Why Bone Is Lost
Oestrogen and testosterone restrain bone breakdown, which is why loss accelerates around menopause and with low testosterone. Add insufficient protein, low mineral status, vitamin D and K2 deficiency, sustained cortisol, thyroid excess, and a life spent without meaningful mechanical loading, and the balance tips.
Coeliac disease and other malabsorption conditions are a common missed contributor, because minerals cannot be used if they are never absorbed.
Beyond the DEXA Number
A DEXA scan measures density at a point in time; it does not tell you whether you are currently losing bone or why. Bone turnover markers show current activity, and repeating them is how you tell whether an approach is working before the next scan.
Hair tissue mineral analysis adds a view of mineral status and the calcium-to-magnesium relationship that a serum calcium cannot show, since serum calcium is defended at the expense of bone.
What Actually Builds Bone
Progressive resistance training and impact loading are the strongest stimulus available. Adequate protein, calcium from food where possible, magnesium, vitamin D with K2, and addressing absorption sit alongside it.
Medication decisions belong with your doctor, particularly after a fracture or with a high fracture-risk score. Root-cause work is about why remodelling tipped and what is modifiable.
