Osteoporosis at 17 years old?!?!

What's your height and weight and body fat?

What's your weight? wrote:

What's your height and weight and body fat?

I’m about 5’10 and around 120lbs. I have minor hyperthyroidism that makes it difficult for me to gain weight. I have grown 10 inches in the last 2.5 years.

Osteoporosis wrote:

What's your weight? wrote:

What's your height and weight and body fat?

I’m about 5’10 and around 120lbs. I have minor hyperthyroidism that makes it difficult for me to gain weight. I have grown 10 inches in the last 2.5 years.

If you can, get some whole raw milk. And limit the amount of anti nutrients you eat. Eat mostly meat, eggs and raw milk. Also, GOMAD is a guaranteed way to gain weight BTW.

Osteoporosis wrote:

After getting 4 stress fractures in the last 8 months, missing out on the entire cross country season, I got a bone scan and was diagnosed with osteoporosis with a bone density of -2.0. Osteoporosis seems to be very rare in teenagers, especially males, so I am wondering what I should do to continue training and try to maintain my fitness. I had trained 70mpw the summer going into this year which was the start of my stress fractures. My doctor said I can’t go above 30mpw and wanted me to stay under 20 mpw for the first few months. I was thinking cross train recovery days and run workouts with everyone else. Does anyone have any advice on how to deal with this as I am feeling kind of hopeless right now.

I assume that -2.0 is your T-score.

Low bone density among both young and old female distance runners is a well-known condition with a large literature. I've seen relatively little about low bone density among male distance runners, although I think that it is much more common than is generally believed. I recall an article in a running magazine about fifteen years ago that discussed low bone density among middle-aged male runners; at least one physician noted that cases he'd seen typically involved (as I recall) thin, high-mileage runners with low body fat and "restrictive" diets.

Although I've read a lot about the subject, and am a longtime patient of one of the country's leading experts on osteoporosis who has studied and treated many amateur and professional athletes (including rather young male and female runners) with low bone density, I don't consider myself an expert. Theories about what causes osteoporosis and how to treat it are still hotly debated. It is certainly not a matter of simply telling people to drink more milk, although that may be a perfectly reasonable thing to do.

Are you working with an endocrinologist who specializes in metabolic bone disorders, including osteoporosis and osteopenia in relatively young males? My impression is that not many endocrinologists, and far fewer internists and orthopedists, have the background to evaluate and treat cases like yours, so you may have to do some digging around for someone with the right expertise and experience. (You can probably find a number of sports medicine specialists who treat young female athletes with low bone density, and they can probably give you some worthwhile advice, but the hormonal issues for young female athletes are likely to be significantly different.)

Until you get more guidance and support for your proposed training program, I would be cautious about trying to maintain high training volume by substituting a lot of cross-training to make up for the lower running volume, because high training volume itself may -- and I want to emphasize the word "may" -- create more problems for your bone density, even if the lower impact of the cross-training allows your stress fractures to heal. One good thing about stress fractures is that they generally heal without many complications if you relieve the stress on the bone for what is usually a fairly predictable period of time. Low bone density creates a different set of challenges, and you need to make sure that you're taking the right steps to keep your bones healthy and strong in the very long term.

Osteoporosis wrote:

After getting 4 stress fractures in the last 8 months, missing out on the entire cross country season, I got a bone scan and was diagnosed with osteoporosis with a bone density of -2.0. Osteoporosis seems to be very rare in teenagers, especially males, so I am wondering what I should do to continue training and try to maintain my fitness. I had trained 70mpw the summer going into this year which was the start of my stress fractures. My doctor said I can’t go above 30mpw and wanted me to stay under 20 mpw for the first few months. I was thinking cross train recovery days and run workouts with everyone else. Does anyone have any advice on how to deal with this as I am feeling kind of hopeless right now.

I think your general plan of going with alternate-aerobic activity on recovery days is sound. I have known/known of people who improved their *running* fitness by focusing on pool running and the bike for several weeks, for instance, and the elliptical can also give you a good workout while mimicking the running motion more closely.

Beyond that, I suspect that you have to get stronger. Not necessarily heavier, but stronger, so that more of the load in running is carried by musculature and less by skeleton. Try to find previous posts on this subject by Alan aka runningart2004, but the essence is to go with multiple-joint exercises, using heavy weight (AFTER learning to do the exercises properly), low reps (typically 3-5), and limited sets. I think runners in general have fetishized core work in the last several years and spent far more time on it than necessary, but some work on core is surely called for--and definitely get some feedback from knowledgeable observers about your form, esp. if they think you're overstriding.

Good luck. Please bump this thread and let us know how you progress in coming weeks/months--it will be helpful to others!

If I make sure to reduce the impact of running, how does high volume training affect me negatively? Does it have something to do with energy levels? If I can't maintain the same volume with cross training, what is the best way to keep my fitness up so that I can continue to race well? Do all miles have the same impact on my injury (recovery runs vs workouts)?

Osteoporosis wrote:

After getting 4 stress fractures in the last 8 months, missing out on the entire cross country season, I got a bone scan and was diagnosed with osteoporosis with a bone density of -2.0. Osteoporosis seems to be very rare in teenagers, especially males, so I am wondering what I should do to continue training and try to maintain my fitness. I had trained 70mpw the summer going into this year which was the start of my stress fractures. My doctor said I can’t go above 30mpw and wanted me to stay under 20 mpw for the first few months. I was thinking cross train recovery days and run workouts with everyone else. Does anyone have any advice on how to deal with this as I am feeling kind of hopeless right now.

What else does your physician want to do for you? Quite frankly if you have hyperthyroidism treatment of that dysfunction may help to resolve your osteoporosis. If the answer is nothing, I might consider pursuing an endocrinologist as part of therapy.

All the best

What does your doctor say?

With osteoporosis the bones are more "brittle " so the more the weight bearing exercises (running higher volume), the greater chance of more stress fractures.

I have done some pool running in shallow water(3-5 feet) and got excellent (in my opinion) workouts. I have not tried the deep water type running. Read about pool running and see what you think. Don't get too discouraged yet. You got this!

I am a big advocate of deep-water running as cross-training or supplemental training for both injured and uninjured runners, and also believe that other aerobic activities can be very useful for maintaining and even improving running fitness. But I want to emphasize that these activities should be considered in the specific context of concerns about osteoporosis and bone health, and those concerns may counsel against trying to maintain a high volume of aerobic cross-training for an adolescent male runner with a history of low bone density and stress fractures, particularly in light of his recent growth spurt. What may be best for his running during the upcoming months may not be what's best for his health over the much longer term, because bone loss can be very difficult to reverse. I'd want to have the input of someone who has experience and expertise in this specific context.

I also agree that weight training can be valuable for runners, especially those who are generally susceptible to injury, but I again want to emphasize the specific context here. For a thin, lightweight runner with low bone density and a history of low-trauma fractures, weight training can be valuable precisely because it specifically stresses the bones and thereby stimulates structural changes that strengthen bones that are typically not stressed and stimulated as much in a lightweight person as they are in a heavier person. Again, however, I'd want the input of an expert here.

Finally, I also encourage the original poster to let us know how things are going.

Osteoporosis wrote:

If I make sure to reduce the impact of running, how does high volume training affect me negatively? Does it have something to do with energy levels? If I can't maintain the same volume with cross training, what is the best way to keep my fitness up so that I can continue to race well? Do all miles have the same impact on my injury (recovery runs vs workouts)?

It probably has something to do with the level of energy expenditure, but I don't think that the relationship is at all straightforward, if only because the brain is constantly involved in regulating everything. There have been bone-density studies of athletes in other sports involving high-volume aerobic training, and the lower loading forces on the bones during those activities combined with the high level of energy expenditure may actually exacerbate bone-density problems over the long term. For example, male cyclists who engage in high-volume training over many years have been found to develop low bone density at relatively high rates. But I don't necessarily want to discourage you from high-volume training; I really want to alert you to possible risks and concerns so that you can properly take them into account, particularly since concerns about low bone density tend to take a back seat until much later in life, when effective treatment of low bone density is especially difficult. I definitely understand your concerns about maintaining fitness for running and racing, and I encourage you to seek out more information about how to balance all of these concerns.

Osteoporosis wrote:After getting 4 stress fractures in the last 8 months, missing out on the entire cross country season, I got a bone scan and was diagnosed with osteoporosis with a bone density of -2.0. Osteoporosis seems to be very rare in teenagers, especially males, so I am wondering what I should do to continue training and try to maintain my fitness. I had trained 70mpw the summer going into this year which was the start of my stress fractures. My doctor said I can’t go above 30mpw and wanted me to stay under 20 mpw for the first few months. I was thinking cross train recovery days and run workouts with everyone else. Does anyone have any advice on how to deal with this as I am feeling kind of hopeless right now.

Check your vitamin D levels ASAP!!! Repetitive stress fractures, osteoporosis and hyperthyroidism suggests that you have severe vitamin D deficiency ongoing for long time. Vitamin D deficiency increases levels of parathyroid hormone that decreases bone mineral density in patients with hyperthyroidism.

Main role of vitamin D is regulating bone metabolism and calcium and phosphorus homeostasis. Parathyroid hormone secretion is directly linked to blood vitamin D levels. It also plays a significant role in modulation of the immune system, enhancing the innate immune response while exerting an inhibitory action on the adaptive immune system.

Drink more raw milk wrote:

If you can, get some whole raw milk. And limit the amount of anti nutrients you eat. Eat mostly meat, eggs and raw milk. Also, GOMAD is a guaranteed way to gain weight BTW.

This. Your hyperthyroidism is probably also linked to poor diet. You may not be easily able to obtain fresh raw milk , but you need fat-soluble D3 and A found only in quality animal products, including cold-water fish such as mackerel and sardines. Also, grass-fed beef liver is packed with these nutrients and pastured eggs are as well. Avoid spinach and other grains and greens that have oxalates and phytates that lock up critical calcium and other nutrients. Basically, you need to remediate with an elimination diet of plant compounds which are blocking nutrients and toxifying your body. This used to be more of a problem with girls is becoming more and more commonas boys are adopting a more animal-deficient "modern" diet.

"Foods with high levels of oxalic acid include spinach, collard greens, sweet potatoes, rhubarb, and beans. Among the foods high in phytic acid are fiber-containing whole-grain products and wheat bran, beans, seeds, nuts, and soy isolates "

Osteoporosis at 17 is serious stuff. You need to be looking for specialists who have extensive experience with this condition. Your average ortho will not be up to date on all the latest treatment options. Also, you should be working with a RD on diet and supplements. This is not the sort of thing you can just read a few things on the internet and go at it.

Pool running is your friend. Sean Wade broke a bunch of age records when he turned 50 by spending hours in the pool hammering away at his cardio. By that point in his career, his body was pretty well trashed and he could not train much more than 30-40 mpw without something coming undone. It is very time intensive and takes a lot of patience. But it really does work if you dedicate yourself to it.

You have low bone density. Not osteoporosis. There's a difference. At 17 you still have time to build bone density IF you make some changes.

Focus on eating more protein. Get plenty of vitamin D, calcium, magnesium and iron through diet if possible, through supplements if necessary. Switch to lactose free milk for several months. I would bet your digestion improves. Get at least 30 minutes of sun exposure every day.

Lift heavy free weights at least 3 times a week. Limit cardio to four 30 minute sessions a week for 3 months. For you, cycling and swimming are actually worse than running because they burn calories without prompting bone growth. Put on at least 5 pounds of lean muscle then start increasing cardio/ running.

The cardio system can respond incredibly quickly to training, IF you are healthy. Right now, to put it bluntly, you are NOT healthy. Bones take years. Build your bones first. Then worry about getting fit.

Good luck-

Chaffee County wrote:

You have low bone density. Not osteoporosis. There's a difference. At 17 you still have time to build bone density IF you make some changes.

. . .

The cardio system can respond incredibly quickly to training, IF you are healthy. Right now, to put it bluntly, you are NOT healthy. Bones take years. Build your bones first. Then worry about getting fit.

Yeah, I've been referring to low bone density rather than osteoporosis, because the specific diagnosis of osteoporosis sounds questionable to me. (Among other things, osteoporosis is typically diagnosed at T-scores of -2.5 or lower, and it's not clear to me that the low bone density in this case is a result of bone loss; T-scores are based on bone density distributions of 30-year-old adults, not 17-year-olds who, as a result of a recent growth spurt and other factors, suddenly find themselves at 5'10" and 120 pounds.) But regardless of the correct term, I agree with "Chaffee County" that, if the bone density is too low, it needs to be treated now as an important long-term health issue in its own right, without undue regard to relatively short-term concerns about running and racing fitness, which typically comes and goes relatively quickly.

What would you recommend I do if heavy cross training isn’t an option? I have a lot of recommendations to lift heavy weights but I’m worried I won’t be in shape if I can’t get intense cardio in.

Vitamin D supplements - which are very cheap. Meat/protein. And free weights. This is what my doctor told me and I have osteopenia due to years of prednisone cycles to treat ulcerative colitis.

This sucks. And I'm sorry you're dealing with this while you're trying to compete and get miles in. But get this treated and figured out now. See specialists and back of the cross training unless it actually is going to help you increase your bone density. This stuff is no joke if you let it linger. I shattered both of my wrists playing indoor soccer a few years ago because of my poor bone density. And in college I broke my wrist playing pickup basketball and it ended my rowing career.

Good luck!

Osteoporosis wrote:

What would you recommend I do if heavy cross training isn’t an option? I have a lot of recommendations to lift heavy weights but I’m worried I won’t be in shape if I can’t get intense cardio in.

From what you've said, here's the kind of thing that I would be concerned about:

As you can see from the article, when the syndrome occurs in females, it's often been called the female athlete triad, but it can occur in males as well. Until I found this article, I wasn't even aware that the syndrome is now more generally called relative energy deficiency in sport (RED-S). Regardless of whether you have all of the symptoms of this specific condition, the combination of low bone density (osteoporosis or osteopenia), high incidence of bone fractures, high training volume (notably among young cross-country runners), low body mass index (BMI) or low body fat levels, and inadequate nutrition can put you at serious long-term risk. Without meaning to be too alarmist about it, I think that you should be consulting with someone who has expertise dealing with this condition. That may be an endocrinologist or a sports medicine doctor who has seen a lot of cases like this. But I think that you need to get the input of a specialist before you get too far into your new athletic program, because some of your proposed training could be counterproductive -- to say the least.

Why can’t you run though? Running actually helps build stronger bones. I’d continue to run just don’t do the silly high mileage which leads to stress injuries anyways even in athletes with normal bone density. If you need to do workouts then do them. Focus more on quality vs quantity. Have easy days though that are more like 3-4 miles rather than 8-10. Or run everyother day or 3 days on 1 day off and lift that 4th day. Also add a off day once a week and just rest imagining ur bones getting stronger!

I think you should still run if you want to (obv as long as the original sfx is healed) . It will help you.