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A structural approach to fracture risk, hope, and empowered decision-making
After speaking with Dr. Andy Bush on this week’s episode of the Stronger Bones Lifestyle Podcast, I’m more convinced than ever that we’re in the middle of a major shift in how we understand and manage bone health.
We’re taught to trust the T-score. It’s the number we get from a DEXA scan—a measurement that supposedly defines whether we’re “normal,” “osteopenic,” or “osteoporotic.” But here’s the truth: your T-score doesn’t tell the full story. In fact, it may be giving you a false sense of risk—or security.
That’s why Dr. Bush and I dove deep into a game-changing technology called REMS (Radiofrequency Echographic Multi Spectrometry). And I can confidently say: if you’re serious about fracture prevention, this is a conversation you can’t afford to miss.
DEXA Scans Miss the Bigger Picture
The DEXA scan measures how much your bones block an X-ray beam. That’s it. It doesn’t tell you how strong your bones actually are. It doesn’t differentiate between functional bone and things like arthritis, bone spurs, or calcified tissue. All of that shows up as “density” — but not necessarily strength.
Dr. Bush explains it best with the chalk vs. pencil analogy: chalk is denser but breaks easily. A pencil is less dense—but it doesn’t snap under pressure. Your bones work the same way. Density is not strength.
What Is REMS, and Why Does It Matter?
REMS is a radiation-free ultrasound technology that measures the structural integrity of your bones by analyzing how sound waves bounce off your tissues. Think of it like your bone’s unique “echo signature.” REMS filters out non-structural elements (like metal from surgery, soft tissue, or calcifications) and focuses on true bone structure.
Even more impressive? It generates a Fragility Score, which compares your bone quality to large databases of people who have fractured—and those who haven’t. This score offers a clearer picture of fracture risk than a standard T-score ever could.
Why Orthopedic Surgeons Are Leading This Shift
Dr. Bush has seen thousands of fractures. As an orthopedic surgeon, his career was built on fixing broken hips, wrists, and spines. Now, he’s focused on preventing them. And unlike many of the professionals making decisions based on density alone, he’s actually handled bones—he’s felt the difference between strong and weak bone in the operating room.
He’s not alone. More orthopedic surgeons are now entering the world of preventative bone care—and it’s giving women new hope.
What You Can Do Today
If you’re feeling confused or frustrated by your bone scan results, you’re not alone. Many women are told they have “osteoporosis” and are placed on medication without understanding what that diagnosis truly means—or what other options exist.
Here are a few steps you can take right now:
✅ Join one of my free bone health masterclasses: Click here
✅ Ask your doctor about TBS (Trabecular Bone Score) if you’re doing a DEXA scan
✅ Focus on strength-building: Muscle is the best friend your bone has
✅ Remember: you are the decision-maker—your doctor is a guide, not the final word
Empowerment Starts With Education
We’ve been handed a narrow, outdated model of bone care — focused on pharmaceuticals and numbers that don’t always reflect reality. But that’s changing.
Dr. Bush reminded me — and reminded all of us—that when we understand bones as structural material, we can make more informed decisions. We can challenge fear-based medicine. We can avoid unnecessary treatments. And most importantly, we can take charge of our own health.
Take Charge of Your Bone Health — Join Our Live Webinar
Break Through the Bone Health Confusion: A Deep Dive with an Orthopedic Surgeon
Webinar: Bone Medications & Hormones — What You Need to Know
Thursday, July 17, 2025 | Live on Zoom
$97 (Replay included for all who register)
In this important session, you’ll learn:
- How the most common osteoporosis medications work in your body
- Risks, side effects, and long-term considerations of bone drugs
- Whether you truly need medication or have other options
- How to discuss your choices confidently with your doctor (includes printable scripts)
- What BHRT (bio-identical hormone replacement therapy) is and how it impacts bones, mood, and aging
- Who is a good candidate for BHRT, and who should proceed with caution
- Types of BHRT and how they’re administered
- Your personal questions answered live by Dr. Andy Bush, orthopedic surgeon
Spots are limited. Don’t miss this chance to get clarity and confidence about your bone health.
Podcast Subscribe Links - Reversing Osteoporosis
Frequently Asked Questions (FAQs)
Oxalates, also known as oxalic acid, are naturally occurring compounds found in many plants, vegetables, and fruits. They are part of a plant’s defense mechanism against predators and can be found in high concentrations in foods like spinach, rhubarb, beets, nuts, chocolate, tea, and certain beans.
Regarding bone health, oxalates can bind to minerals such as calcium in the gut, forming calcium oxalate. This compound is not easily absorbed by the body, meaning the calcium that could have been utilized for bone strengthening is instead excreted. This process can potentially lead to lower calcium availability for bone health, which can be particularly concerning for individuals at risk of osteoporosis or other bone-related issues.
However, for most women, dietary oxalates do not pose a significant threat to bone health, especially if their diet is balanced with enough calcium and they do not have a history of kidney stones.
Your gut is crucial for stronger bones for several reasons:
- Nutrient Absorption: The gut is where most nutrient absorption occurs. For bones to be healthy and strong, they need a variety of nutrients, particularly calcium, phosphorus, magnesium, and vitamin D. A healthy gut efficiently absorbs these essential nutrients from your diet and facilitates their transportation to the bones.
- Gut Microbiome and Bone Health: Research has shown that the gut microbiome (the community of bacteria living in your intestines) can influence bone density. Certain gut bacteria help in producing short-chain fatty acids (SCFAs) like butyrate, which have been shown to promote bone health. SCFAs can enhance the absorption of minerals necessary for bone strength and play a role in reducing inflammation, which can negatively affect bone health.
- Hormone Regulation: The gut helps regulate hormones that are involved in bone metabolism, including insulin, thyroid hormones, and sex hormones like estrogen. For example, estrogen is vital for bone density, and gut health can influence estrogen levels through the enterohepatic circulation, where estrogens are processed in the liver and intestines.
- Reducing Inflammation: Chronic inflammation, which can stem from poor gut health, is linked to many conditions that compromise bone strength, such as osteoporosis. A healthy gut helps to reduce systemic inflammation, protecting bones from inflammatory damage.
- Immune System Modulation: The majority of the immune system is located in the gut. An imbalance in the immune system can lead to autoimmune conditions, some of which affect the bones. Maintaining gut health helps to ensure the immune system works correctly, protecting against autoimmune reactions that could impact bone health.
In essence, maintaining a healthy gut contributes significantly to stronger bones by ensuring the effective absorption of vital nutrients, regulating hormones, reducing inflammation, and supporting a healthy immune system. Therefore, a diet rich in bone-healthy nutrients, prebiotics, and probiotics, along with lifestyle factors that promote gut health, is key to maintaining strong bones.