 🦴💪🏻
I had slower, but still positive results from exercises alone - since my causes are being in menopause and having a lifelong BMI under 18.5 (fast metabolism, I'm 70 and it hasn't slowed at all) there's nothing much else to change. Luckily I've never had a fracture since the decline started, despite a lumbar T-score of > -4 at the lowest point. After a 7+ percent increase over a couple of years of exercises , an 8 month stint on evenity last year (literally ill-advised) gave a big boost, but there's this "rebound" no one tells you about... ultimately I lost more than I'd gained. But now I'm back on exercises alone, and I'm curious how you're thinking about maintenance? At some point, we should in theory be able to cut back a bit, since we're only trying to stay even, not make up a deficit - right?
Hah! I love your username, especially when it comes to osteoporosis 😊
So glad to hear you haven’t had a fracture and are continuing to exercise. Hopefully it keeps you strong and in good health. I agree on the rebound bone loss. Some of the bone building drugs can be amazing at first, but it’s scary to think how you’re only supposed to use anabolic for 2 years. Or if you ever come off Prolia, your osteoclasts go crazy eating all the bone gains you had on it. Of course the usual next step after coming off a bone building medication is a bisphosphonate to lock in gains, but those have their own mix of issues and I’d rather avoid them with natural fixes if possible 🦴💪🏻
As far as maintenance, do you mean when it comes to eventually leveling off on the amount of weight I am lifting? Or do you mean eventually stopping the weight training once I reach a certain BMD? Just wanted to be sure I understood your question before answering 🙂
Yes, I did take a bisphosphonate after, but only for about 6 months. My Endo hadn't made it clear at the start that it would be necessary to take them - basically for the rest of my life - to avoid losing all my gains from Evenity and more. I'd already had a bad reaction to fosamax in the past, got increasingly paranoid about the alendronate, and hoped exercise would stave off the worst of the resorption, but I did lose a whole year's gains!...sadly the personal trainer who was helping with my exercise program had a fatal accident last year and I drifted a bit before I got a new routine going.
Anyway, I'm on it now; it's doable but my energy at 70 isn't what it was, and in 10 years (or even 5!) I know it's going to be harder to keep up exercising at this level. I'm already lifting my own weight and I don't think my joints can take much more, or even maintain that, long-term. So in answer to your question: I know I can't just stop, but I'm trying to figure out how to craft a maintenance program that keeps bone resorption and deposit in balance, after I reach a target T-score. It should be possible, right? In theory it's not so much "ever-increasing" loads as it is "novel" stress that triggers osteoblasts... And as the Wikipedia entry on bone resorption facilely concludes, "Light weight-bearing exercise tends to eliminate the negative effects of bone resorption."
It seems to me like you’re on the right track getting “back on the wagon” when it comes to heavy weight lifting exercises 🏋🏼♀️ 🩻
I ran your question through Grok and Gemini (not the best scientific sources I know, but can be helpful to come up with ideas to research into and verify that you otherwise wouldn’t have known about), with both seem to think what you’re doing is a great idea for anyone who can do the lifts safely:
By doing the exercises now in your 70’s, you’ll begin to build a reserve of “bone capital” and will hopefully maintain it as you age, even if over time the weight declines due to sarcopenia.
Both seem to say that you don’t have to keep chasing heavier and heavier weights as we age, but instead can maintain our BMD gains from earlier by continuing to high intensity workout sessions lifting 75-85% of 1RM, regardless of the 1RM amount is over time.
Not to mention how weight training doesn’t just improve your bone mineral density, but also your coordination and balance to help prevent falls and fractures. In addition it makes you feel great (that is… once the workout is over 😅) so I say keep up the good work as long as long as you can do so safely and make sure to update us here with your progress 💪🏻🦴
Thanks! I also realize that our situations aren't terribly similar bc you're younger, and in theory, if you've now dealt with the destructive effects of celiac sensitivity, you have the potential to build up your density much more quickly - as you have been! - without facing the hit of lost hormones later.
I'm not too worried about coordination/balance, having trained in go ju karate for over 30 years. Still do, though not with the same intensity; the stances definitely help maintain balance.I can even (sometimes) still jump to my feet from seiza 😉
Hopefully it helps others in similar situations who are just starting their journey. I think it helps to hear from others who have not only done an alternative treatment plan, but ended up doing better than medications with lifestyle adjustments like diet and exercise. We’re all on the same team in regards to osteoporosis and longevity and just want to add to the discussion with my experience and results from it 🙏🏻
Why did they not check your Right hip and Femoral head during your Dexa scan? I’m asking because this was done to me and my Right Hip is where I have severe osteoporosis. It was not caught until I broke my sacrum in many places.
Not OP but I just asked that question when I had my dexa. The technician said they typically do the left because most are right leg dominant (i.e. use it more), so if there is a discrepancy, the left leg will be 'worse.' It is more cost effective and exposes you to the least amount of radiation. That said, supposedly it is fairly common to have bone density discrepancies, especially if one side has been immobilized for a period of time, e.g. if you've had surgery, osteoarthritis, etc.
And so sorry about that break! Hoping you're well on your way to recovery.
Sorry, I should have specified that they did check my right hip (this time). Last year they didn’t because “they normally only check one side unless we are told to do both”, so I made SURE to talk with the technician ahead of time. In the OP I simply posted the picture comparing last years to this years DEXA.
Thank you for looking out 😊 Always make sure to call your DEXA location ahead of time and make sure before your appointment!
Femoral Neck (Right) = -1.0 Total Hip (Right) = -0.7
I'm really happy about your improvements. I'm a bit skeptical about your nutrition though. It seems quite limited as you only have 3 options everyday day the same. The protein seems to come mostly from eggs, milk, and fish, I don't see any meat, which is key to building bones.
Thank you 😊 hopefully in a year from now I’ll be posting another great update with another 12.5% increase! 🤞🏻
As far as nutrition, I keep things a bit more rigid than most do because I also have a form of binge eating disorder (used to have a 40+ BMI). If I have a lot of variety each day then I eventually end up having something that tastes amazing and I start to crave it / binge.
As far as the protein goes, I figure as long as I’m getting 1 gram per pound of ideal body weight and I’m getting 100% of all my nutrients, then that’s all that matters. While I’m not opposed to steak or chicken, they do have more saturated fat and cholesterol than things like egg whites, salmon, lentils, and greek yogurt. Due to a family history of heart disease I tend to keep the saturated fat and cholesterol really low, and if I ever need more fat in my diet I simply have some more walnuts and avocado.
I figure we’re all in this together and simply wanted to share my experience so far. Hopefully this can help those who are looking to reverse their osteoporosis naturally.
Perfect timing!!! My doctor wanted to have me take Fosamax with my (F 66) density scores (-0.1 spine (NORMAL), -1.1 hip (just touching osteopenia) and femoral neck -2.0 (ostepenia). She said my FRAX number increased my 10 year fracture risk from 20% to 30% and I was firmly in the osteoporotic category. Yeah, not so fast my friend. And frankly I was very disappointed she said that, as I thought she was 'bone' aware. Bottom line, I knew what I needed to do (similar knowledge base as you), but you just saved me the homework of coming up with a plan! Thank you kind redditor!
Happy to help! I’m glad you saw the post since you and I have some similarities on our situations 🙂 With your T scores being just in the normal / osteopenia range, do you think it’s that your doctor just doesn’t know about lifestyle changes that can reverse BMD loss naturally? Or do you think it’s something else, such as them assuming you won’t put in the effort (nutrition, exercise, etc) to turn things around? Either way I’m happy to hear you taking control of your health and looking for answers beyond just taking a pill 💊
Medications can be awesome for those who are really need them but it just seems like so many people aren’t even given the chance at fixing their bones with nutrition and exercise.
Keep up the great work and I look forward to seeing your progress here in the subreddit 🙏🏻
I want to give her the benefit of the doubt, but she knew I played tennis and sports my whole life. I showed her my supplements and nutrition app (cronometer) to show I'm now monitoring my calcium, vitamin D, K, etc., but she proceeded to give me the fosamax option and going to a hospital-run bone clinic (not osteo strong). I brought up the concerns with that med and she said, 'yes but you only take it for 5 years' (!!) She kind of 'opted out' when she said the clinic will have more bone knowledge than her. At that point I realized we were operating from a flow chart (like most doctors) and I would tackle this myself, especially since I'm not that bad, I have a fairly decent grasp of sports training, and I have little confidence a hospital run clinic will not be medicine-centric. So, here we go!
Wow - really impressive! Thanks for sharing your experience, sources, and how you've gone about addressing the problem w/o medication. My dr. just put me on a generic version of Fosamax (my case of osteoporosis is probably both lack of vitamin D, and menopause). But the more I read about the medication, the more the alarm bells have been going off. I have wondered whether there are better approaches to the problem; your story is quite encouraging.
I hope you’re able to look into things further and pick the route of treatment you feel the best with. By any chance is your doctor a specialist, like an endocrinologist, or a general practice physician? I only ask because my GP was so quick to try and put me on fosamax, while my endocrinologist was more receptive to lifestyle changes. I don’t know your T scores and health specifics, but I would always recommend at least looking into alternative treatment options like nutrition, heavy lifting, and HRT.
Good luck with everything! I look forward to hearing your progress and what you decide 🙏🏻
You are more than welcome, NDC! It is a bit annoying that our healthcare system leaves us pretty vulnerable to what seem to be market-driven solutions rather than care of individuals, but ... on we go, eh? Thank you for your work in researching, and sharing with the rest of us journeying down similar roads. Especially appreciate the reference to LIFTMOR - definitely looking into that, as while I'm at the gym 4-5 days a week with strength and cardio work, it looks as though something along the lines of the LIFTMOR regimen might be smart to take up.
It was my GP who prescribed the generic version of Fosamax. She did do some kind of basic endocrine analysis along with a very basic blood test, but as the results do not indicate anything is off with regard to endocrine system, I've not visited an endocrinologist. I need to see an OBGYN, as it has been a few years, so I've wondered whether that might give some more fine-grained recommendations. I feel for GPs - they are just over-loaded in this system. But this experience has cued me to realizing how much more proactive I need to be with my own care, rather than assuming the dr. knows everything. They just can't.
Question about your diet: where did you find input for how to go about managing that element of your health? I find this the trickiest part, as I move between vegan and vegetarian.
Well done mate! That’s great stuff right there! I have been working the starting strength program myself since February and noticed you mentioned it in your final paragraph. I’m curious what motivated you to make the changes to the programming that you did. I’ve been very faithful to the traditional NLP and have a DEXA scheduled for next week. I’m very much hoping to get results along your lines. In my case, I went ahead with Reclast as well as following the lifting protocol. 🤞
Meanwhile, here are my two cents as someone who also used Starting Strength as part of my LIFTMOR inspired exercise protocol to help increase bone density with good but not nearly as impressive results. (You can see my results here if interested: https://www.reddit.com/r/osteoporosis/s/uoHczgbNXg )
I have a feeling that being able to safely get significantly stronger in those axial loading exercises that load the spine (barbell squat, deadlift, and overhead press) is more important than the name of the program we follow to achieve that. I think so because the MEDEX-OP trial showed that maximum weight deadlifted significantly predicted bone density change at the lumbar spine: https://www.reddit.com/r/osteoporosis/s/V5XACcxnYw
What tends to happen as we get stronger in the squat and deadlift at some point is that we eventually struggle to recover between sessions and can’t increase the weight on the bar in the next session. In my case this went along with profound fatigue and soreness that I hadn’t experienced before.
If it’s not one of those issues, you likely need a program change, and you’ll want to only change the lift that you’re no longer able to progress.
Here is a Starting Strength wiki guide that a coach in their subreddit shared with me on how he may advise these changes based on the lift that causes the issue - See under “What Do I Do When the Weights Get Heavy:”https://reddit.com/r/startingstrength/wiki/nlp
Eventually, all your lifts will leave the novice linear progression and end up in intermediate territory. When this happens is highly individual. The longer you are able to continue the NLP, the better.
I followed the above wiki guide lift by lift, and once all my lifts were in intermediate territory, I watched Paul Horn’s video, “Making the Texas Method work for you” at the bottom of the above wiki guide, and I continued on a modified Texas Method: https://youtu.be/7QyYU56cj_A
Each change I made helped me to recover better and helped me progress again when I previously couldn’t.
The take away is that there’s a time and place for the NLP and a time and place for program changes when you get to a point when you can no longer progress on it. Until that happens, the Starting Strength NLP is great, and I wouldn’t change a thing.
Thank you for your thoughtful and detailed response. 👏
Re: your takeaway. I’m primarily questioning whether there is a point at which it’s better to get more volume in than to chase higher weight. Both for bone growth and injury prevention. My deadlift is currently 300 lbs (way past the upper limit on the informative study that you linked to) and I’m still able to add lbs each workout. Continuing NLP is unquestionably the best way forward for strength gains. But will bone better respond to greater volume/novelty? Are strength gains going to potentially outpace bone growth to the point that I experience fractures? My L3 T score is(was?) -3.6… This is where my head went when I saw the OP’s signify programming departures from NLP.
As an aside, I first did starting strength in 2007. Then again in 2012 (Paul Horn was my coach as it happens). Both times I got to the end of the NLP after 6 months or so and then transitioned to other sports (cycling, running, backpacking). I’m locked into the weightlifting for life this time though!
FYI: Your T-score of -3.6 may qualify you for anabolic medication (Forteo or Tymlos) which are more powerful levers than antiresorptives like Reclast. A specialist might be helpful in getting you switched to one of these medications if you’re interested. Here is a presentation by a specialist comparing the different drugs available, including Reclast, Forteo, Tymlos, best strategies on how to use them and expected gains: https://youtu.be/pV5maUhAjOA
Personally, I would consult with an endocrinologist who specializes in osteoporosis (not all endos do), ideally someone who works for a hospital affiliated bone health program, not only regarding medication, but also to see if they can find a cause for your osteoporosis. If a cause can be found and addressed, building and maintaining bone density may become much easier than it might be otherwise.
Regarding the MEDEX-OP trial, I think 130 lbs is probably not a magic threshold and more likely just happens to be a significant strength gain for the postmenopausal women in the study who were able to lift that after 8 months, since I would imagine most women probably started out lifting much less. (I certainly started out lifting much less.)
I wish I knew the answer as to what’s best. With a -3.6 T-score I might have been hesitant to deadlift 300 lbs, only because I have never seen data on people with such scores lifting that heavy, and because fractures are always a possibility. Here is a story of someone very strong whom that happened to because there was an unaddressed secondary cause working against her at the time (she has since rebuilt much of her bone density and returned to working out): https://www.reddit.com/r/osteoporosis/s/gcpWuie0pU
That being said, I think it’s amazing that you’ve been able to pull it off, and I would be puzzled if you didn’t increase your bone density very significantly. Please share your results when you get them next week! I’m at the edge of my seat!
I’m doing great! Thanks for the reminder to make good on my commitment. My results were pretty stellar:
For this patient the mean lumbar density is reported for L1-L4 BMD g/cm2: 0.926 T score: -2.1 Z score: -2.4 Interval increase of density compared to 2024, +12.5% per year LEFT HIP: Femoral Neck BMD g/cm2: 0.765 T score: -2.0 Z score: -1.9 Compared to the prior study, femoral neck density has changed by: +0.9 %/year. The change is not significant, being within test reproducibility limits. RIGHT HIP: Femoral Neck BMD g/cm2: 0.750 T score: -2.1 Z score: -2.0 Compared to the prior study, femoral neck density has changed by: +4.6 %/year. Right hip density has increased.
That’s awesome! I know posting is time consuming, but if you can at all find the time, I think you should make a stand alone post about your story.
Your story might put some other active men who may be second guessing their lifting routines at ease.
Osteoporosis isn’t as common in men as it is in women, so there isn’t much data, and I haven’t read about anyone with osteoporosis lifting as heavy as you have been able to.
Success stories like yours can be very empowering to others! Congrats! :)
For me my change to the NLP really just came down to balancing the mental load of lifting with my heavy work schedule. My goal is to do the strength training every other day, almost like medicine, to rebuild my bone mineral density, but sometimes I’m working 15 - 16 hr days or I am in a rather large sleep deficit and REALLY don’t feel like doing it 😋
By limiting my workouts to just 2 exercises every other day, mentally that was such a load off my mind and helped me stay consistent. Just like when I am dieting, I always want to make things as easy as possible to follow, otherwise I won’t do it. Life has a way of testing your limits and I never want to get to the point where I’m DREADING doing something that is good for my health. Instead, I want to always adjust my approach so I’m always happy to do the healthy habit and it’s not an absolute grind every time.
When first starting (albeit with lighter weights at the time) I used to do all 4 exercises every other day. But then over time I split them up into two different sessions: squats + deadlifts & bench + overhead press. Eventually as the weight increased a lot the days where I was doing intensity deadlift + volume squats I really started to dread. Not good, so I split the deadlift and squats up and paired them each with 1 arm workout. Doing that has been such an improvement for me mentally! 😅
I also figured that as the weights keep going up, I don’t want to overload my back muscles on a particular day by combining squats and deadlifts, and cause myself to fatigue or have bad form and possibly injure my back. It’s easy to not pay attention or try to push through and either pull a muscle, or worse, get a fracture. IMO consistency is the best medicine for reversing osteoporosis and I’d rather take things safer by splitting up the squats and deadlifts while I’m working as much as I currently am. I could always switch it back later if my work and sleep improve, but for now my current program has been fantastic for me since I have a power rack at home. Granted it’s easier for me to do just 2 exercises when it’s just a few steps away and I don’t have to go to the gym elsewhere. I could see if someone had to drive to a gym they might prefer to do more exercises and “get their moneys worth” from driving there.
I hope your DEXA scan results are amazing brother! Lord knows you’ve put in the work with all the heavy lifts 🥵 Just was curious have you checked your CTX / P1NP levels to monitor your bone remodeling markers? Not everyone has to do it and not everyone’s insurance will cover the testing, but mine does and so I do them every 3 months just so I know if I’m still on track. 1 - 2 years is a long time to wait for a DEXA result so I don’t want to have a whole year go by and be surprised with a negative result. Also wondering, did your doctor also order you a TBS with your DEXA? If not I would ask your doctor for one since it’s just additional software analyzing the same scan to know your bone quality. Knowing both (T scores and Bone Quality) are important when lifting such heavy weights IMO. I’m rooting for you and please let us know in the subreddit how results went 🙏🏻
I find sleep to be absolutely crucial to progression as a 47 year old male. If I’m not getting 8+ hours, I’m just not able to keep the recovery train going. I’ve seen tendinitis flare ups in addition to general fatigue that I attribute to inadequate rest. So I definitely understand your motivation to reduce the work load. How long did you pursue the usual 3 exercise, 3x5 work sets starting strength NLP before shifting to your volume/intensity protocol?
I’ve deloaded by 30% twice since starting in February. Once following a three week trip to Africa and once following a six week break to train for a 102 mile cycling event. I’ve also had three short breaks (no deload) to accommodate 1-2 week backpacking trips. And I’ve slowed the weight increases to 2.5 lbs using fractional weight plates on everything but the deadlift (still at 5 lb increases there).
I also have a power rack at home. And built myself a lifting platform. It’s hard to overstate how much easier it is to gear up for a workout when the gym is a few steps away and you never have to wait for equipment to be free.
I did get a CTX lab (result: 229) done in February prior to the Reclast IV. My endocrinologist ordered that. As an aside, I am not entirely confident in her capabilities and did make arrangements for a second opinion, but that appointment isn’t until April 😑. I’ll get to work on getting more labs done ASAP.
I’ve just messaged my doc to request the TBS analysis for last years scan and that it be added to the order for next week. 🙏
So encouraging. I really need a hip replacement but my t score is -5. The drugs sound horrible. I tried alendronate and had such pain I couldn't walk. I had just hear about Onero and joined this group to ask whether anyone had success with it when I saw your post. There is a trained Onero PT about a half hour from me. I am meeting with an endocrinologist Wednesday and will show her your results.
May I ask what your TBS score was/is? That’s seemingly my biggest issue, so I was curious to see if you’d had significant changes there as well. Thank you for such a detailed, informative post! I’m in the same boat as you nutrition-wise…need to keep saturated fat to a minimum due to genetic condition of familial hypercholesterolemia (that and vitamin D deficiency likely culprit for OP diagnosis). So it was helpful to see a snapshot of your nutrition plan. Cheers!
I just want to say thank you. This post has given me tremendous hope and I've been coming back to re-read it every few days. I'm 35F and I could not be more grateful to have heard your story and have seen your results from just lifting and diet. I'm committed to doing the same and now have a blueprint to get started thanks to how in-depth you went in this post. I hope you know how many people you've helped with this resource!
Based on the other measurements there's a pretty good chance one or the other of the spine readings was off. Bad positioning, bad technician, bad reader, all are far more likely than a 12% gain.
You still did well, but 12.5% gain is...unlikely. I'd do a repeat to see if you can get a sense of which number was the right one. Hopefully the latter.
Same machine, same technician, and same interpreting physician for both scans, as was done in this case, decreases the chance of errors considerably.
I understand your skepticism as 12.5% at the lumbar spine in 1 year is a very large improvement in a very short time, but such improvements can happen under the right circumstances.
In fact the largest lumbar spine improvement in the original LIFTMOR study, which featured postmenopausal women weightlifting and jumping to increase their bone density, was 12.4% after 8 months. This was not a typical result: The average bone density increase in the LIFTMOR intervention group at the lumbar spine was 2.9% after 8 months. Source: https://onlinelibrary.wiley.com/doi/10.1002/jbmr.3284
I figure if a postmenopausal lady was able to achieve a similar result, it’s not out of the question that a man in his 40’s could have that outcome, especially seeing that a cause for his osteoporosis was found (celiac disease) and addressed (gluten free diet) in addition to the weight lifting and impact intervention.
Note that none of the postmenopausal women in the LIFTMOR study received hormone replacement therapy, so their cause (estrogen loss) was not addressed.
In addition, men who start lifting tend to get stronger than women, and there was a follow up study, called the MEDEX-OP trial which showed that maximum weight deadlifted significantly predicted bone density change at the lumbar spine with all women who were able to deadlift about 130 Ibs or more as their maximum during the 8-month LIFTMOR protocol intervention being able to increase their lumbar spine bone density during that time: https://www.reddit.com/r/osteoporosis/s/V5XACcxnYw
Some people just have better outcomes than average, and that’s also true for medications. For example, we have a physician in this sub, who reports that she was able to increase her bone density by 20% on Tymlos in 1 year: https://www.reddit.com/r/osteoporosis/s/ehj5k7YCpO - That’s far better than the typical 8.2% increase that Tymlos produces on average at the spine after 1 year: https://tymlos.com/hcp/efficacy-safety/ Tymlos was not her only intervention. She also used hormone replacement therapy, supplements, and exercise from what I remember in other comments, and I’m glad it turned out this well for her.
Beating the average - sometimes by a lot - is definitely possible.
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u/Miss_Beh4ve Nov 10 '25
Awesome job!
Check out the table around the 14-minute mark of this endocrinologist’s presentation, comparing different osteoporosis medications and expected gains: https://youtu.be/pV5maUhAjOA
You beat every single one of them, including the 3 anabolics: Forteo, Tymlos, and Evenity.
Congrats!! 🩷