Listen above or download and subscribe to your favorite podcast network by clicking one of the icons below.
How outdated diagnostics may be misleading women—and what you need to know instead
As a yoga therapist and bone health educator, I’ve spoken with hundreds of women who are scared, confused, or discouraged after receiving their DEXA scan results. Many don’t even understand what a T-score is—yet it’s being used to determine life-altering treatment decisions like starting medication.
That’s why I brought back Dr. Andy Bush, an orthopedic surgeon who’s made the bold move from fracture fixation to fracture prevention. He now runs a dedicated bone clinic and has performed more REMS scans (a newer, radiation-free bone assessment) than any other practitioner in the U.S.
Together, we unpacked the limitations of the traditional DEXA scan—and explored better ways to understand your true fracture risk.
What Is a T-Score, and What Does It Really Mean?
A T-score is the number most women are handed after a DEXA scan. It compares your bone density to that of a healthy 20–29-year-old white woman—regardless of your age, size, ethnicity, or lifestyle.
Dr. Bush explained how flawed this model is. For example, if you’re a small, active 60-year-old woman, comparing you to a 29-year-old is not only unrealistic—it’s statistically biased. Many women are labeled as having osteoporosis based on a single number, when their actual fracture risk might be low.
T-scores only measure one thing: density. But bones aren’t just about density—they’re about structure, strength, and behavior under pressure.
Why Structure Matters More Than Density
Dr. Bush uses a helpful analogy: if you drop a piece of chalk and a pencil, which one breaks?
The chalk, despite being four times as dense, shatters. The pencil bounces.
DEXA scans would tell you the chalk is “healthier” based on its density—but the structure of the pencil is what makes it stronger. This is why DEXA often fails to predict who will actually fracture. In fact, 50% of all fractures occur in women who don’t have osteoporosis by T-score standards.
Enter REMS: A Better Way to Measure Bone Health
REMS (Radiofrequency Echographic Multi-Spectrometry) is a cutting-edge ultrasound technology that evaluates bone structure, not just density. It’s non-invasive, has zero radiation, and provides a fragility score—a more accurate reflection of whether your bones are likely to break.
Dr. Bush shared that many of his patients who were told they had osteoporosis based on a DEXA actually showed strong, fracture-resistant bones on a REMS scan. That means they didn’t need medication, and in fact, prescribing it would have been inappropriate.
Action Steps You Can Take Today:
✅ Ask your doctor about TBS or advanced structural scans like REMS
✅ Focus on building muscle, improving balance, and reducing falls
✅ Don’t panic if you see a “bad” T-score—get a second opinion
✅ Join one of my bone health masterclasses to understand your options
✅ Bring questions and data to your doctor—be an equal partner in your care
We are more than a number. Your strength, your history, your habits—they all matter when it comes to your bones. Let’s move beyond fear-based medicine and toward informed, empowered decision-making.
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.