What are you doing for training, how much weight have you gained in the last 2 years, why did you have the bone specific alk phos lab obtained, and what medications do you take?
Member
bone density testing
At my most recent annual physical, it was discovered that I had abnormally high bone-specific alkaline phosphatase (mine=41ug/L, reference=6.5-20.1ug/L). Other metabolic parameters were normal. This prompted further testing with a bone scan and a bone density test.
The bone scan revealed, “Mild increased activity in bilateral AC joint, likely degenerative change. No significant focal increased activity in the ribs, spine, and pelvic bones. Mild increased activity in both ankles which may represent degenerative change.”
The subsequent bone density test revealed, “LUMBAR SPINE: L1-L4 Total measures 0.907 (g/cm2) with a T-score of -1.7 and a Z-score of -1.6. FEMUR: Left Femoral total measures 0.868 (g/cm2) with a T-score of -1.1 and a Z-score of -0.9. Femoral neck measures 0.863 (g/cm2) with a T-score of -0.5 and a Z-score of 0.0.
Although these results fall within the normal range, according to Bone Density Scans and Bone Health Screenings they indicate some degree of osteopenia, which isn’t something I neither want or think I deserve since I have been barbell training hard for several years. I was hoping my T-scores would be higher.
Since this is a nutrition forum, do you have dietary or training tips to strengthen my bones? For the moment, I think I ought to utilize the PRAL scale to reduce my acid load, mostly by eating even more fruits and vegetables instead of whole grains. Now when I read or hear words like “alkalize” and “detox” I become wary that I am wandering into the land of pseudoscience. But the following article that elaborates on PRAL includes references and goes into sufficient detail to be deemed credible in my opinion: Covering your nutritional bases
I am a 39-year old male. 5’10”, 170 pounds (up from 135, but evidently still afflicted with grade 1.5 gains-openia).
In addition, I have the following medical concerns:
1. Hyopgonadism? A few years ago I had secondary hypogonadism due to practically no production of luteinizing hormone by my pituitary. My endocrinologist successfully treated it with temporary use of clomiphene citrate. My recent testosterone tests have been puzzling; an abysmal 219 when tested about 3 hours after waking, but a few weeks later a typical 461 when tested about an hour after waking.
2. Hereditary high cholesterol (was 314), which I already brought down to 185 by cutting out egg yolks, red meat, dairy fat, refined oils, and unfiltered coffee. I eat lots of legumes now.
3. Structural deformities: hiatal hernia and mild thoracic scoliosis (upper cross syndrome). I don’t know if these are an issue, although the hiatal hernia gives me heartburn.
4. Dairy makes me feel bloated and yogurt gives me horrible heartburn.
5. Occasional unipolar depression; oddly, I sometimes feel irritable after a hard workout even if I achieve a PR… but moderate intensity cardio usually makes me feel a bit better.
✓ Member
What are you doing for training, how much weight have you gained in the last 2 years, why did you have the bone specific alk phos lab obtained, and what medications do you take?
Member
1. Here is what I've been doing for training in a typical week, a 4-day split with added cardio:
LOWER DAY 1
Deadlift warmup sets
Deadlift 5x1 @ RPE 7 (usually 275)
Deadlift 5x1 @ RPE 8 (usually 315)
Deadlift 5x1 @ RPE 10 (last time was 345)
Squat warmup sets
Squat 5x3 @ RPE 9.5 (last time was 265)
UPPER DAY 1
Bench warmup sets
Bench 5x3 @ RPE 9.5-10 (last time was 180)
Chins 5 sets @ RPE 10
Dips 5 sets @ RPE 10
LOWER DAY 2
Squat warmup sets
Squat 5x3 @ RPE 9.5-10 (last time was 285)
Back extensions 3 sets @ RPE 9.5-10
Hanging leg raise 3 sets @RPE 9.5-10
HIIT on recumbent bicycle for 20 minutes
UPPER DAY 2
Press warmup sets
Press 5x3 @ RPE 9.5-10 (last time was 115)
Chins 5 sets @ RPE 10
Dips 5 sets @ RPE 10
In addition, each week I do the following cardio:
1. Two 30-minute LISS sessions at heart rate around 150.
2. One 20-25 minute HIIT session on elliptical.
3. Walking like 13,000 steps a day to, around, and back from school.
2. I've gained about 10 pounds over the last 2 years. Well before I started strength training, my BW was 135 when I reached my full adult height.
3. The bone specific alk phos was ordered because my overall alkaline phosphatase was above the reference range when I had my annual physical, which includes comprehensive metabolic panel.
4. I take no medications currently. I do take some supplements, including a B-complex, creatine monohydrate, omega-3, and 5000 IU vitamin D (since my last vitamin D blood test was only at 35, which despite being "normal" is suboptimal. I was on a variety of antidepressants like Prozac, Luvox, and Wellbutrin between the age of like 16-28, then tried the same drugs again for about a year during 2015-2016. But I now avoid antidepressants because although they quenched my anxiety, they made me ambivalent and lazy with regard to academics and career (but not training). Also, as mentioned above, I temporarily took clomiphene citrate back in like 2014 to successfully treat secondary hypogonadism.
✓ Member
Hmm, kind of looks like a novice LP split up into 4 days, but then you're doing conditioning as well and underweight. I don't think this is related to your initial question, however.
I don't really have a good reason for you to not be above average for BMD besides being underweight and genetic predisposition.
Member
It's interesting. As an idiot observer my first thought was, "wow, the OP is really underweight."Originally Posted by Jordan Feigenbaum
My next thought was, "wow, they're also not quite as strong as I would hope for someone who has been training hard for a very long time."
I then thought "there sure is a lot of medical stuff presenting itself and it subtly seems like these are the justifications for being underweight and under-srrong."
But then I thought, "meh, I'm not a doctor, but still..."
Member
Another things I forgot to include, which goes waaaay back in time...
My low bone density may largely be due to being horrendously underweight as a child as a result of taking Ritalin until 9th grade (Bone Density Lower with Use of ADHD Stimulant Medicine | Endocrine Society), compounded by having relatively low testosterone as an adult.
I don't know if there is much I can do to fix this problem now, having already been barbell training hard for 7 years (well at least hard by compared to the ordinary folks at my local YMCA's who seem totally amazed that I can even do sets with 300 pounds on the bar). I might help myself a little bit by completely ditching non-weight-bearing exercises like elliptical, biking, and swimming, and do ALL my cardio via repeats of 200 meter sprints sprints and jumping rope. Ditching grains in favor of tubers and more fruit might also help. Anyway, I'm scheduled for another bone test in one year.
Posting Permissions