Friday Q&A: osteoporosis; Paxlovid; COVID misinformation; & breathing and heart rate

Our last Q&A of 2023! 🎉

ICYMI 👉

• Your Holiday Survival Guide, Part 1: Protecting Your Physical Health

• Your Holiday Survival Guide, Part 2: Protecting Your Mental Health

• The Gift of 4-7-8 Breathing

---

Question #1 (about osteoporosis) is free for all subscribers. Questions #2-4 (on Paxlovid; COVID misinformation; & breathing and heart rate) are for paid subscribers only. If you would like a paid subscription but it’s not in your budget, please message me directly!

Click here to submit your questions (about anything) for future Q&A posts!

Disclaimer: The views expressed here are entirely my own. They do not reflect those of my employer, nor are they a substitute for advice from your personal physician.

---

QUESTION #1: OSTEOPOROSIS

I keep hearing "take calcium & D" and do weight bearing exercise for bone health. I've been seriously running for 40 years and am very diet conscious and almost no alcohol. But my bone mineral density has just gotten worse with each scan. Doctors suggest I start Fosamax or similar drugs. Then I started doing "yoga for osteoporosis" 2 years ago and my Bone Density scores actually improved. Is yoga enough?

- Kathleen

Dear Kathleen,

You are correct. Yoga and other weight-bearing exercises are excellent ways to help prevent and treat osteoporosis. Longitudinal studies of aging consistently show that people who engage in activities to maintain their bone and muscle mass not only have a reduced risk of osteoporosis, they also have better mobility, cognition, and quality of life.

Muscle mass and tone naturally decline with age. Even 20 to 30 minutes of weight-bearing exercise twice a week is enough to make a significant difference in muscle strength. One common recommendation I make for patients who already enjoy walking is to wear a weighted vest on their trail. This simple intervention augments the cardiovascular benefits of walking and improves spine strength, too!

Consuming a calcium-rich diet and taking a vitamin D supplement (as needed) are also important for bone health. Fosamax, Boniva, and the other bisphosphonates are prescription medications for osteoporosis, however if you are doing well with lifestyle changes, you may not need meds. Of course, sometimes it’s the combination of medicines and habit changes that does the trick, so be sure to talk with your doctor about what’s best for you. 

I wrote a longer piece about maintaining skeletal health here. I hope it’s helpful!

Photo by Chris Hardy on Unsplash

---

If you like what you are reading, hit the ❤️ button on this post so more people can discover my writing on Substack! 🙏

---

QUESTION #2: PAXLOVID

My mom is 70 and just tested positive for COVID for what we think is the first time. She has received all possible vaccines/boosters. I suggested that she ask to take Paxlovid, per your and others' recommendations. Her doctor told her not to take it, due its risk of side effects (high blood pressure and possible kidney damage) and rebound effect. They say it has not been shown to affect either transmission of virus or long COVID. I'm very confused, since you say someone like her should take it (due to age). What gives?

-Kate

Dear Kate,