Strong Legs, Weak Bones

First, let me get the good news out of the way. My recovery is going well, and the doctor cleared me for Mitchell. Fitness is snapping back, and I’m even relatively optimistic that I can do well. I will not be riding with a time in mind, but I think that based on my recent performances, I could do better than I hoped. Most likely I will be within the 8-10 hour range — slower than last year, but pretty strong given my recent injury battles.

We finally got the results from my bone scan. I suspected my bone density to be on the low side, but it still came in well below my expectations. According to the test, both of my femurs are in the osteopenic range. That means that if not improved, this condition could eventually develop into osteoporosis. As my doctor put it, this changes the dialog for the last several months. This was likely the underlying cause of the injuries, and also the likely culprit for some of the pain I endured during the recovery.

I have to give a shout to Hill Junkie and all my doctor friends who pushed me towards getting a bone scan. I had asked for one in the past, but it took some persistence to get the doctors to order the test.

The question is, what caused this? It is not normal for someone my age to lose bone density. I brushed off my laptop, and did some not-very-scientific internet diagnostics last night. Here are my conclusions:

1. No Weight Bearing Exercises. Cycling may be great exercise, but it is not great for bone strength. The doctor suggested running, walking or weightlifting. A friend suggested jumprope. I’ll be doing nothing at least for the next couple months while the hip continues to recover.

2. Diet Cola. My last remaining vice is that I drink way too many diet soft drinks. My daily routine is one in the morning, one at lunch, and sometimes one in the afternoon. If I’m feeling particularly sluggish, I’ll have one before I ride the bike. The average is probably 2-3 a day, which some recent studies have said can lead to hip deterioration. That’s a warning sign if I’ve ever heard one.

3. Thyroid Issues. A good friend of mine encouraged me to check some levels in my thyroid. I have had thyroid issues in the past, so this is a distinct possibility.

The next step is more diagnostics, and probably more supplements. I’ll be working again with my family doctor to determine my needs. There’s a chance I’ll need to see an endocrinologist.

The good news is that I caught this early. If this was a problem that went unnoticed, I would have a tough time when I turn 70.

In the meantime, I’ll continue riding my bike.


18 responses to “Strong Legs, Weak Bones

  • doug brownjr.

    You seriously need to take a look at the importance of supplementing magnesium, the correct form of course, for improving your bone density. Let me know if you need any info.

  • Doug Jansen

    Since I learned of my low bone density over two years ago, I’ve been supplementing with calcium and magnesium all year and D in the winter months (too far north to make vitamin D from the sun half the year). I’ve also been running twice a week. In two years, I’ve gained bone density only the hip of leg I broke, which was nearly in osteoporosis range (T-score of -2.1), but stayed flat in spine and other hip. While I hoped for more improvement, this is not all bad. At 50, I should be on a downward slope.

    • aaronwest

      Doug, our T-scores are pretty close so your experiences are encouraging. I think a reasonable goal is to maintain current levels while I age, and any reduction is a bonus. Running will help, and I’ll work in some other weight bearing exercises once I get recovered. I’ve already heard some interesting suggestions (jumprope, plyometrics, weightlifting).

  • Robert Armstrong

    Hi Aaron – I’ve written a few blog posts on this topic that may be of interest (see below). Beside the soda’s, which should never enter your home, or your body, you should take a close look at your overall diet and monitor your pH daily until you become slightly alkaline. The typical North American diet is an overwhelming contributor to this condition and many other chronic diseases. Good luck.

    http://www.nofinishlineblog.com/2010/07/do-you-know-your-bodys-ph-why-is-it-important.html

    http://www.nofinishlineblog.com/2010/06/osteoporosiswhats-the-best-way-to-reduce-the-risk-and-prevent-bone-loss.html

    • aaronwest

      Those are both excellent articles. Thanks for sharing them with me. What’s unusual is that ever since I’ve started cycling, my diet has become significantly less acidic. The exceptions are with protein, which are pretty much exclusively with meats. Going low acidic is almost like going vegan. It’ll be a challenge trying to put together a new diet that keeps my bones healthy, while also keeping me fueled for a high level of exercise. It’ll require a lot of tweaking over the coming months. I’m curious what sorts of food you use for protein.

  • Cherry

    Oh boy, what are some treatments for osteoporosis? That’s also another reason why I run sometimes, knowing cycling is low impact. Strength training is another area I constant slack on ….

    • aaronwest

      That’s wise of you to mix in running. I think there are some medicines for osteoporosis, but it is generally one of those things that once it starts, it is too late to stop. At least that’s my understanding, as this is all new to me. I’m sure I’ll be an expert in no time. 🙂

      • Robert Armstrong

        Hi Aaron – your comments above have a couple things you may want to look into. 1) The FDA ordered a warning for all drugs in the bisphosphonate family, which are specifically designed to treat Osteoporosis, because they are now known to cause hip fractures, 2) you can stop or even reverse the effects of pre-Osteoporosis by eating a healthy diet consisting of fruits, vegetables, lean protein that are slightly alkaline on the pH scale. Combine this with moderate load bearing exercise, like light weights and you should see some favorable results.

        You also asked for some protein recommendations. Let me start with diet guidelines. I recommend to everyone I coach and personally eat a diet that’s predominately fruits, vegetables, leafy green, some carbohydrates (rice, pasta) and lean meat (fish, chicken, some beef), and two smoothies a day with lots of field berries and Organic Whey Protein Concentrate. There’s a big difference between Whey Protein Concentrate and Whey Protein Isolate for someone with your condition. Read my blog on this topic: http://www.nofinishlineblog.com/2011/05/is-your-protein-powder-bad-for-your-health.html

        Specifically regarding how much protein you should consume daily; you should eat the equivalent number in grams to your weight in Kilograms. For example, I weight 151lbs (68kg). It is recommended that I eat 68gm of protein a day, but because I’m a very active athlete, I add 10% 20% to this number and consume 75gm to 82gm of protein from all sources per day. And just so you understand how little this is; 75gms of Protein is less than a 1/4lb hamburger. If I eat more than this amount my body has to process and eliminate the excess byproducts, most of which are highly acidic.

        One last comment. Eating healthy is the best fuel for athletes.

        Enjoy the Ride….Rob

      • aaronwest

        Thank you, thank you! This is such amazing information. It sounds like my training diet mostly conforms to this, although I may try to work in a morning smoothie in addition to the evening protein shake. I stay away from red meat already. Will keep an eye on the drugs they prescribe, if any. The sports med doc said he would rather see how my bones respond to diet changes and weight bearing before he tries medicine.

  • exmaschine

    I don’t know if you’re interested, but I play tennis as well as cycle. It’s enough impact on the joints and bones to be productive in preventing loss of density. Running is tough on the knees and back if you have any issues (as I do) But if not, then a bit of running is good for jolting those bones buddy! B-Ball might be a way to get in some work. Jumping rope like you mentioned, would be good too.

    • aaronwest

      Good suggestion. I’m a big fan of tennis and used to play, still have decent rackets and everything, but they’ve pretty much mothballed the nearby court. This might be something I look into once I get healed up. I played basketball in high school as a kid. The jump shot is probably long gone. Racket ball might also be an option. .

  • Brian Lube

    If you get your Thyroid checked, make sure they are checking not just TSH but free T3 and T4 levels, as well as T3 uptake if you can get them to do the testing. This may also sound strange, but have them check your Vit D levels as well. If you aren’t absorbing D properly your thyroid won’t work properly. Also remember that D is fat soluble, so if you go crazy low fat you may not be metabolizing D properly.

    I have thyroid issues, and it took me years to get a doctor that really understood Thyroid issues. Also be aware that the synthetic Thyroid prescriptions can cause bone density issues, where the animal based ones actually can increase bone density in some cases because of the extra hormones in the pill. Armour take more effort to manage than Synthroid, but since it’s not just T4 my body accepts it a lot better. Many Doctors will flat out refuse to work with you trying out Armour, because it used to be measured in grains, and it can be tricky to get stabilized if you aren’t patient with it.

    I’m looking forward to riding in Mitchell this year. Maybe if I’m lucky we’ll ride together for a bit.

    • aaronwest

      Hey Brian, since I don’t understand much of what you said, I’m assuming that my thyroid issues are a little different than yours. My next doc appt is in the morning and I have a feeling he’ll check all my levels, including vitamin D. What’s weird is I have a physical every year and haven’t noticed anything out of the ordinary in years.

      If you’re slow you’ll probably get a shot at riding with me. 🙂
      I’ll be wearing a Vork Cycling jersey riding a white Cervelo. Say hey if you see me.

      • Brian Lube

        I’ve been diagnosed with HypoThyroidism, which is where your body doesn’t produce enough thyroid hormone. The problem is that the thyroid has 2 different hormones (T3 and T4) and the control hormone is called TSH. Most dr’s diagnose based on TSH alone. For me it wasn’t a clear indication of the issues.

        The main symptom is typically weight gain and lack of energy in adults.

      • aaronwest

        Ahh, mine is a little different than that, and hasn’t been an issue for many years. Hope you are able to keep yours under control.

  • Jim Brennan

    Your writing comes alive when you are pumping the pistons. Good to see you back in action, Aaron

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