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In Part 2 of my conversation with Dr. Wendy Warner, we go even deeper into what’s really happening in women’s bone health—and why so many women are being unnecessarily frightened into medication decisions.
If you listened to Part 1, you already know that bone density alone doesn’t tell the whole story. In this episode, we explore how flawed measurements, lifestyle factors, and outdated messaging have created a system that often scares women instead of empowering them.
And the truth may surprise you.
When Bone Scans Don’t Tell the Full Story
One of the biggest issues we discussed is the reliability of DEXA scans.
I recently spoke with a woman whose lumbar spine scan showed extremely low bone density, yet her hip scores were completely normal. When I looked closer, the severe scoliosis in her spine made it almost impossible for the scan to produce accurate data.
Yet those numbers were being used to pressure her into medication.
DEXA scans are mathematical calculations that require balanced data from both sides of the spine to generate a reliable result. When structural abnormalities like scoliosis are present, those calculations can become distorted.
And unfortunately, many women don’t realize this.
Doctors often rely on these numbers alone when recommending medications—even when the scan itself may be inconclusive.
A Better Way to Assess Bone Strength
Dr. Warner and I also discussed REMS scans, a newer ultrasound-based technology that measures both bone mineral density and the collagen matrix that gives bone its structure.
Unlike DEXA scans, REMS evaluates the entire bone, including the protein collagen framework that holds minerals together.
That distinction matters because bone strength isn’t just about minerals—it’s about the integrity of the whole structure.
Another advantage? REMS scans don’t expose patients to radiation, since they use ultrasound technology.
While these machines are still becoming available in the U.S., they represent an exciting shift toward more accurate bone assessment.
The Lifestyle Factors That Truly Build Bone
One of the most important messages from this conversation is that bone health is not simply a medication issue—it’s a lifestyle issue.
In fact, Dr. Warner shared something profound: in her practice, only a very small percentage of women truly require medication—and even then, only temporarily while underlying causes of bone loss are addressed.
Those underlying factors often include:
- Chronic stress and elevated cortisol
- Blood sugar dysregulation
- Inflammation and autoimmune activity
- Poor gut health and nutrient absorption
- Sedentary lifestyle or lack of movement
When these issues are corrected, many women are able to rebuild bone naturally.
Movement Matters More Than You Think
Many women believe the only way to strengthen bones is through heavy weight lifting or high-impact exercise.
But that’s simply not true.
Practices like yoga, Tai Chi, and Qigong can improve bone health while also enhancing balance, flexibility, and body awareness.
These practices reduce fall risk and help regulate cortisol levels—both of which are critical for maintaining strong bones.
The goal isn’t punishment through extreme exercise.
The goal is consistent, intelligent movement that supports the whole body.
My Biggest Takeaway
The most important lesson from this conversation is that women deserve better information.
For decades we’ve been told that bone health is about calcium supplements, DEXA scores, and medications.
But the reality is much more complex—and much more hopeful.
Your bones are living tissue.
They respond to your nutrition, your stress levels, your movement patterns, and your overall metabolic health.
When we address those root causes, we often discover that the body is far more capable of rebuilding bone than we were ever led to believe.
And that is exactly why this conversation matters.
If you’re ready to take a root-cause approach to bone health, learn more about my Healthy Gut, Healthy Bones program here:
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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.